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dc.contributor.authorRosen, R
dc.contributor.authorWieringa, S
dc.contributor.authorGreenhalgh, T
dc.contributor.authorLeone, C
dc.contributor.authorRybczynska-Bunt, S
dc.contributor.authorHughes, G
dc.contributor.authorMoore, L
dc.contributor.authorShaw, S
dc.contributor.authorWherton, J
dc.contributor.authorByng, R
dc.date.accessioned2022-06-28T08:57:58Z
dc.date.issued2022-04-29
dc.identifier.issn2398-3795
dc.identifier.issn2398-3795
dc.identifier.otherARTN BJGPO20210204
dc.identifier.urihttp://hdl.handle.net/10026.1/19346
dc.description.abstract

<jats:sec><jats:title>Background</jats:title><jats:p>The Covid-19 pandemic-related rise in remote consulting raises questions about the nature and type of risks in remote general practice</jats:p></jats:sec><jats:sec><jats:title>Aim</jats:title><jats:p>To develop an empirically-based and theory-informed taxonomy of risks associated with remote consultations.</jats:p></jats:sec><jats:sec><jats:title>Design and setting</jats:title><jats:p>Qualitative sub-study of data selected from the wider datasets of three large, multi-site, mixed-method studies of remote care in general practice prior to and during the Covid-19 pandemic in the UK</jats:p></jats:sec><jats:sec><jats:title>Method</jats:title><jats:p>Semi-structured interviews and focus groups with a total of 176 clinicians, and 45 patients. We analysed data thematically, taking account of an existing framework of domains of clinical risk.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The Covid-19 pandemic brought changes to estates (eg, how waiting rooms were used), access pathways, technologies, and interpersonal interactions. Six domains of risk were evident in relation to[1] practice organisation and set-up (including digital inequalities of access, technology failure and reduced service efficiency); [2] communication and the therapeutic relationship (including a shift to more transactional consultations); [3] quality of clinical care (including missed diagnoses, safeguarding challenges, over-investigation and over-treatment); [4] increased burden on the patient (eg, to self-examine and navigate between services); [5] reduced opportunities for screening and managing the social determinants of health; and [6] workforce (including increased clinician stress and fewer opportunities for learning).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Notwithstanding potential benefits, if remote consultations are to work safely, risks must be actively mitigated by measures that include digital inclusion strategies, enhanced safety-netting and training and support for staff.</jats:p></jats:sec>

dc.format.extentBJGPO.2021.0204-BJGPO.2021.0204
dc.format.mediumElectronic-Print
dc.languageen
dc.language.isoeng
dc.publisherRoyal College of General Practitioners
dc.subjectremote consultations
dc.subjectclinical risk
dc.subjectgeneral practice
dc.subjectfamily practice
dc.subjecttelemedicine
dc.subjectsafeguarding
dc.titleClinical risk in remote consultations in general practice: findings from in-Covid-19 pandemic qualitative research
dc.typejournal-article
dc.typeArticle
plymouth.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/35487581
plymouth.issue3
plymouth.volume6
plymouth.publisher-urlhttp://dx.doi.org/10.3399/bjgpo.2021.0204
plymouth.publication-statusPublished
plymouth.journalBJGP Open
dc.identifier.doi10.3399/bjgpo.2021.0204
plymouth.organisational-group/Plymouth
plymouth.organisational-group/Plymouth/Faculty of Health
plymouth.organisational-group/Plymouth/Faculty of Health/Peninsula Medical School
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA/UoA03 Allied Health Professions, Dentistry, Nursing and Pharmacy
plymouth.organisational-group/Plymouth/Research Groups
plymouth.organisational-group/Plymouth/Research Groups/FoH - Community and Primary Care
plymouth.organisational-group/Plymouth/Research Groups/Institute of Health and Community
plymouth.organisational-group/Plymouth/Research Groups/Institute of Translational and Stratified Medicine (ITSMED)
plymouth.organisational-group/Plymouth/Research Groups/Institute of Translational and Stratified Medicine (ITSMED)/CCT&PS
plymouth.organisational-group/Plymouth/Research Groups/Plymouth Institute of Health and Care Research (PIHR)
plymouth.organisational-group/Plymouth/Users by role
plymouth.organisational-group/Plymouth/Users by role/Academics
dc.publisher.placeEngland
dcterms.dateAccepted2022-01-18
dc.rights.embargodate2022-6-29
dc.identifier.eissn2398-3795
dc.rights.embargoperiodNot known
rioxxterms.versionofrecord10.3399/bjgpo.2021.0204
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2022-04-29
rioxxterms.typeJournal Article/Review


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