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dc.contributor.authorGreenhalgh, T
dc.contributor.authorShaw, SE
dc.contributor.authorAlvarez Nishio, A
dc.contributor.authorByng, Richard
dc.contributor.authorClarke, A
dc.contributor.authorDakin, F
dc.contributor.authorFaulkner, S
dc.contributor.authorHemmings, N
dc.contributor.authorHusain, L
dc.contributor.authorKalin, A
dc.contributor.authorLadds, E
dc.contributor.authorMoore, L
dc.contributor.authorRosen, R
dc.contributor.authorRybczynska-Bunt, Sarah
dc.contributor.authorWherton, J
dc.contributor.authorWieringa, S

<ns4:p><ns4:bold>Background:</ns4:bold> Accessing and receiving care remotely (by telephone, video or online) became the default option during the coronavirus disease 2019 (COVID-19) pandemic, but in-person care has unique benefits in some circumstances. We are studying UK general practices as they try to balance remote and in-person care, with recurrent waves of COVID-19 and various post-pandemic backlogs.</ns4:p><ns4:p> <ns4:bold>Methods: </ns4:bold>Mixed-methods (mostly qualitative) case study across 11 general practices. Researchers-in-residence have built relationships with practices and become familiar with their contexts and activities; they are following their progress for two years via staff and patient interviews, documents and ethnography, and supporting improvement efforts through co-design. In this paper, we report baseline data.</ns4:p><ns4:p> <ns4:bold>Results:</ns4:bold> Reflecting our maximum-variety sampling strategy, the 11 practices vary in size, setting, ethos, staffing, population demographics and digital maturity, but share common contextual features—notably system-level stressors such as high workload and staff shortages, and UK’s technical and regulatory infrastructure. We have identified both commonalities and differences between practices in terms of how they: 1] manage the ‘digital front door’ (access and triage) and balance demand and capacity; 2] strive for high standards of quality and safety; 3] ensure digital inclusion and mitigate wider inequalities; 4] support and train their staff (clinical and non-clinical), students and trainees; 5] select, install, pilot and use technologies and the digital infrastructure which support them; and 6] involve patients in their improvement efforts.</ns4:p><ns4:p> <ns4:bold>Conclusions:</ns4:bold> General practices’ responses to pandemic-induced disruptive innovation appear unique and situated.  We anticipate that by focusing on depth and detail, this longitudinal study will throw light on why a solution that works well in one practice does not work at all in another. As the study unfolds, we will explore how practices achieve timely diagnosis of urgent or serious illness and manage continuity of care, long-term conditions and complex needs.</ns4:p>

dc.publisherNational Institute for Health and Care Research (NIHR)
dc.subjectEmerging Infectious Diseases
dc.subjectClinical Research
dc.subject8.1 Organisation and delivery of services
dc.subjectGeneric health relevance
dc.titleRemote care in UK general practice: baseline data on 11 case studies
plymouth.publication-statusPublished online
plymouth.journalNIHR Open Research
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.rights.embargoperiodNot known
rioxxterms.funderEconomic and Social Research Council
rioxxterms.identifier.projectRemote-by-Default Care in the COVID-19 pandemic: addressing the micro-,meso-,and macro-level challenges of a radical new service model
rioxxterms.typeJournal Article/Review
plymouth.funderRemote-by-Default Care in the COVID-19 pandemic: addressing the micro-,meso-,and macro-level challenges of a radical new service model::Economic and Social Research Council

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