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Alternatives to the face-to-face consultation in general practice : focused ethnographic case study
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Atherton, Helen, Brant, Heather, Ziebland, Sue, Bikker, Annemieke, Campbell, John, Gibson, Andy, McKinstry, Brian, Porqueddu, Tania and Salisbury, Chris (2018) Alternatives to the face-to-face consultation in general practice : focused ethnographic case study. British Journal of General Practice, 68 (669). e293-e300. bjgp18X694853. doi:10.3399/bjgp18X694853 ISSN 0960-1643.
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Official URL: https://doi.org/10.3399/bjgp18X694853
Abstract
Background NHS policy encourages general practices to introduce alternatives to the face-to-face consultation, such as telephone, email, e-consultation systems, or internet video. Most have been slow to adopt these, citing concerns about workload. This project builds on previous research by focusing on the experiences of patients and practitioners who have used one or more of these alternatives.
Aim To understand how, under what conditions, for which patients, and in what ways, alternatives to face-to-face consultations present benefits and challenges to patients and practitioners in general practice.
Design and setting Focused ethnographic case studies took place in eight UK general practices between June 2015 and March 2016.
Method Non-participant observation, informal conversations with staff, and semi-structured interviews with staff and patients were conducted. Practice documents and protocols were reviewed. Data were analysed through charting and the ‘one sheet of paper’ mind-map method to identify the line of argument in each thematic report.
Results Case study practices had different rationales for offering alternatives to the face-to-face consultation. Beliefs varied about which patients and health issues were suitable. Co-workers were often unaware of each other’s practice; for example, practice policies for use of e-consultations systems with patients were not known about or followed. Patients reported benefits including convenience and access. Staff and some patients regarded the face-to-face consultation as the ideal.
Conclusion Experience of implementing alternatives to the face-to-face consultation suggests that changes in patient access and staff workload may be both modest and gradual. Practices planning to implement them should consider carefully their reasons for doing so and involve the whole practice team.
| Item Type: | Journal Article | ||||||||
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| Subjects: | R Medicine > R Medicine (General) | ||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Social Science & Systems in Health (SSSH) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Communication in medicine, Medical appointments and schedules, Primary care (Medicine) -- Great Britain, Physicians (General practice) -- Great Britain | ||||||||
| Journal or Publication Title: | British Journal of General Practice | ||||||||
| Publisher: | Royal College of General Practitioners | ||||||||
| ISSN: | 0960-1643 | ||||||||
| Official Date: | April 2018 | ||||||||
| Dates: |
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| Volume: | 68 | ||||||||
| Number: | 669 | ||||||||
| Page Range: | e293-e300 | ||||||||
| Article Number: | bjgp18X694853 | ||||||||
| DOI: | 10.3399/bjgp18X694853 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||||
| Date of first compliant deposit: | 1 August 2017 | ||||||||
| Date of first compliant Open Access: | 30 April 2018 | ||||||||
| RIOXX Funder/Project Grant: |
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| Adapted As: | Atherton H, Brant H, Ziebland S, Bikker A, Campbell J, Gibson A, et al. The potential of alternatives to face-to-face consultation in general practice, and the impact on different patient groups: a mixed-methods case study. Health Serv Deliv Res 2018;6(20) https://doi.org/10.3310/hsdr06200 April 2018. Accepted 8 June 2017. Available 28 March 2018 | ||||||||
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