Does my practice need to sign up to take part?

No, you do not need to sign up. You can share the Germ Defence weblink with your patients as soon as you can in whatever way suits you best.

I am worried that this will make more work for my practice

When Germ Defence was trialled in 2009 during the swine ‘flu pandemic (by 20,000 patients) it reduced the number of patient consultations in the group that was randomised to receive it. Our recent pilot work has not suggested any increase in practice contact from patients after sending the recommended text message out to them. We have made this study as easy as possible for practices, with no sign-up required. You do not need to send any data to the research team or follow up any patients. All you need to do is send out the Germ Defence weblink to all your patients aged 16 and over.

Is Germ Defence safe for patients?

There is no evidence that Germ Defence causes any harm for patients. It has previously been trialled in 20,000 people and was specifically developed with the help of patients. We have conducted many interviews with patients to make sure it is as acceptable and effective as possible.

Is sending the Germ Defence weblink to my patients in line with General Data Protection Regulation (GDPR)?

We have sought advice on this from the NIHR Clinical Research Network and NHS-X and both have assured us that sending out details of this non-commercial website is in line with GDPR.

Can I edit the text message?

We ask that you do not remove anything from the text message, nor edit it too much. We strongly recommend sending a practice text to a colleague to check that the text is appropriately formatted before sending it out to your patients.

Sending texts to patients will cost our practice financially - is there any reimbursement?

We are unable to reimburse practices for any financial costs. We hope that by reducing COVID-19 frequency/severity and consultation frequency, sending out a text message will benefit practices and the healthcare system in the long-term. One option to avoid any financial burden would be to send out the unique weblink to Germ Defence to your patients by e-mail. We have provided a sample e-mail that you can use.

I am worried about texting patients as they are already receiving a lot of texts from practices

It is up to you if you choose to send this text out. We have piloted the Germ Defence intervention with many patients who have said they found it acceptable and useful.

I do not want to send a text message to patients

If you do not want to send a text message, you can e-mail patients or share the weblink via social media or on your practice website. However, our piloting work has suggested that texting is the best way to get this information to patients.

Some of my patients do not speak or read English

Germ Defence is available in more than 20 languages and these translations can be accessed from the main page of the Germ Defence website. If you would like to send our text message to your patients in a language other than English, we have suggested some translations.

Some of my patients don’t have access to the Internet

We understand that an advice website like Germ Defence will not be the best way to reach all patients, but we are unable to provide an alternative in this study. We have summarised the key information using an infographic, although this will still need someone (e.g. family or friend) to access the website on behalf of those patients initially.

Can I share the link with other practices?

We ask that you do not do this as we have randomly selected practices to take part in the study and will be comparing healthcare outcomes in different areas using nationally available NHS data.

Why did you need to randomise practices?

Although Germ Defence was effective in a trial of 20,000 people during the 2009 swine ‘flu pandemic, it has been adapted for use with COVID-19 and has not yet been proven to work. The randomised controlled trial will help to show whether it is effective and whether it can be used in the future.

I am part of a Primary Care Network (PCN). Can I send the text out to all the practices in the network?

We ask that you do not do this as every practice has been sent their own weblink.

I do not work in a ‘research active’ practice. Do I have to take part?

We are asking all practices in England to take part. Germ Defence has been developed for all patients and we hope that as many people as possible will use it in to limit the spread of COVID-19, reduce infection severity/duration and reduce unnecessary or inappropriate healthcare utilisation.

I work in a ‘research active’ practice. What is the incentive for taking part?

Sharing the weblink will potentially help limit the spread of COVID-19 and reduce consultation frequency.

Will practices be eligible for service support costs?

No, service support costs are not provided for this study.

Who has approved the study?

The study has been approved by Yorkshire & The Humber (Leeds West) Research Ethics Committee on behalf of the Health Research Authority (reference 20/YH/0261). Chris Whitty, the Chief Medical Officer (CMO) for England, has made this a national priority project and it also has the support of the Royal College of General Practitioners (RCGP). We have registered the trial with the ISRCTN registry under the ID number 14602359.

Further questions or concerns about Germ Defence?

Please contact the Germ Defence team by e-mailing germdefence-study@bristol.ac.uk.