Even before the COVID-19 pandemic the drive for the NHS to make more use of digital technology had already started to take centre stage. The NHS long-term plan committed GP practices to offer online consultations from April 2020 and video consultations from April 2021. Digital health tools were promoted as having great potential to improve patient access to healthcare, as well as its quality and efficiency.

The COVID-19 pandemic accelerated the uptake of remote consultation options (phone, video or online e-consultations). While the rapid implementation of remote consulting to transform NHS services overnight to address the Covid-19 pandemic is a great achievement, it is important to be aware of the benefits and possible downsides. Despite the increased use of remote consultations, many questions remain about the long-term impact of remote consultations on service delivery, working practices, workload and staff wellbeing.

Understanding of the impacts of remote consultations on staff is vital to minimise negative effects and harness the positives, to improve them in the future.

This project is a collaboration with the National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) and West of England Academic Health Science Network (WEAHSN).

Project aims

We want to research how the NHS has implemented alternatives to face-to-face consultations and their effects on health care staff. We will interview clinicians who work in GP practices and hospitals to examine their experiences and views in relation to:

• working practices such as flexible working, remote working, efficiency and workload
• healthcare service delivery, such as impact on patient care
• impacts on staff well-being, including concerns about the risk of harm to patients, morale, staff recruitment and retention
• lessons learnt to improve future implementation of remote consultations, for example infrastructure and training.

Anticipated impacts

We will share our findings with patients, clinicians, policymakers and technology developers to:

• raise awareness of the consequences of remote consultations
• inform guidance for future digital health interventions.

How we will involve people

We will work closely with public contributors from the NIHR ARC West Health Systems Panel as well as having a public contributor on our project team.

We will set up a patient and public involvement group to help shape and identify research questions and comment on findings. Towards the end of the study their support will focus on interpreting results and how to share them more widely.

Research team

Professor Jeremy Horwood, Centre for Academic Primary Care, University of Bristol and NIHR ARC West

Dr Christalla Pithara-McKeown, NIHR ARC West

Professor Chris Salisbury, Centre for Academic Primary Care

Professor John Macleod, Centre for Academic Primary Care

Lead collaborator

Natasha Swinscoe, West of England Academic Health Science Network