Digital access to care

Demand and capacity pressures in Primary Care

Primary Care is facing enormous demand and capacity pressures.

Technology has been heralded as part of the solution but its implementation has been far from plane sailing, and the loss of a traditional face-to-face GP service threatens the core values of primary care. Remote by Default 2: the new normal (RBD2) builds on the previous study Remote-by-default 1 which took place during the Covid-19 pandemic. RBD1 and RBD2 are led by Professor Trisha Greenhalgh and Sara Shaw from the University of Oxford who collaborate with the University of Plymouth, the Nuffield Trust and Thrive by Design.

RBD2 explores both the benefits and drawbacks of remote care and explores the potential models such as blended (remote and face-to-face) approaches. The project follows 11 general practices for two years, exploring how they introduce, refine, and in some cases work around remote care solutions.

Dr Sarah Rybczynska-Bunt and Professor Richard Byng lead on digital inequalities in primary care and work closely with the ‘Deep End’ group of practices working with complex populations. Investigation of the scale-up of ‘remote-by-default’ working, where patients could no longer automatically access face-to-face appointments helped identify positive and negative impacts on individuals living in poverty or with complex needs.

A Care Navigation study is also underway and looks at the support offered to people with social care needs to access remote primary care. We focus on three groups potentially marginalised by the expansion of remote, technology and internet-enabled, primary care:

1. Homeless/insecurely housed people
2. Older adults in receipt of domiciliary care
3. People residing in care homes.

Our activities throughout the project include:

Two years of action research with 11 GP practices to help deliver their priority goals
Four digital inclusion workshops to help co-design ways to combine remote and face-to-face models.
Four cross-sector stakeholder events with follow-on support for policy action one how to deliver and support a more equitable, less risky remote-by-default service
Strengthened infrastructure for supporting digital innovation in the NHS.