Additional information

Acknowledgements

Steering Group Committee: Amrit Takhar, David Parkes, and Jeremy Horwood.

Patient Advisory Group (PAG): Laiya Bailey, Julie Harvey, Diana Lewis-Frost, Ben Marshall, Penny Thompson, Malcolm Turner, Lynn Tatnell, Andrea Shelly.

Sponsors: Vivienne Shaw (Lead), Pam Baxter (Co-Sponsor).

Sponsor team: Alexander Philips, Sarah Hider.

Administrator: Ellie Kingsland.

Survey support: Jodie Button, Mayam Gomez-Cano, Sine MacDonald, Isabelle Mayne, Charlotte Reburn, Claire Wright.

Project development: Richard Moore.

Clinical Research Networks (CRNs): East of England, North Thames, South West Peninsula, West Midlands, North West Coast.

All patients, general practices and general practice staff who supported and participated in the study.

Contributions of authors

Gary Abel (https://orcid.org/0000-0003-2231-5161) (Associate Professor of Primary Care, Study Coordinator) co-applicant, responsible for overall study design and co-ordination of work packages, led on work package 2, final report writing and review.

Helen Atherton (https://orcid.org/0000-0002-7072-1925) (Associate Professor of Primary Care Research) co-applicant, responsible for overall study design, and design of work package 3, led work package 3, conducted qualitative data analysis and synthesis, final report writing and review.

Jon Sussex (https://orcid.org/0000-0001-8970-4546) (Chief Economist) co-applicant, conceived the original research idea, contributed to overall study design, led work packages 1 and 4, conducted synthesis, final report writing and review.

Nurunnahar Akter (https://orcid.org/0000-0002-8802-9080) (Statistician, Data Analyst) conducted data analysis, modelling and synthesis for work package 2, final report writing and review.

Abodunrin Q Aminu (https://orcid.org/0000-0002-2349-407X) (Statistician, Data Analyst) conducted data analysis, modelling and synthesis for work package 2, final report writing and review.

Wiktoria Bak (https://orcid.org/0000-0002-5125-521X) (Medical Research Intern) analysis of the work package 2A practice survey, qualitative analysis of free-text responses and final report review.

Carol Bryce (https://orcid.org/0000-0003-1484-9032) (Assistant Professor) acquisition, analysis and interpretation of data for work package 3 and focused ethnography case studies, development of patient survey for work package 2B. Contributed to final report writing and review.

Christopher E Clark (https://orcid.org/0000-0002-7526-3038) (Clinical Senior Lecturer) co-applicant, supported conduct, analysis and writing up of literature review. Supported development and dissemination of surveys. Contributed throughout to all work packages and to final report writing and review.

Emma Cockcroft (https://orcid.org/0000-0003-3798-9492) (Research Fellow, PPIE) co-applicant, co-ordinated and led PPIE throughout all work packages, final report writing and review.

Hamish Evans (https://orcid.org/0000-0001-5941-4708) (Analyst) conducted work package 2A – practice survey and final report review.

Evangelos Gkousis (https://orcid.org/0000-0002-8560-8650) (Analyst) conducted work package 1, analysed and synthesised data, contributed to writing work package 1 chapter of final report.

Georgia Jenkins (https://orcid.org/0000-0003-2018-9974) (Research Assistant, PPIE) co-ordinated and led PPIE throughout the work packages, final report writing and review.

Caroline Jenkinson (https://orcid.org/0000-0002-9978-185X) (Research Fellow, Mental Health Patient Survey) conducted the mental health patient survey in work package 2B, final report writing and review.

Nada Khan (https://orcid.org/0000-0002-4014-5525) (NIHR Academic Clinical Fellow) qualitative data analysis work package 2, final report writing and review.

Jeffrey Lambert (https://orcid.org/0000-0003-4774-9054) (Lecturer) co-applicant, supported development and dissemination, analysis and interpretation of surveys and contributed to final report writing and review.

Brandi Leach (https://orcid.org/0000-0003-3262-1541) (Senior Analyst) conducted work package 1, analysed and synthesised data; conducted work package 2A – practice survey; conducted work package 4, synthesised data; final report writing and review.

Christine Marriott (https://orcid.org/0000-0002-8450-6222) (Patient Representative, PPIE contributions) co-applicant, contributed to all work packages and final report review.

Jennifer Newbould (https://orcid.org/0000-0002-2602-6984) (Research Leader) co-applicant, led the ethnographic element of work package 3. Conducted data analysis and synthesis, final report writing and review.

Sarah Parkinson (https://orcid.org/0000-0002-2858-1842) (Senior Analyst) conducted work package 1, analysed and synthesised data, contributed to writing work package 1 chapter of final report and review.

Jo Parsons (https://orcid.org/0000-0002-6542-8492) (Research Fellow) conducted and analysed mental health patient interviews, work package 3, final report writing and review.

Emma Pitchforth (https://orcid.org/0000-0001-9055-9331) (Senior Lecturer and Senior Research Fellow) co-applicant, contributed to overall study design, led on stakeholder interviews, conducted qualitative data collection and analysis for work package 3, final report writing and review.

Laura Sheard (https://orcid.org/0000-0002-9241-8361) (Associate Professor of Health Sciences) co-applicant, advised on work package 3 and conducted qualitative analysis, final report review.

Stephanie Stockwell (https://orcid.org/0000-0001-7828-3758) (Analyst) conducted qualitative data collection, analysis and synthesis for work package 3, final report writing and review.

Chloe Thomas (https://orcid.org/0000-0002-8881-3393) (Research Assistant and Administrator) provided administration support throughout the work packages, organised and minuted all meetings, assisted with survey data processing, final report review.

Bethan Treadgold (https://orcid.org/0000-0002-0255-7422) (Research Fellow) conducted qualitative data collection, analysis and synthesis for work package 3, final report writing and review.

Rachel Winder (https://orcid.org/0000-0002-9926-1280) (Research Fellow, Project Manager) responsible for the overall project management, conducted work package 2 including design and conduct of the surveys, conducted qualitative data collection (stakeholder interviews) and analysis for work package 3, involved in work package 4 synthesis, final report writing and review.

John L Campbell (https://orcid.org/0000-0002-6752-3493) (Professor of General Practice and Primary Care, Chief Investigator) co-applicant, responsible for overall study design and co-ordination of work packages. Contributed throughout to all work packages final report writing and review.

Disclosure of interests

Full disclosure of interests: Completed ICMJE forms for all authors, including all related interests, or available in the tool kit on the NIHR journals Library report publication page at https://doi.org/10.3310/JKYT5803.

Primary conflicts of interest: All authors were funded by NIHR for their role in the project. Gary Abel serves on a Technical Expert Panel for the Agency for Healthcare Research and Quality (AHRQ), USA Safety Program for Telemedicine. An honoraria has been offered for taking part, which as yet has not been claimed. He has received funding as co-applicant for evaluating video and hybrid group consultations in general practice: mixed-methods, participatory study National Institute for Health and Care Research (NIHR) Health Services and Delivery Research (HS&DR) programme (NIHR133895). Helen Atherton declares relevant financial activities outside the submitted work: University of Warwick/eConsult Ltd: Warwick Industrial Fellowship funding a PhD Student, half the funding comes from eConsult Ltd. Paid to institution for purpose of funding studentship; NIHR 200778: Staff time and research costs paid to institution; NIHR PB-PG-1217-20033: Staff time and research costs paid to institution; NIHR 133620: Staff time and research costs paid to institution; University of Warwick/Advanced Ltd: Warwick Industrial Fellowship funding a PhD Student, half the funding comes from Advanced Ltd. Paid to institution for purpose of funding studentship; Medicspot Ltd: Analysed data provided by Medicspot Ltd. £1000 to institution to cover transcript costs for interviews conducted as part of study. She also received payment or honoraria for a lecture on e-mail consultation given to academic group at Aarhus University in 2020 – 500 Euro honorarium paid to her institution. She received support for attending meetings and/or travel: Royal College of General Practitioners Conference invited speaker October 2021: Registration fees paid for, one night of accommodation paid for, travel reimbursed directly to me. Royal College of General Practitioners Scientific Foundation Board meeting attendance December 2022 – Travel expenses reimbursed to her. She is an Advisory Board Member for NIHR128285 (no payments at all and the topic is relevant to the manuscript) and Digital-First Primary Care evaluation steering group NHS England and Improvement (no payments at all, content is relevant to the project). John L Campbell has received funding as co-applicant for evaluating video and hybrid group consultations in general practice: mixed-methods, participatory study National Institute for Health and Care Research (NIHR) Health Services and Delivery Research (HS&DR) programme (NIHR133895). He is also a member of the HTA National Stakeholder Advisory Group. Christopher E Clark is a board member of the HTA Prioritisation Committee: Primary and Community Based Care (A). He has received honoraria from ReCor Medical and Bayer UK for hypertension work unrelated to the topics discussed in this report. He is also Chair of the RCGP Rural Forum Steering Group. Christine Marriott has received payments for attending Di-Facto meetings and reviewing documents. Jennifer Newbould has received funding as co-applicant on another NIHR grant: 16/138/31 – NIHR HS&DR Rapid Service Evaluation Research Team – BRACE Centre. Payment was made to their employing institution: RAND Europe Community Interest Company. Jon Sussex has received funding as co-applicant on another NIHR grant: 16/138/31 – NIHR HS&DR Rapid Service Evaluation Research Team – BRACE Centre. Payment was made to his employing institution: RAND Europe Community Interest Company. Rachel Winder is a co-applicant on another NIHR grant – NIHR201070. Funding was provided to her employing institution. She also works in a GP practice which has participated in the Di-Facto surveys.

Patient data statement

This work used data provided by patients and collected by the NHS as part of their care and support. Using patient data is vital to improve health and care for everyone. There is huge potential to make better use of information from people’s patient records, to understand more about disease, develop new treatments, monitor safety, and plan NHS services. Patient data should be kept safe and secure, to protect everyone’s privacy, and it is important that there are safeguards to make sure that they are stored and used responsibly. Everyone should be able to find out about how patient data are used. #datasaveslives You can find out more about the background to this citation here: https://understandingpatientdata.org.uk/data-citation

Data-sharing statement

General Practice Patient Survey data were obtained under a data sharing agreement with NHS England. Study data may be made available to appropriate individuals on a case-by-case basis following an application to the Chief Investigator.

Ethics statement

Ethical approval was obtained for the patient survey and ethnographic case studies from the North East – Newcastle and North Tyneside 2 Research Ethics Committee on 27 April 2021, Health Research Authority approval was obtained in July 2021 (Integrated Research Application System number: 289425, protocol number: L01886).

During the course of the study, two minor and one major amendment were approved by the ethics committee, which included the inclusion of the mental health element of the study (approved 10 April 2022). All researchers conducting the fieldwork within practices obtained a research passport. Current protocol number: V1.3

Information governance statement

University of Exeter is committed to handling all personal information in line with the UK Data Protection Act (2018) and the General Data Protection Regulation (EU GDPR) 2016/679. Under the Data Protection legislation, University of Exeter is the Data Controller and the data processor and you can find out more about how we handle personal data, including how to exercise your individual rights and the contact details for our Data Protection Officer here: www.exeter.ac.uk/about/oursite/dataprotection/dpo/

Department of Health and Social Care disclaimer

This publication presents independent research commissioned by the National Institute for Health and Care Research (NIHR). The views and opinions expressed by the interviewees in this publication are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, MRC, NIHR Coordinating Centre, the Health and Social Care Delivery Research programme or the Department of Health and Social Care.

This monograph was published based on current knowledge at the time and date of publication. NIHR is committed to being inclusive and will continually monitor best practice and guidance in relation to terminology and language to ensure that we remain relevant to our stakeholders.

Declaration of transparency

The lead author* affirms that this manuscript is an honest, accurate and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned (and, if relevant, registered) have been explained.

* The manuscript’s guarantor:

Signatory:

Publications

Leach B, Parkinson S, Gkousis E, Abel G, Atherton H, Campbell J, Clark C, et al. Digital facilitation to support patient access to web-based primary care services: scoping literature review. J Med Internet Res 2022;24(7):e33911. https://doi.org/10.2196/33911

Khan N, Pitchforth E, Winder R, Abel G, Clark CE, Cockcroft E, Campbell J. What helps patients access web-based services in primary care? Free-text analysis of patient responses to the Di-Facto questionnaire. BMC Primary Care 2024;25:20. https://doi.org/10.1186/s12875-023-02257-5

List of potential journal publications:

Disclaimers

This article presents independent research funded by the National Institute for Health and Care Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, the HSDR programme or the Department of Health and Social Care. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, the HSDR programme or the Department of Health and Social Care.