Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford.
Br J Gen Pract. 2022 Jun 30;72(720):e483-e491. doi: 10.3399/BJGP.2021.0673. Print 2022 Jul.
Group consultations have been gaining ground as a novel approach to service delivery. When in-person care was restricted owing to COVID-19, general practice staff began delivering group consultations remotely over video.
To examine how multiple interacting influences underpinned implementation and delivery of video group consultations (VGCs).
Qualitative study in general practice in England.
a) 32 semi-structured interviews with patients, clinical, and non-clinical staff (from eight GP surgeries in total), NHS policymakers and programme managers, and other stakeholders; b) observation in relevant training and operational meetings; and c) three co-design workshops (21 participants). Thematic analysis was informed by the Planning and Evaluating Remote Consulting Services (PERCS) framework.
In the first year of the pandemic, VGCs focused on supporting those with long-term conditions or other shared health and social needs. Most patients welcomed clinical and peer input, and the opportunity to access their practice remotely during lockdown. However, not everyone agreed to engage in group-based care or was able to access IT equipment. At practice level, significant work was needed to deliver VGCs, such as setting up the digital infrastructure, gaining team buy-in, developing new patient-facing online facilitation roles, managing background operational processes, protecting online confidentiality, and ensuring professional indemnity cover. Training provided nationally was seen as instrumental in capacity building for VGC implementation.
Small scale VGC implementation addressed unmet need during the pandemic. However, embedding VGCs in routine care requires rethinking of operational, infrastructural, and clinical processes. Additional research on costs and benefits at service and patient level is needed.
小组咨询作为一种新的服务提供方式已经越来越受到关注。由于 COVID-19 的影响，当面护理受到限制，全科医生开始通过视频远程提供小组咨询。
研究多种相互作用的影响因素如何支撑视频小组咨询（VGC）的实施和交付。
英格兰全科医学中的定性研究。
a）对来自 8 家全科医生手术的患者、临床和非临床人员（共 32 名）、NHS 政策制定者和项目管理人员以及其他利益相关者进行了 32 次半结构化访谈；b）观察相关培训和运营会议；c）三次共同设计研讨会（21 名参与者）。主题分析受规划和评估远程咨询服务（PERCS）框架的启发。
在大流行的第一年，VGC 主要集中在支持那些患有长期疾病或其他共同的健康和社会需求的患者。大多数患者欢迎临床和同伴的投入，以及在封锁期间远程访问他们的实践的机会。然而，并非所有人都同意参与基于小组的护理，或者能够获得 IT 设备。在实践层面，需要进行大量工作来提供 VGC，例如建立数字基础设施、获得团队支持、开发新的面向患者的在线促进角色、管理后台运营流程、保护在线保密性和确保专业赔偿保险。全国范围内提供的培训被认为是 VGC 实施能力建设的关键。
小规模的 VGC 实施在大流行期间满足了未满足的需求。然而，将 VGC 嵌入常规护理需要重新思考运营、基础设施和临床流程。需要在服务和患者层面进一步研究成本和效益。
