Remote access to general practice and inclusion health-a qualitative study of patient perspectives

Background COVID-19 has led to rapid and widespread adoption of remote consultations and triage-first pathways in general practice. However, there is a lack of evidence on how these changes have been perceived by patients from inclusion health groups.

Aim To explore the perspectives of individuals from inclusion health groups on the provision and accessibility of general practice services remotely.

Design & setting A qualitative study with individuals fromGypsy, Roma and Traveller communities, sex workers, vulnerable migrantsand those experiencing homelessness, recruited by Healthwatch in east London.

Method The study materials were co-produced with people with lived experience of social exclusion. Semi-structured interviews with 21 participantswere audio-recorded, transcribed, and analysed using the framework method.

Results Analysis identified barriers to access due lack of translation availability, digital exclusion and a complex healthcare system which is difficult to navigate. The role of triage and of general practice in emergencies often seemed unclear to participants. Other themes identified included the importance of trust and face-to-face consultations options for ensuring safety and the benefits of remote access, particularly in terms of convenience and saving time. Themes on reducing barriers included improving staff capacity and communication, offering tailored options and continuity of care and simplifying care processes.

Conclusion The study highlighted the importance ofa tailored approach for addressing the multiple barriers to care for inclusion health groups and the need for clearer and inclusive communication on the available triage and care pathways.