Review explores patients' and physicians' experiences with remote consultations in primary care

According to the Royal College of General Practitioners, at the peak of the Covid-19 pandemic, the ways in which patients accessed their GP reversed from around 70% face-to-face and 30% by phone, video or online pre-pandemic to around 30% face-to-face and 70% remote.

The Surrey researchers reviewed 24 papers from PubMed and PsychInfo for studies that explored both patients' and physicians' experiences with remote consultations in primary care.

The review follows the new NHS England guidance, which states that GP practices are now required to 'offer and promote' remote consultations under changes to the General Medical Services contract.

Primary care practitioners also suggested that remote consultations enabled better monitoring of cases, as patients with chronic illnesses were able to adjust their medication over the phone immediately, without having to wait for a face-to-face appointment to become available.

The review found that in some cases, telephone consultations helped patients feel empowered to express themselves more clearly and that face-to-face consultations could sometimes be intimidating, with patients less likely to share sensitive information during in-person appointments.

Although online consultations improved access to care and were convenient for some patients, they often resulted in a loss of valuable non-verbal communication such as eye contact, facial expressions, gestures, posture, and body language. This can make clinical decision making harder, as GP's have less information to inform their choices. Another factor is the suggestion that there are still some patients who have limited online access; therefore, online appointments are not viable.

The pandemic has shown that ways of receiving care that previously seemed impossible are actually possible, and in some cases, preferable to patients. 

Our research shows that remote consultations have advantages, particularly in terms of access and convenience for the majority of patients. Our research also shows that remote consultations have disadvantages, such as exacerbating clinical decision making for new symptoms/conditions. The pandemic has shown us that high-quality care can be delivered remotely, and many practices now have the appropriate means to do so effectively."

Dr Robert Kerrison, senior author of the study and Lecturer in Cancer Care, University of Surrey