Abstract

Remote consulting was introduced quickly into UK general practice in March 2020 as an emergency response to COVID-19. In July 2020, 'remote-first' became long-term government policy. To explore how this change was portrayed in national newspapers and how depictions changed over time. Thematic analysis of newspaper articles referring to remote GP consultations from two time periods: 2 March-31 May 2020 (period 1) and 30 July-12 August 2020 (period 2). Articles were identified through, and extracted from, LexisNexis Academic UK. A coding system of themes and narrative devices was developed and applied to the data. The analysis was developed iteratively, amending the coding structure as new data were added. Remote consulting was widely covered in newspapers. Articles in period 1 depicted it positively, equating digital change with progress and linking novel technological solutions with improved efficiency and safety (for example, infection control) in a service that was overdue for modernisation. Articles in period 2 questioned the persistence of a remote-first service now that the pandemic was waning, emphasising, for example, missed diagnoses, challenges to the therapeutic relationship, and digital inequalities. As the first wave of the pandemic came and went, media depictions of remote consulting evolved from an 'efficiency and safety' narrative to a 'risks, inequalities, and lack of choice' narrative. To restore public trust in general practice, public communication should emphasise the wide menu of consulting options now available to patients and measures being taken to assure safety and avoid inequity.

Highlights

  • The shift from in-person to remote-bydefault consulting in UK general practice, introduced in March 2020 as part of the infection control measures for the first wave of the COVID-19 pandemic,[1] was arguably the fastest and most extensive scale-up of a major service innovation in the NHS since 1948

  • As the first wave of the pandemic came and went, media depictions of remote consulting evolved from an ‘efficiency and safety’ narrative to a ‘risks, inequalities, and lack of choice’ narrative

  • To restore public trust in general practice, public communication should emphasise the wide menu of consulting options available to patients and measures being taken to assure safety and avoid inequity

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Summary

Introduction

The shift from in-person to remote-bydefault consulting in UK general practice, introduced in March 2020 as part of the infection control measures for the first wave of the COVID-19 pandemic,[1] was arguably the fastest and most extensive scale-up of a major service innovation in the NHS since 1948. Clinical assessment of patients shifted almost overnight to online or telephone triage, followed by telephone or video callback and a face-to-face consultation only in rare circumstances;[2] one large practice, for example, observed a 92.5% decrease in face-to-face consultations between the beginning and end of March 2020, and a corresponding increase in telephone and e-consultations.[3]. Many assumed that these arrangements would be temporary. In July 2020, ‘remote-first’ became long-term government policy

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