scholarly journals Developing and evaluating a tool to measure general practice productivity: a multimethod study

2019 ◽  
Vol 7 (13) ◽  
pp. 1-184
Author(s):  
Jeremy Dawson ◽  
Anna Rigby-Brown ◽  
Lee Adams ◽  
Richard Baker ◽  
Julia Fernando ◽  
...  
Keyword(s):  
General Practice ◽  
Online Survey ◽  
Financial Data ◽  
Productivity Index ◽  
Patient Questionnaire ◽  
Control Group ◽  
Productivity Measurement ◽  
Data Feedback ◽  
Patient Representatives ◽  
General Practices

Background Systems for measuring the performance of general practices are extremely limited. Objectives The aim was to develop, pilot test and evaluate a measure of productivity that can be applied across all typical general practices in England, and that may result in improvements in practice, thereby leading to better patient outcomes. Methods Stage 1 – the approach used was based on the Productivity Measurement and Enhancement System (ProMES). Through 16 workshops with 80 general practice staff and 72 patient representatives, the objectives of general practices were identified, as were indicators that could measure these objectives and systems to convert the indicators into an effectiveness score and a productivity index. This was followed by a consensus exercise involving a face-to-face meeting with 16 stakeholders and an online survey with 27 respondents. An online version of the tool [termed the General Practice Effectiveness Tool (GPET)] and detailed guidance were created. Stage 2 – 51 practices were trained to use the GPET for up to 6 months, entering data on each indicator monthly and getting automated feedback on changes in effectiveness over time. The feasibility and acceptability of the GPET were examined via 38 telephone interviews with practice representatives, an online survey of practice managers and two focus groups with patient representatives. Results The workshops resulted in 11 objectives across four performance areas: (1) clinical care, (2) practice management, (3) patient focus and (4) external focus. These were measured by 52 indicators, gathered from clinical information systems, practice records, checklists, a short patient questionnaire and a short staff questionnaire. The consensus exercise suggested that this model was appropriate, but that the tool would be of more benefit in tracking productivity within practices than in performance management. Thirty-eight out of 51 practices provided monthly data, but only 28 practices did so for the full period. Limited time and personnel changes made participation difficult for some. Over the pilot period, practice effectiveness increased significantly. Perceptions of the GPET were varied. Usefulness was given an average rating of 4.5 out of 10.0. Ease of use was more positive, scoring 5.6 out of 10.0. Five indicators were highlighted as problematic to gather, and 27% of practices had difficulties entering data. Feedback from interviews suggested difficulties using the online system and finding time to make use of feedback. Most practices could not provide sufficient monthly financial data to calculate a conventional productivity index. Limitations It was not possible to create a measure that provides comparability between all practices, and most practices could not provide sufficient financial data to create a productivity index, leaving an effectiveness measure instead. Having a relatively small number of practices, with no control group, limited this study, and there was a limited timescale for the testing and evaluation. Implications The GPET has demonstrated some viability as a tool to aid practice improvement. The model devised could serve as a basis for measuring effectiveness in general practice more widely. Future work Some additional research is needed to refine the GPET. Enhanced testing with a control sample would evaluate whether or not it is the use of the GPET that leads to improved performance. Funding The National Institute for Health Research Health Services and Delivery Research programme.

scholarly journals Telehealth consultations in general practice during a pandemic lockdown: survey and interviews on patient experiences and preferences

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Fiona Imlach ◽  
Eileen McKinlay ◽  
Lesley Middleton ◽  
Jonathan Kennedy ◽  
Megan Pledger ◽  
...  
Keyword(s):  
Health Care ◽  
General Practice ◽  
Access To Health Care ◽  
Online Survey ◽  
Sudden Change ◽  
High Satisfaction ◽  
The Future ◽  
Clinical Relationship ◽  
General Practices ◽  
Key Aspects

Abstract Background During the first COVID-19 pandemic ‘lockdown’ in Aotearoa/New Zealand (March–May 2020, in which strict ‘stay at home’ measures were introduced), general practices were advised to use telephone and video consultations (telehealth) wherever possible instead of the usual in-person visits. This was a sudden change for most practices and patients. This research aimed to explore how patients accessed general practice during lockdown and evaluate their experiences with telehealth, to inform how telehealth could be most effectively used in the future. Methods Using a mixed-method approach, we undertook an online survey and in-depth interviews with adults (> 18 years) who had contact with practices during lockdown, recruited through social media and email lists. We present descriptive statistics from the survey data (n = 1010) and qualitative analysis of interview data (n = 38) and open-ended survey questions, using a framework of access to health care, from the patient’s perspective. Results In general, patients reported high satisfaction with telehealth in general practice during lockdown. Telehealth was convenient and allowed patients to safely access health care without having to weigh-up the fear of COVID-19 infection against the need to be seen. Telehealth worked best for routine and familiar health issues and when rapport was established between patients and clinicians. This was easier with a pre-existing clinical relationship, but not impossible without one. Telehealth was less suitable when a physical examination was needed, when the diagnosis was unknown or for patients who had a strong preference to be seen in-person. Conclusions Even in this disruptive lockdown period, that prompted an unexpected and rapid implementation of telehealth services in general practices, most patients had positive experiences with telehealth. In the future, patients want the choice of consultation type to match their needs, circumstances, and preferences. Technological issues and funding barriers may need to be addressed, and clear communication for both patients and clinicians is needed about key aspects of telehealth (e.g. cost, appropriateness, privacy). Maintaining telehealth as an option post-lockdown has the potential to increase timely and safe access to primary health care for many patients.

scholarly journals Exploring learning needs for general practice based pharmacist: Are behavioural and influencing skills needed?

2020 ◽  
Vol 18 (2) ◽  
pp. 1814
Author(s):  
Chris F. Johnson ◽  
Jan Smith ◽  
Heather Harrison ◽  
Richard Hassett
Keyword(s):  
General Practice ◽  
Learning Styles ◽  
Self Efficacy ◽  
Online Survey ◽  
Improve Patient Care ◽  
Learning Needs ◽  
White Ethnicity ◽  
Resilience Scale ◽  
Cost Efficiencies ◽  
General Practices

Background: Embedding pharmacists in general practice has been shown to create cost efficiencies, improve patient care and free general practitioner capacity. Consequently, there is a drive to recruit additional pharmacists to work within general practices. However, equipping pharmacists with behaviour and influencing skills may further optimise their impact. Key elements which may enhance behaviour and influencing skills include self-efficacy and resilience. Objective: This study aimed to: 1) Assess general practice pharmacists’ self-efficacy and resilience. 2) Explore differences primarily between pharmacists reporting lower and higher self-efficacy, secondarily for those reporting lower and higher scores for resilience. Methods: All 159 NHS Greater Glasgow and Clyde general practice pharmacists were invited to complete an online survey in May 2019. The survey captured anonymised data covering: demographics; professional experience; qualifications, prescribing status and preferred learning styles. Unconscious learning needs for behavioural and influencing skills were assessed using validated tools: the new general self-efficacy scale (GSES) and short general resilience scale (GRIT). Participants’ responses were differentiated by the lowest quartile and higher quartiles of GSES and GRIT scores, and analysed to identify differences. Results: The survey was completed by 57% (91/159) of eligible pharmacists; mean age 38 (range 24-60) years; 91% were of white ethnicity and 89% female. The median time qualified was 14 (1-38) years and 3 (1-22) years working in general practices. Overall pharmacists scored well on the GSES, mean 25 (SD 3; 95%CI 24.4-25.6), and GRIT, mean 30 (SD 4; 95%CI 29.6-30.4), out of a maximum 32 and 40 respectively. A significant positive correlation between GSES and GRIT scores was found (Pearson’s r=0.284, p=0.006). However, no significant differences were identified between pharmacists scoring in the lower and upper quartiles by GSES or GRIT. Overall respondents reported their preferred learning styles were activists (46%) or pragmatists (29%). The majority (91%) preferred blended learning methods as opposed to 38% or less for a range of online methods. Conclusions: General practice pharmacists on average scored highly for self-efficacy and resilience. Higher scores did not appear to be associated with demographic, years of practice, professional or educational experience. Prospective interventions to support those with lower scores may enhance and optimise pharmacists’ effectiveness in general practice.

scholarly journals Exploring learning needs for general practice based pharmacist: Are behavioural and influencing skills needed?

2020 ◽  
Vol 18 (2) ◽  
pp. 1814
Author(s):  
Chris F. Johnson ◽  
Jan Smith ◽  
Heather Harrison ◽  
Richard Hassett
Keyword(s):  
General Practice ◽  
Learning Styles ◽  
Self Efficacy ◽  
Online Survey ◽  
Improve Patient Care ◽  
Learning Needs ◽  
White Ethnicity ◽  
Resilience Scale ◽  
Cost Efficiencies ◽  
General Practices

Background: Embedding pharmacists in general practice has been shown to create cost efficiencies, improve patient care and free general practitioner capacity. Consequently, there is a drive to recruit additional pharmacists to work within general practices. However, equipping pharmacists with behaviour and influencing skills may further optimise their impact. Key elements which may enhance behaviour and influencing skills include self-efficacy and resilience. Objective: This study aimed to: 1) Assess general practice pharmacists’ self-efficacy and resilience. 2) Explore differences primarily between pharmacists reporting lower and higher self-efficacy, secondarily for those reporting lower and higher scores for resilience. Methods: All 159 NHS Greater Glasgow and Clyde general practice pharmacists were invited to complete an online survey in May 2019. The survey captured anonymised data covering: demographics; professional experience; qualifications, prescribing status and preferred learning styles. Unconscious learning needs for behavioural and influencing skills were assessed using validated tools: the new general self-efficacy scale (GSES) and short general resilience scale (GRIT). Participants’ responses were differentiated by the lowest quartile and higher quartiles of GSES and GRIT scores, and analysed to identify differences. Results: The survey was completed by 57% (91/159) of eligible pharmacists; mean age 38 (range 24-60) years; 91% were of white ethnicity and 89% female. The median time qualified was 14 (1-38) years and 3 (1-22) years working in general practices. Overall pharmacists scored well on the GSES, mean 25 (SD 3; 95%CI 24.4-25.6), and GRIT, mean 30 (SD 4; 95%CI 29.6-30.4), out of a maximum 32 and 40 respectively. A significant positive correlation between GSES and GRIT scores was found (Pearson’s r=0.284, p=0.006). However, no significant differences were identified between pharmacists scoring in the lower and upper quartiles by GSES or GRIT. Overall respondents reported their preferred learning styles were activists (46%) or pragmatists (29%). The majority (91%) preferred blended learning methods as opposed to 38% or less for a range of online methods. Conclusions: General practice pharmacists on average scored highly for self-efficacy and resilience. Higher scores did not appear to be associated with demographic, years of practice, professional or educational experience. Prospective interventions to support those with lower scores may enhance and optimise pharmacists’ effectiveness in general practice.

scholarly journals Telehealth consultations in general practice during a pandemic lockdown: survey and interviews on patient experiences and preferences

2021 ◽  
Author(s):  
F Imlach ◽  
E McKinlay ◽  
Lesley Middleton ◽  
J Kennedy ◽  
Megan Pledger ◽  
...  
Keyword(s):  
Health Care ◽  
General Practice ◽  
Access To Health Care ◽  
Online Survey ◽  
Sudden Change ◽  
High Satisfaction ◽  
The Future ◽  
Clinical Relationship ◽  
General Practices ◽  
Key Aspects

© 2020, The Author(s). Background: During the first COVID-19 pandemic ‘lockdown’ in Aotearoa/New Zealand (March–May 2020, in which strict ‘stay at home’ measures were introduced), general practices were advised to use telephone and video consultations (telehealth) wherever possible instead of the usual in-person visits. This was a sudden change for most practices and patients. This research aimed to explore how patients accessed general practice during lockdown and evaluate their experiences with telehealth, to inform how telehealth could be most effectively used in the future. Methods: Using a mixed-method approach, we undertook an online survey and in-depth interviews with adults (> 18 years) who had contact with practices during lockdown, recruited through social media and email lists. We present descriptive statistics from the survey data (n = 1010) and qualitative analysis of interview data (n = 38) and open-ended survey questions, using a framework of access to health care, from the patient’s perspective. Results: In general, patients reported high satisfaction with telehealth in general practice during lockdown. Telehealth was convenient and allowed patients to safely access health care without having to weigh-up the fear of COVID-19 infection against the need to be seen. Telehealth worked best for routine and familiar health issues and when rapport was established between patients and clinicians. This was easier with a pre-existing clinical relationship, but not impossible without one. Telehealth was less suitable when a physical examination was needed, when the diagnosis was unknown or for patients who had a strong preference to be seen in-person. Conclusions: Even in this disruptive lockdown period, that prompted an unexpected and rapid implementation of telehealth services in general practices, most patients had positive experiences with telehealth. In the future, patients want the choice of consultation type to match their needs, circumstances, and preferences. Technological issues and funding barriers may need to be addressed, and clear communication for both patients and clinicians is needed about key aspects of telehealth (e.g. cost, appropriateness, privacy). Maintaining telehealth as an option post-lockdown has the potential to increase timely and safe access to primary health care for many patients.

scholarly journals Exploring the feasibility of patient safety huddles in general practice

2020 ◽  
Vol 21 ◽  
Author(s):  
Hannah Panayiotou ◽  
Charlotte Higgs ◽  
Robbie Foy
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Patient Safety ◽  
Online Survey ◽  
Healthcare Systems ◽  
Practice Staff ◽  
Care Structure ◽  
Potential Benefits ◽  
Current Context ◽  
General Practices

Abstract Background: Patient safety is a key priority for healthcare systems. Patient safety huddles have been advocated as a way to improve safety. We explored the feasibility of huddles in general practice. Methods: We invited all general practices in West Yorkshire to complete an online survey and interviewed practice staff. Results: Thirty-four out of 306 practices (11.1%) responded to our survey. Of these, 22 practices (64.7%) reported having breaks for staff to meet and eight (23.5%) reported no longer having breaks in their practices. Seven interviewees identified several barriers to safety huddles including time and current culture; individuals felt meetings or breaks would not be easily integrated into current primary care structure. Discussion: Despite their initial promise, there are major challenges to introducing patient safety huddles within the current context of UK general practice. General practice staff may need more convincing of potential benefits.

scholarly journals The SMARTscreen Trial: a randomised controlled trial investigating the efficacy of a GP-endorsed narrative SMS to increase participation in the Australian National Bowel Cancer Screening Program

Trials ◽  
2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Anna Wood ◽  
Jon D. Emery ◽  
Mark Jenkins ◽  
Patty Chondros ◽  
Tina Campbell ◽  
...  
Keyword(s):  
General Practice ◽  
Screening Program ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Cancer Screening Program ◽  
Sms Intervention ◽  
Bowel Cancer Screening ◽  
General Practices ◽  
Randomised Controlled

Abstract Background Increasing participation in the Australian National Bowel Cancer Screening Program (NBCSP) is the most efficient and cost-effective way of reducing mortality associated with colorectal cancer by detecting and treating early-stage disease. Currently, only 44% of Australians aged 50–74 years complete the NBCSP. This efficacy trial aims to test whether this SMS intervention is an effective method for increasing participation in the NBCSP. Furthermore, a process evaluation will explore the barriers and facilitators to sending the SMS from general practice. Methods We will recruit 20 general practices in the western region of Victoria, Australia to participate in a cluster randomised controlled trial. General practices will be randomly allocated with a 1:1 ratio to either a control or intervention group. Established general practice software will be used to identify patients aged 50 to 60 years old who are due to receive a NBCSP kit in the next month. The SMS intervention includes GP endorsement and links to narrative messages about the benefits of and instructions on how to complete the NBCSP kit. It will be sent from intervention general practices to eligible patients prior to receiving the NBCSP kit. We require 1400 eligible patients to provide 80% power with a two-sided 5% significance level to detect a 10% increase in CRC screening participation in the intervention group compared to the control group. Our primary outcome is the difference in the proportion of eligible patients who completed a faecal occult blood test (FOBT) between the intervention and control group for up to 12 months after the SMS was sent, as recorded in their electronic medical record (EMR). A process evaluation using interview data collected from general practice staff (GP, practice managers, nurses) and patients will explore the feasibility and acceptability of sending and receiving a SMS to prompt completing a NBCSP kit. Discussion This efficacy trial will provide initial trial evidence of the utility of an SMS narrative intervention to increase participation in the NBCSP. The results will inform decisions about the need for and design of a larger, multi-state trial of this SMS intervention to determine its cost-effectiveness and future implementation. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12620001020976. Registered on 17 October 2020.

scholarly journals Telehealth consultations in general practice during a pandemic lockdown: survey and interviews on patient experiences and preferences

2021 ◽  
Author(s):  
F Imlach ◽  
E McKinlay ◽  
Lesley Middleton ◽  
J Kennedy ◽  
Megan Pledger ◽  
...  
Keyword(s):  
Health Care ◽  
General Practice ◽  
Access To Health Care ◽  
Online Survey ◽  
Sudden Change ◽  
High Satisfaction ◽  
The Future ◽  
Clinical Relationship ◽  
General Practices ◽  
Key Aspects

© 2020, The Author(s). Background: During the first COVID-19 pandemic ‘lockdown’ in Aotearoa/New Zealand (March–May 2020, in which strict ‘stay at home’ measures were introduced), general practices were advised to use telephone and video consultations (telehealth) wherever possible instead of the usual in-person visits. This was a sudden change for most practices and patients. This research aimed to explore how patients accessed general practice during lockdown and evaluate their experiences with telehealth, to inform how telehealth could be most effectively used in the future. Methods: Using a mixed-method approach, we undertook an online survey and in-depth interviews with adults (> 18 years) who had contact with practices during lockdown, recruited through social media and email lists. We present descriptive statistics from the survey data (n = 1010) and qualitative analysis of interview data (n = 38) and open-ended survey questions, using a framework of access to health care, from the patient’s perspective. Results: In general, patients reported high satisfaction with telehealth in general practice during lockdown. Telehealth was convenient and allowed patients to safely access health care without having to weigh-up the fear of COVID-19 infection against the need to be seen. Telehealth worked best for routine and familiar health issues and when rapport was established between patients and clinicians. This was easier with a pre-existing clinical relationship, but not impossible without one. Telehealth was less suitable when a physical examination was needed, when the diagnosis was unknown or for patients who had a strong preference to be seen in-person. Conclusions: Even in this disruptive lockdown period, that prompted an unexpected and rapid implementation of telehealth services in general practices, most patients had positive experiences with telehealth. In the future, patients want the choice of consultation type to match their needs, circumstances, and preferences. Technological issues and funding barriers may need to be addressed, and clear communication for both patients and clinicians is needed about key aspects of telehealth (e.g. cost, appropriateness, privacy). Maintaining telehealth as an option post-lockdown has the potential to increase timely and safe access to primary health care for many patients.

scholarly journals Telehealth Consultations in General Practice During a Pandemic Lockdown: Survey and Interviews on Patient Experiences and Preferences

2020 ◽  
Author(s):  
Fiona Imlach ◽  
Eileen McKinlay ◽  
Lesley Middleton ◽  
Jonathan Kennedy ◽  
Megan Pledger ◽  
...  
Keyword(s):  
Health Care ◽  
General Practice ◽  
Access To Health Care ◽  
Online Survey ◽  
Sudden Change ◽  
High Satisfaction ◽  
The Future ◽  
Clinical Relationship ◽  
General Practices ◽  
Key Aspects

Abstract BackgroundDuring the first COVID-19 pandemic ‘lockdown’ in Aotearoa/New Zealand (March-May 2020, in which strict ‘stay at home’ measures were introduced), general practices were advised to use telephone and video consultations (telehealth) wherever possible instead of the usual in-person visits. This was a sudden change for most practices and patients. This research aimed to explore how patients accessed general practice during lockdown and evaluate their experiences with telehealth, to inform how telehealth could be most effectively used in the future. MethodsUsing a mixed-method approach, we undertook an online survey and in-depth interviews with adults (>18 years) who had contact with practices during lockdown, recruited through social media and email lists. We present descriptive statistics from the survey data (n=1,010) and qualitative analysis of interview data (n=38) and open-ended survey questions, using a framework of access to health care, from the patient’s perspective.ResultsIn general, patients reported high satisfaction with telehealth in general practice during lockdown. Telehealth was convenient and allowed patients to safely access health care without having to weigh-up the fear of COVID-19 infection against the need to be seen. Telehealth worked best for routine and familiar health issues and when rapport was established between patients and clinicians. This was easier with a pre-existing clinical relationship, but not impossible without one. Telehealth was less suitable when a physical examination was needed, when the diagnosis was unknown or for patients who had a strong preference to be seen in-person. ConclusionsEven in this disruptive lockdown period, that prompted an unexpected and rapid implementation of telehealth services in general practices, most patients had positive experiences with telehealth. In the future, patients want the choice of consultation type to match their needs, circumstances, and preferences. Technological issues and funding barriers may need to be addressed, and clear communication for both patients and clinicians is needed about key aspects of telehealth (e.g. cost, appropriateness, privacy). Maintaining telehealth as an option post-lockdown has the potential to increase timely and safe access to primary health care for many patients.

scholarly journals The SMARTscreen Trial: A Randomised Controlled Trial Investigating The Efficacy of a GP-Endorsed Narrative SMS To Increase Participation in The Australian National Bowel Cancer Screening Program.

2021 ◽  
Author(s):  
Anna Wood ◽  
Jon David Emery ◽  
Mark Jenkins ◽  
Patty Chondros ◽  
Tina Campbell ◽  
...  
Keyword(s):  
General Practice ◽  
Screening Program ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Cancer Screening Program ◽  
Sms Intervention ◽  
Bowel Cancer Screening ◽  
General Practices ◽  
Randomised Controlled

Abstract Background: Increasing participation in the Australian National Bowel Cancer Screening Program (NBCSP) is the most efficient and cost-effective way of reducing mortality associated with colorectal cancer by detecting and treating early-stage disease. Currently only 44% of Australians aged 50 -74 years complete the NBCSP. This efficacy trial aims to test whether this SMS intervention is an effective method for increasing participation in the NBCSP. Furthermore, a process evaluation will explore the barriers and facilitators to sending the SMS from general practice.Methods: We will recruit 20 general practices in the western region of Victoria, Australia to participate in a cluster randomised controlled trial. General practices will be randomly allocated with a 1:1 ratio to either a control or intervention group. Established general practice software will be used to identify patients aged 50 to 60 years old who are due to receive a NBCSP kit in the next month. The SMS intervention includes GP endorsement and links to narratives messages about the benefits of and instructions on how to complete the NBCSP kit. It will be sent from intervention general practices to eligible patients prior to receiving the NBCSP kit. We require 1400 eligible patients to provide 80% power with two-sided 5% significance level to detect a 10% increase in CRC screening participation in the intervention group compared to control group. Our primary outcome is the difference in the proportion of eligible patients who completed a faecal occult blood test (FOBT) between the intervention and control group for up to twelve months after the SMS was sent, as recorded in their electronic medical record (EMR). A process evaluation using interview data collected from general practice staff (GP, practice managers, nurses) and patients will explore the feasibility and acceptability of sending and receiving a SMS to prompt completing a NBCSP kit.Discussion: This efficacy trial will provide initial trial evidence of the utility of an SMS narrative intervention to increase participation in the NBCSP. The results will inform decisions about the need for and design of a larger, multi-state trial of this SMS intervention to determine its cost-effectiveness and future implementationTrial registration: Australian New Zealand Clinical Trials Registry: ACTRN12620001020976, 17th October 2020

scholarly journals How COVID-19 has affected general practice consultations and income: general practitioner cross-sectional population survey evidence from Ireland

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e044685
Author(s):  
Robyn Homeniuk ◽  
Claire Collins
Keyword(s):  
General Practice ◽  
General Practitioners ◽  
Online Survey ◽  
Quality Care ◽  
Cross Sectional ◽  
Practice Nurses ◽  
Global Pandemic ◽  
Before And After ◽  
General Practices ◽  
The Impact

ObjectivesHow general practice is delivered in many countries has drastically changed due to the COVID-19 pandemic. This study aimed to answer the question of how general practice has changed in Ireland in response to COVID-19.DesignThe Irish College of General Practitioners surveyed its membership before and after the global pandemic hit Ireland using a cross-sectional online survey instrument.SettingThis study focuses on primary care, specifically general practice, in Ireland.ParticipantsIn February 2020 before the global pandemic, 526 general practices across Ireland submitted responses to the survey; 538 general practices responded to the second survey during the pandemic in June 2020. This covers 32% and 33% of practices in Ireland, respectively.Main outcome measuresThe type of consultations by general practitioners (GPs) and practice nurses in both surveys is the main outcome measure reported in this paper. Other changes such as the perceived change in attendance by certain patient groups and practice income are also reported.ResultsFace-to-face consultations significantly (p<0.001) decreased from a median of 26 (IQR 21.3–30) to a median of 8 (IQR 6–13). GP telemedicine consultations increased (p<0.001) from a median of 2.4 (IQR 0–5.3) to a median of 11.3 (IQR 6–19). The majority of practices (80.0%) reported reduced practice profit. Respondents reported a decline in non-COVID-19-related consultations among certain patient cohorts—92.0% for children under 6 years old; 79.5% for patients over 70 years.ConclusionsIt is likely that the way general practice is delivered will not return to as it was before the COVID-19 pandemic and increased telemedicine can be expected. However, it is necessary to assess the impact of this shift on patient health and to assess healthcare provider and patient experience to ensure continued high-quality care and patient safety.

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