Project News, Dissemination and Publications

We are delighted to announce that we have expanded the Di-Facto study with another work package that will focus on how people living with mental health conditions are experiencing digital facilitation in primary care. A mental health focus will be included in work package 2’s patient survey, and case study interviews in work package 3. Some new members of staff specialising in mental health research have joined the team and we look forward to carrying out this focused piece of research on a group who are often under-surveyed but whose experience of primary care is especially important to understand.

A massive congratulations to our growing Di-Facto team, some brilliant work progressed. Below is a brief update of our 4 work packages, as described in the About page.

Review
We have now completed our review of the research literature of 80 papers and have now submitted the article for publication in the peer reviewed scientific literature.
Survey
We have now completed a survey of 500 practices and received 156 practice responses. The patient survey is ongoing and nearing completion.
Observe
We are undertaking ethnographic (observational & qualitative) research in 6 practices and are anticipating working with a further 2 practices. We are also undertaking interviews with key stakeholder representatives.
Develop
We have already begun to integrate the findings from the key elements of our research and over the next 6 months will bring our findings together under an overall “synthesis” of our work.

The team have been making excellent progress in some trying months. All work packages are underway and discussions about dissemination have already started! Below is a brief summary of our progress to date:

• Literature review:  Completed – publication of results pending
• Practice survey: recruitment completed. 156 practices completed the survey. Analyses in progress.
• Patient survey: 147 practices (who completed a practice survey) have been invited to conduct a search and mailout to invite patients to participate. More than 3500 patients invited so far.
• Ethnographic case study (observations in 6 to 8 practices, interviews with up to 32 patients and staff): Five practices invited and participating in the ethnographic filed work. Interviews with staff, patients are well underway.
• Stakeholders interviews: These are underway. Interviews with individuals with national, CCG and practice level expertise in digital facilitation in primary care.
• Synthesis of analyses of literature review and practice survey underway.

Our Di-Facto intern, Victoria Bak, was invited to attend the 49th Society for Academic Primary Care Annual Scientific Meeting at the end of June 2021, in which the Di-Facto team presented. Victoria wrote a piece about her experiences and reflecting on the event.

As part of my internship with the Di-Facto team, I was invited to attend the online 49th Society for Academic Primary Care Annual scientific meeting (SAPC ASM). The topic chosen was ‘Living and Dying Well,’ a primary care focus that has become even more crucial in the light of the pandemic. The ASM was held on an online platform, where you could easily access each presentation through the online programme. Workshops, presentations, networking sessions, and a variety of speakers covered a wide range of problems and solutions related to primary care throughout the two-day event.

On the first day, Professor Gary Abel gave a presentation about one aspect of the Di-Facto project ‘Awareness and use of online services in general practice: analysis of GP Patient Survey data’. The findings of the GP Patient Survey indicated that some patients were less likely to use online services, which will become a disadvantage if primary care services become accessible solely through digital methods. As a result, digital facilitation may be able to make a significant difference.  On the same theme and project, Dr Brandi Leach presented a poster titled ‘What is the potential for digital facilitation to support patient access to online primary care service? A scoping literature review’. The poster depicted the first stage of the Di-Facto project, illustrating what digital facilitation is, how it works, and how to use it effectively. Both Gary Abel’s presentation and the poster emphasise the need for digital facilitation in primary care to minimise inequalities, particularly for disadvantaged populations who may not have easy access to digital services.

The programme covered a wide range of topics in relation to primary care. This year’s Helen Lester Memorial Lecture was delivered by Dr. Wendy Ann Webb, who spoke compassionately about her research about end-of-life care priorities for the homeless population in the UK. Dr. Webb concluded that a new approach for supporting the homeless population at the end of life is needed, one which focuses on hostel services rather than palliative care and typical hospice services. According to the findings of the study, this could be a step forward in ensuring that the homeless population wishes, of remaining in a familiar setting, being remembered and not planning for their end of life care, are met.

Professors Joe Rosenthal, Alex Harding, and Dr. Jane Kirby presented new SAPC innovations in undergraduate teaching, including an online library of recorded GP consultations, a resource that demonstratrd how GPs manage individual consultations and make decisions. As a student, this topic resonated with me as there has been so much change in my online teaching over the past year. I attended several talks which talked about the qualitative data collection through ethnography and interviews, which are techniques also used as part of the Di-Facto project. This was especially eye-opening for me as an intern because during my degree I have only worked with quantitative data. Qualitative data is important for obtaining original insights and can result in new hypotheses being generated.

The event was a great opportunity to learn about and enjoy a wide range of topics, ranging from scientific research to reflective poetry readings, regarding the ASM’s theme. This was my first online scientific conference, and while it’s difficult to truly replace face-to-face interactions with online interaction, there were regular online networking sessions. I would like to thank John Campbell, my supervisor, for inviting me to the event. The event was both informative and enjoyable, and I look forwa

rd to exploring certain topics about primary care further.

The Di-Facto team began working on the project as outlined in the proposal in March 2020 and we have made excellent progress, especially given the COVID-19 pandemic. Below is a brief summary of our progress to date:

• Work package 1 – Scoping Review – the literature review of primary care digital facilitation is nearing completion, and RAND are going to be presenting their scoping review at some conferences in 2021.
• Work package 2 – Patient and Practice survey – and 3 – Qualitative ethnographic study – are recruiting practices and patients to answer questions on a survey, and to undertake ethnographic and qualitative work of digital facilitation in practice.
• Advisory group – our advisory group have met twice and are up to date with the current challenges of the project, notably COVID-19’s impact on recruitment of participants and keeping to the timelines in our proposal. We’ve had some invaluable insight into the value of the project, especially as some practices are undergoing a bit of a digital revolution right now

The team’s presentations in 2023 include:

• HSR UK 2023, July
  • Jenny Newbould, Digital facilitation in primary care, a focused ethnographic study of the experiences of staff, patients and stakeholders

• SAPC ASM 2023, July
  • Gary Abel, Di-Facto patient survey: Digital facilitation to support patient access to online services in primary care
  • Carol Bryce, The hidden work of engaging with online services: ethnographic case study on digital facilitation
  • Nada Khan What helps patients access online services in primary care? Free-text analysis of patient responses to the Di-Facto survey.
  • Jenny Newbould, Digital facilitation in primary care, a focused ethnographic study of the experiences of staff, patients and stakeholders.
  • Jo Parsons, How do patients with a mental health diagnosis interact with online services at the general practice? A qualitative study
  • Steph Stockwell, Going digital: evolution of the general practice receptionist role
  • Bethan Treadgold, How are staff and patients supported to access and use digital services in primary care? Interview study with stakeholders
• SW SAPC 2023, March
  • Gary Abel, Di-Facto patient survey: Digital facilitation to support patient access to online services in primary care
  • Carol Bryce, The hidden work of engaging with online services: ethnographic case study on digital facilitation
  • Jo Parsons, How do patients with a mental health diagnosis interact with online services at the general practice? A qualitative study
  • Bethan Treadgold, How are staff and patients supported to access and use digital services in primary care? Interview study with stakeholders
  • Rachel Winder, Di-Facto patient survey: Digital facilitation to support patient access to online services in primary care

The team’s presentations in 2022:

• HSR UK 2022, July
  • Carol Bryce, Facilitating access to online NHS primary care services a focussed ethnography

• SAPC ASM 2022, July
  • Gary Abel, Di-Facto: Supporting access to online services in general practices – the patients’ perspective
  • Steph Stockwell, Facilitating access to online NHS primary care services a focused ethnography
  • Bethan Treadgold, How are staff and patients supported to use online services in primary care? Findings from qualitative stakeholder interviews

• SW SAPC 2022, March
  • Vicky Bak, Facilitating access to online NHS primary care services: thematic content analysis of practice survey free-text responses
  • Jeff Lambert, Facilitating access to online NHS primary care services – current experience and future potential (Di-Facto): The Practice Survey
  • Rachel Winder, Di-Facto: Supporting access to online services in general practices – the patients’ perspective
  • Helen Atherton, Facilitating access to online NHS primary care services a focussed ethnography

The team’s presentations in 2021:

• HSR UK 2021, July
  • Brandi Leach, Digital facilitation to support patient access to online primary care service: A scoping literature review
• SAPC ASM 2021, July
  • Gary Abel, Awareness and use of online services in general practice: analysis of GP Patient Survey data
  • Brandi Leach, What is the potential for digital facilitation to support patient access to online primary care service? A scoping literature review

We’ve also presented our work at expert-led seminars on digital technology research:

• Digital Technologies in Primary Care Special Interest Group, 21st October 2021
  • Jeff Lambert, Facilitating access to online NHS primary care services – current experience and future potential (Di-Facto): The Practice Survey
• King’s College London Technology and Science seminar, 6th October 2021
  • Gary Abel, The Di-Facto project – Digital Facilitation in Primary Care – 6 October 2021