Training for GPs and other practice staff has not kept pace with remote consultation technology, researchers have warned.
A new approach is needed to make sure clinical and non-clinical staff are providing the best care when offering a mix of consultation types including face to face, telephone and care provided by video or online communication, they said.
Their conclusion is based on a series of interviews, workshops and case studies of 12 general practices followed for two years, as well as published research, which found many staff did not feel as confident or capable as they wanted to.
They found that from senior GPs through to receptionists, all staff in primary care felt undertrained for digital and remote models of care delivery.
A common theme in the research was that there had been too much focus on how to use new technologies rather than how to work together to provide good care for patients across different consultation types.
Learning to use new technologies and new models of consultation happened in the context of a pandemic, high workload, understaffing and complex workflows, the team reports in the British Journal of General Practice.
A set of training competencies for staff providing remote general practice services was compiled by the team from Nuffield Department of Primary Care Health Sciences at the University of Oxford and University of Plymouth.
It includes technical knowledge, triage skills, learning around ethics and governance as well as communication skills for those who are new to the profession.
For more established clinicians, there should also be training in advanced triage capability and prioritisation of patients as well as how to build and maintain therapeutic relationships through remote care.
This training should also include how to supervise, teach and co-ordinate other staff learning how to use remote consultation models and technology, they concluded.
A particular area where participants wanted more training was around passing requests between different staff members, or making judgements about which patients to contact remotely and which to put on another staff member’s urgent call-back list, the researchers said.
They stressed that some aspects of training should occur ‘on the job’ and involve the whole team.
It follows a recent study, also from the University of Oxford, that found serious harm to patients associated with remote consultations was ‘extremely rare’.
Study lead Professor Trisha Greenhalgh said: ‘New remote and digital ways of working are often introduced with the hope of increasing efficiency in the health service.
‘But this will only happen if staff are adequately trained, particularly since these new modalities often come with complex workflows and require coordination across staff groups.
‘Our research shows that few general practice staff currently feel capable and confident to use all the modalities (telephone, video and electronic consultations) to their full potential.
‘We hope that the competencies we have produced will help educational providers address these deficiencies.’
Co-author Dr Rebecca Rosen, a senior research fellow at the Nuffield Trust added: ‘Remote consultations by phone or online have a huge part to play in improving access to general practice.
‘But we must be sure that the consultations are safe, and acceptable to both patients and staff.
‘With multi-professional teamworking now the norm in general practice, this study shows that we must improve training in remote consulting skills for the whole practice team as a matter of urgency.’
A version of this story first appeared on our sister publication Pulse
