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Digital First Primary Care

Digital first primary for those with multiple long-term conditions: The views of patients, carers and health professionals

General practices across England are under mounting pressure due to rising patient demand, increased complexity of patient care, and challenges in GP recruitment and retention. To address these issues, greater adoption of digital technologies in primary care has been advocated. One key aspect of this transformation is digital first primary care, where patients initiate GP consultations through digital channels rather than face-to-face interactions. The use of digital first primary care has surged in recent years, especially during the COVID-19 pandemic. At the height of the pandemic, NHS England advised all general practices to book appointments online and conduct remote consultations via telephone or video.

While several studies have explored the use of digital approaches in primary care, most have focused on understanding platform types, usage patterns, and their impact on general practice. However, there remains a lack of evidence regarding their effectiveness in addressing the complex needs of patients with multiple long-term conditions. This rapid evaluation aims to gather insights from patients, their carers, and health professionals about digital first primary care.

This project ran from September 2021 to May 2022.

Our Approach

Our rapid evaluation will answer research questions concerned with understanding the impact of digital first services in primary care for patients living with multiple long-term conditions:

  • What is the experience of digital first primary care for patients with multiple long-term conditions, their carers and health professionals, both before and during the COVID-19 pandemic?
  • What is the impact of digital first primary care on the nature of consultations for carers/patients with multiple long-term conditions and health professionals, which includes aspects such as the health professional(s) spoken to, timeliness of care, and continuity of care?
  • What, if any, are the advantages or disadvantages of digital first primary care for patients with multiple long-term conditions, and their carers?
  • What lessons can be learnt from staff, patients’ and carers’ views for future service delivery for patients with multiple long-term conditions in primary care? Are there individual groups within the community where there is particular learning for future service provision?

Our evaluation comprises three distinct work packages (WP):

  • WP1: Locating the study within the wider context, engaging with literature, as well as co-designing the study approach and research questions with service users.
  • WP2: Interviews with patients/carers of those with multiple long-term conditions who have experienced digital first primary care and health professionals.
  • WP3: Analysis of data, generation of themes, and testing findings with service users.
  • WP4: Synthesis, reporting and dissemination.

Our Team

Our Outputs

National Institute for Health and Care Research, Health Services and Delivery Research stream (NIHR HSDR) published report Digital First Primary Care for those with multiple long-term conditions: a rapid review of the views of stakeholders; Jennifer Newbould, Lucy Hocking, Manbinder Sidhu, Kelly Daniel; July 2024