The safety and quality of online consulting and prescribing services
Funding
BNSSCG CCG Research Capability Funding (Local development)
What is the research question?
What is the safety and quality of online consulting and prescribing services, and what are the risks, benefits and user experiences of these services?
What is the problem?
NHS and private online healthcare services comprise online doctor websites providing real-time video or questionnaire based medical consultations which may involve issuing a prescription. Online pharmacies offer a range of services including prescribing, mail-order of medicines, and collection and delivery of medicines prescribed by a regular prescriber such as a GP. As online consultations and other online models of care are expanding and evolving, access to and the efficiency of health services are hoped to improve, however, the anticipated benefits are not necessarily being achieved. There is limited understanding of how these new digital capabilities will be integrated in the existing health care system, and whether they will have the intended positive impact on usual care in NHS general practice. As prescribing is a core element of many of these services, it is possible that concerns may extend specifically to the quality and safety of medicines use.
What is the aim of the research?
To establish whether the prescribing and dispensing of medicines via online services is safe and appropriate, describe how they impact upon patients’ experiences of care, and evaluate how they fit within the wider service landscape including whether they meet the delivery of the key medicines related priorities outlined in the NHS Long Term Plan such as medicines optimisation and concerns about over-prescribing.
How will this be achieved?
The team will conduct a systematic review of existing evidence of benefits and harms of online prescribing, then complete semi-structured interviews with the following groups: clinicians delivering care via new online services; patients receiving care via new online services; clinicians (e.g. GPs) providing usual care to patients who have received other care via new online services; and individuals working within local and national regulatory and monitoring authorities (e.g. CCGs, CQC). They will also investigate the nature of prescribing via online services by reviewing patient prescription items and their corresponding clinical cases.
How will this be achieved?
The team intend to test the feasibility and impact of different interventions to improving primary care services for people with an existing or emerging eating disorder. Two interventions are aimed at enabling GPs to rapidly provide appropriate support and referral, and two are aimed at empowering patients and carers in seeking appropriate support without delay.
Who is leading the research?
Dr Rupert Payne, Consultant Senior Lecturer in Primary Health Care, Centre for Academic Primary Care, Population Health Sciences, University of Bristol.
Further information:
For more information or to get involved in this project, please contact bnssg.research@nhs.net.