Exploring the experiences and preferences of South Asian patients’ of primary care in England since COVID-19.

Nicola Small, Yumna Masood, Fiona Stevenson, Benjamin C. Brown, Caroline Sanders, Brian McMillan, Helen Atherton, Tandrima Mazumdar, Nigat Ara, Humera Haqqani, Sudeh Cheraghi-Sohi

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction

Remote (digital and/or telephone) access and consultation models are being driven by national policy with the goal being that the National Health Service (NHS) operates on a remote-first (digital-first) basis by 2029. Previous research has suggested that remote methods of access to care and consulting may act to widen health inequalities for certain patients and/or groups such as those from ethnic minorities. South Asian (SA) patients comprise the largest ethnic minority group in England. Understanding the experiences and needs of this group are critical to ensuring that general practice can deliver equitable, quality health care.

Methods

Qualitative study. 37 participants (from Indian, Pakistani and/or Bangladeshi background)) were recruited to take part either in-person preferred language focus groups or remote semi-structured interviews in the English language. Thematic analysis was conducted to identify themes in the qualitative data.

Findings

Three major inter-linked themes were identified: 1) reduced access, 2) reduced patient choice, and 3) quality and safety concerns. The findings highlight access issues split by i) general issues with appointment access via any remote means and ii) specific issues related to language barriers creating additional barriers to access and care. Some patients valued the convenience of remote access but also raised concerns regarding appointment availability and reduced patient choice. Face-to-face consultations were preferable but less available. The findings underscore how participants perceived remote care to be of lesser quality and less safe. Concerns were greatest for those with limited English proficiency with the removal of non-verbal aspects of communication and ‘hands-on’ care leading to perceptions of reduced psycho-social safety.

Conclusion

South Asian patients’ experiences of remote-led primary care access and care delivery was negative with only a minority viewing it positively and for certain limited scenarios. Face-to-face models of care remain the preferred mode of consultation, particularly for those with LEP. Hybrid models of access offer patients the greatest choice and are likely to meet the varying needs of the South-Asian patient population going forwards. The remote first approach to primary care may be achievable as a service ideal, but its limitations need to be recognised and accounted for to ensure that primary care can be an equitable service, both now and in the future.
Original languageEnglish
JournalHealth Expectations
Volume27
Issue number1
DOIs
Publication statusPublished - 5 Feb 2024

Keywords

  • General practice
  • COVID-19 access
  • triage
  • qualitative
  • telephone
  • South Asian

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