Remote-by-Default Care in the COVID-19 Pandemic: addressing the micro-,meso-, and macro-level challenges of a radical new service model

AIM In the context of COVID-19, to address micro- (technical tools, clinical techniques), meso- (organisational change) and macro (national infrastructure) aspects of a remote-by-default service model in primary care. OBJECTIVES 1. Validate and embed evidence-based tools for remote assessment and monitoring. 2. Support local implementation teams to overcome technical, operational and professional barriers and implement remote-by-default service models rapidly and at scale. 3. Generate and apply insights on how NHS infrastructure can better support and be supported by digital innovation in a time of crisis. RESEARCH QUESTIONS 1. How can technology support assessment and monitoring of patients at a distance? 2. How can we achieve rapid spread and scale up of remote-by-default models of primary care? 3. What insights can we glean from this time of crisis that will help build a more resilient NHS? OUTLINE METHODS 1. TOOLS: Qualitative research to develop instruments followed by quantitative validation studies. 2. IMPLEMENTATION AND SCALE-UP: Four contrasting case studies in different localities, nested in an over-arching analysis of national policy. Action research (informed by interviews, ethnography, documents, datasets) by virtual researchers-in-residence. 3. WORKSHOPS AND SCENARIO-TESTING: Involving policymakers, regulators, professional bodies, industry, patients/citizens, to identify ways to strengthen infrastructure for rapid change.