OP87 Evaluating video and hybrid group consultations in general practice: A mixed-methods, multi-site, participatory study (TOGETHER-2)

Background Group consultations are increasingly used in primary care to support management of chronic conditions. Since the pandemic, healthcare practitioners in the UK have started delivering group consultations using video-based platforms. Our NIHR-funded evaluation examined if and how video and hybrid group consultations (VHGCs) can be implemented and sustained to meet the complex, diverse needs of patients in general practice. Methods This is a mixed-methods, participatory evaluation across four case and three comparison sites in England. Surgeries differed in location, size, ethnic diversity, deprivation, rurality, and VHGC focus (e.g. diabetes, menopause, cancer). Qualitative methods included ethnographic observations of 20 VHGCs and back-end processes (60hrs), and semi-structured interviews with 30 patients/carers, 20 staff and 15 decision-makers. Qualitative analysis was abductive, informed by social theory. Quantitative methods included patient surveys (patient experience, digital confidence) and analysis of subsequent healthcare utilisation using primary and secondary care data (planned for 2024). Results VHGCs lasted 1–2 hours, typically included 5–10 patients, and were delivered by a clinical lead (e.g. nurse, pharmacist) and a facilitator (e.g. receptionist, social navigator). They combined clinical, education, and peer support elements, with variations between conditions and surgeries. Preliminary survey results (N=35, case sites only) indicate that most patients (91.4%) rated their experience of VHGCs as (very) good, with interviews suggesting patients particularly value experiential knowledge sharing and emotional support. Whilst most (82.9%) survey respondents reported being comfortable discussing their condition, interviews indicated some were uncomfortable sharing intimate illness experiences or experienced distress from identity tensions (e.g. comparing poorly to others, expecting deterioration). Although VHGCs were normatively framed by staff as giving patients ‘more clinician time’, 22.9% of survey respondents did not discuss everything they wanted to, with 25.7% reporting the need for a one-to-one follow-up. Our qualitative data mirrored this, indicating time is not necessarily equally distributed between patients. While most survey respondents reported high digital confidence (93.8%), response rates were significantly lower in socioeconomically deprived areas, and our qualitative findings suggest that VHGCs can prove difficult to sustain due to digital poverty and challenges with inclusion. The presentation will compare patient experience across our case and comparison sites, and discuss qualitative findings to illustrate why, how, and in which circumstances VHGCs are appropriate. Discussion Although many patients report positive experiences of VHGCs, attention is needed on how VHGCs are delivered differently between surgeries, and in what contexts they may not fully address different care needs of patients.