Exploring the potential of email as a method of consultation in English general practice

Background Email is a popular and commonly used method of communication, though not widely used in the healthcare setting. In England, policy has pushed for the introduction of email as a method of consultation in general practice. However, there is very little evidence available on its use in England and professional bodies have taken a neutral or negative stance to its use. The aim of this study was to explore the potential for email as a method of consultation in English general practice, and describe the key factors that may influence its normalisation. Methods A mixed methods approach was used. A systematic review was carried out to identify the extent of the experimental evidence base. An interview study was carried out with patient and professional (GPs, practice managers) participants who had used email for consultation, to establish their experiences and opinions, and to identify barriers and facilitators to its use. Normalisation process theory was used in interpreting the interview study results, so that the factors influencing normalisation might be identified. Results The review found that the existing evidence base for email consultation is poor and as such it is not possible to draw conclusions as to the effect of email as an intervention. The interview study identified that email consultation largely arose as a result of patient demand, and it brought advantages for both groups. However there were problems associated with it and these related largely to the uncertainties surrounding its use. Conclusions Email consultation is not a normalised method of consultation in English general practice despite the positive factors that patients and professionals associate with its use. It lacks a regulatory framework, which makes it difficult to use. Formal guidance on how to approach its use is required, along with methodologically rigorous research upon which policymakers and practitioners can base their decision making.EThOS - Electronic Theses Online ServiceGBUnited Kingdo