Study Design

The research will incorporate two studies:

Intervention Development Study

Three GP practices in the Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group area will develop the intervention with 15 patients each. This will be done separately, firstly for the online pre-consultation form and secondly for the closure report. After trying the form and the report in one practice, we will interview the GPs, nurses, administrators and patients who used them. We will then implement improvements before testing in the next practice. After testing in three practices, we will be ready to run a feasibility study.

Feasibilty Study

In the feasibility study the pre-consultation form and the consultation closure report will be used together in a single consultation. The GP or nurse will review the pre-consultation form before the patient arrives and acknowledge that they have read it, before allowing the patient to speak without interruption. The GP or nurse will then provide the patient with printed information at the end. This is the basis of the Consultation Open and Close Intervention, which is shown here. This study will run from October 2020 to October 2021. It will involve four intervention practices (who use the COAC intervention) and two control practices (who do not use the intervention, but we will collect data from so that we can compare them to the intervention practices). Feasibility studies are smaller studies designed to find out whether it is feasible to carry out a larger study, but they are not large enough to test the intervention properly. The feasibility study will not establish whether the COAC intervention reduces re-consultation rates and improves patient satisfaction but will allow us to investigate whether we can collect the data to determine this. We will look at the data to see if it seems to improve things and will ask patients and clinicians if they found it beneficial, but it will not be possible to know for sure that it has a benefit without doing a larger study. Depending on the results of the feasibility study, we will aim to do this larger study within five years.

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