What is the impact of a shift to remote consultations? A qualitative interview study in primary and secondary healthcare.

Objective: The COVID-19 pandemic prompted a significant increase in the use of remote consultations-by telephone or video-in both primary and secondary healthcare. The reported advantages of remote consulting for both patients and clinicians include greater efficiency, flexibility and convenience. However, disadvantages, such as the uncertainty created by a loss of face-to-face contact, have also been highlighted. The aim of this study was to explore, explain and interpret patients' and clinicians' perceptions and experiences of remote consultations and assist decision-making about their future use.

Methods: A qualitative study based on semistructured online interviews. Methods: Primary mental healthcare or secondary care cardiology services, London, UK, February-March 2022. Methods: Primary care mental health patients (n=5), primary care clinicians (general practitioners) (n=15), secondary care cardiology patients (n=9) and secondary care cardiology clinicians (n=5).

Results: The results demonstrate that a range of factors have influenced the experiences of both clinicians and patients and indicate shifts in the norms of professional practice and clinician-patient relationships.

Conclusions: Patients and clinicians demonstrated pragmatic acceptance of remote consultations and, looking forward, a preference for a balanced 'hybrid model' of remote and face-to-face appointments. The study also highlights a need to consolidate and build on the informal learning and adaptation to remote consulting that has already taken place.