Project 717 | Social and Ethical Aspects of Remote and Hybrid Care in the Special Allocation Scheme in general practice (SEARCH): A mixed methods study

What is the background to this research?

The ‘Special Allocation Scheme’ (SAS) is for patients who have been excluded from their GP practice after being reported for aggressive or violent behaviour. This scheme offers GP care in a secure environment, often in a practice outside these patients’ local area. The option of providing remote care is therefore necessary, but currently we don’t know whether and how this might benefit this patient group.

These patients are often excluded in lots of ways and so are not often included in research. There is currently extremely limited evidence available on who these patients are, what their potential (digital) needs might be, and how this service can best be organised for patients and staff involved. It is likely that many of these patients already experience multiple disadvantages, and it might be difficult for staff to know how best to support these patients.

What will we do?

This research aims to understand how care is provided to this patient group and their experiences of this care, with a focus on remote and in-person appointment options. We will do this using a variety of research methods as well as patient and public involvement. We will start by trying to find out how and where care for patients on SAS is currently provided through a national survey. We will explore numbers of patients on the scheme, relevant (digital) needs, and any current challenges experienced by providers. We will then take a closer look at care provided to patients on SAS through observations and interviews with patients and staff at three diverse SAS providers across the country. We will prepare for this work by involving people who are experienced in working for and with patients on SAS, as well as patients who have lived experience of exclusion. This will help to make sure that our data collection plans and materials are safe, ethical, and sensitive. We will also conduct interviews with policy and decision makers to explore how our findings relate to the way services are designed on a national level.

How will this research benefit patients?

Current and future SAS patients will benefit from this research. Direct benefits will arise from creating opportunities for inclusion in (and shaping of) research and Patient Public Involvement. The overall study findings will provide crucial evidence on the accessibility, inclusivity, and quality of services, to inform how care is delivered to excluded patients in the healthcare system. A key output will be a “best practice toolkit” created in two workshops that bring together (former) SAS patients, NHS staff, relevant charities, policy makers, and designers. We will make the evidence and resources we produce available to healthcare providers to improve SAS services.”