I-ACT Study - Improving access to primary care for vulnerable older people
Some people find it particularly difficult to book an appointment with a GP or nurse at the GP practice or get suitable transport. The I-ACT study is the first step as we aim to gather important information about how to plan and run a larger study.
The study is about helping people over 65 years old who might have difficulties with the booking system or transport to the GP practice. There will be four GP practices in this study; three will be supported to find ways that may make it easier for patients to obtain appointments and travel to and from the practice and one will be asked to carry on as usual. The four GP practices that will take part are – Hoveton and Wroxham Medical Centre, Bridge Street Surgery (Downham Market), Cromer Group Practice and Mattishall Surgery. We have not yet allocated which of these practices will be supported to improve access and which will carry on as usual. The allocation will take place after patients have been recruited.
What types of patients are we looking for?
As this study is about helping people who find it difficult to get to or see a GP or nurse at their surgery, we are only looking for people who do not have good access to a car in their immediate household. For example people who rely on a lift from friends or family, public transport, taxis, walking, cycling or community transport to get to the surgery. Unfortunately we’re not able to include people with dementia or major memory problems, which would prevent them from consenting or completing questionnaires, or people who can’t speak English.
We will recruit 10 patients from each of the 4 GP practices on a first-come first-served basis. The four GP practices in this study will be randomly split into two groups; three to be in the intervention group and one in the control group. GP practices in the intervention group will be supported by researchers to improve their booking system and transport. Each practice will be able to choose themselves how they do this. The practice in the control group will be asked to carry on as usual.
What will it involve for patients?
We will first meet with you, either at home or a convenient place, to answer any questions you may have and ask you to complete a consent form. At this meeting the researcher will ask you to fill out a questionnaire that should take about 20 mins. Then once your practice has been assigned to either the control or intervention group, information will be collected for a period of six to nine months. Over that period every time you try to book an appointment or attend an appointment at the surgery we will ask you to fill out a short questionnaire and send it back to us. We will give you paper copies of the questionnaire and envelopes that are already stamped and addressed, so that you can return the questionnaire to us by post, free of charge. We will ask the practice every month if you’ve had any appointments and send you a reminder in case you’ve forgotten to complete the questionnaire for us. After about six to nine months we will ask you to complete a final questionnaire.
Towards the end of the study we will want to speak to two patients from each GP practice for about 1 hour to hear their experiences. We will send you a letter with more information closer to the time. You can choose at that point if you want to take part in the interview.
Who is organising and funding the research?
The research is funded by the National Institute for Health Research (NIHR). The study has been reviewed by the Research Ethics Committee (Ref: 16/NE/0424). Patient and public representatives have been involved at all stages of the development and review process. The research is sponsored by the University of East Anglia. The research is supported by Norfolk and Suffolk Primary and Community Care Research Office.
When will is start and finish?
We hope that practices will start sending invitation to patients in April 2017. Those who want to take part will be contacted in May, June and July 2017. Practices allocated to the intervention group will then have three months to develop their service (August to October 2017) and then there will be six months of running the service (November 2017 to April 2018). So we expect the study to run from spring 2017 to spring 2018.
Who is leading the research?
Dr John Ford is leading the research, along with an experienced team including Prof Nick Steel, Prof Andy Jones, Prof Tom Shakespeare, Prof Ann Marie Swart, Dr Allan Clark, Prof Garry Barton, Dr Erika Sims and Dr Geoff Wong.
John Ford (researcher)
Tel: 01603 591743
Postal address: Norwich Medical School, University of East Anglia, Chancellors Drive, Norwich, NR4 7TJ