Background: Remote consulting was introduced quickly into UK general practice in March 2020 as an emergency response to Covid-19. In July 2020, ‘remote-first’ became long-term government policy. Aim: To explore how this change was portrayed in national newspapers and how depictions changed over time. Design and setting: We undertook a thematic analysis of newspaper articles referring to remote GP consultations from two time periods: March-May 2020 and July-August 2020. Method: Articles were identified through, and extracted from, LexisNexis® Academic UK. A coding system of themes and narrative devices was developed and applied to the data. The analysis was developed iteratively, amending the coding structure as new data were added. Results: Remote consulting was widely covered in newspapers. Articles in period 1 depicted it positively, equating digital change with progress and linking novel technological solutions with improved efficiency and safety (e.g. infection control) in a service that was overdue for modernisation. Articles in period 2 questioned the persistence of a remote-first service now that the pandemic was waning, emphasising (for example) missed diagnoses, challenges to the therapeutic relationship, and digital inequalities. Conclusion: As the first wave of the pandemic came and went, media depictions of remote consulting evolved from an ‘efficiency and safety’ narrative to a ‘risks, inequalities and lack of choice’ narrative. To restore public trust in general practice, public communication should emphasise the wide menu of consulting options now available to patients and measures being taken to assure safety and avoid inequity.
During crises (major events characterised by uncertainty, urgency and threat), society must make sense of rapidly unfolding events. This happens mainly through narrativising—depicting a setting, characters and a meaningful sequence of events and actions unfolding over time. In the early months of the pandemic, UK general practice shifted from face-to-face consultations to a remote-by-default model (telephone, video or e-consultation). This shift was initially widely accepted by press and public, but support waned after a politician declared that the change would be permanent. We invoke Burke’s dramatistic pentad of act, scene, agent, agency and purpose to theorise findings from a detailed analysis of media coverage of the remote-by-default policy and reactions to it. We consider the 12 weeks from March to June 2020 (first lockdown, when remote-by-default services had just been introduced) and 1 week from late July 2020 (following the ministerial announcement). The initial introduction of remote consulting had strong narrative coherence in which all parts of the pentad were balanced: scene (a deadly virus threatening the country) aligned with act (lockdown, including avoiding face-to-face appointments unless essential), agents (the National Health Service and digital technology as heroic macro-actors), agency (general practitioners ‘deployed’) and purpose (to control the pandemic). The later period, however, was characterised by a mismatch between scene (a country emerging from lockdown and resuming normal life), act (imposition of the remote model), agent (a politician known for his enthusiasm for technology), agency (top-down directive) and purpose (modernisation). Whereas media narratives in the first period aligned with the genre of heroic adventure (suggesting a worthy battle, bravely fought), those of the second had characteristics of farce (something both comic and grotesque). We conclude that close reading of media narratives may surface potential misalignments between policy decisions and the context in which they must be implemented.
Background: Following a large-scale, pandemic-driven shift to remote consulting in UK general practice in 2020, 2021 saw a partial return to in-person consultations. This occurred in the context of extreme workload pressures due to backlogs, staff shortages and task shifting. Aim: To study media depictions of remote consultations in UK general practice at a time of system stress. Design and Setting: Thematic analysis of national newspaper articles about remote GP consultations from two time periods: 13–26 May 2021, following an NHS England letter, and 14–27 Oct 2021, following a government-backed directive, both stipulating a return to in-person consulting. Method: Articles were identified through, and retrieved from, LexisNexis. A coding system of themes and narrative devices was developed iteratively to inform data analysis. Results: 25 articles reported on the letter and 75 on the directive. Newspaper coverage of remote consulting was strikingly negative. The right-leaning press in particular praised the return to in-person consultations, depicting remote care as creating access barriers and compromising safety. Two newspapers led national campaigns pressuring the government to require GPs to offer in-person consultations. GPs were quoted as reluctant to return to an “in-person by default” service (as it would further pressurise a system already close to breaking point). Conclusion: Remote consultations have become associated in the media with poor practice. Some newspapers were actively leading the “war” on general practice rather than merely reporting on it. Proactive dialogue between practitioners and the media might help minimise polarisation and improve perceptions around general practice.
Previous scholarship suggests that elite media have tended to pay little attention to the adverse environmental impacts associated with meat consumption and production. Through content analysis of 116 articles from 2019, published on eight popular online news sites consumed by a wide range of demographics in the UK, including lower-income groups (the sector most likely to eat meat), we identify common anti-meat and pro-meat environmental narratives, solutions and recommendations, and the dominant sentiment towards both meat consumption and production. We observed a significantly greater presence of anti-meat consumption and/or production narratives than pro-meat. Over half the articles showed anti-meat consumption sentiment, with only 5% predominately in favour. 10% were against unspecified or industrial production practices, 28% were against industrial-scale farming but supported sustainable methods; and none were entirely in favour of the meat industry. These findings are reflected in the dominant recommendation, present in over 60% of articles, to eat less meat. Our results add substantially to previous media research, particularly showing the increased volume of coverage of the meat-environment nexus, varying levels of contestation around meat eating, and the division of responsibility between consumers and industry.
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