The 'One in a Million' study: creating a database of UK primary care consultations

Background: Around one million primary care consultations happen in England every day. Despite this, much of what happens in these visits remains a “black box”.

Aim: To create an archive of video-recorded consultations and linked data based on a large sample of routine face-to-face doctor-patient consultations with consent for use in future research and training.

Design and setting: Cross-sectional study in 12 General Practices (West of England)

Method: Up to two general practitioners (GPs) from each practice took part in the study. Over one to two days, consecutive patients were approached until up to 20 eligible patients for each GP consented to be video-recorded. Eligible patients were 18+ years, consulting on their own behalf, English-speaking and with capacity to consent. GP questionnaires were selfadministered. Patient questionnaires were self-administered immediately pre-consultation and post-consultation and GPs filled out a checklist after each recording. A follow-up questionnaire was sent to patients after 10 days, and data about subsequent related consultations were collected from medical records 3 months later.

Results: 421 (86%) of 485 patients approached were eligible. 334 (79%) eligible patients consented to participate and 327 consultations with 23 GPs were successfully recorded (307 video, 20 audio only). The majority of patients (n=300, 89%) consented to use by other researchers, subject to specific ethical approval.

Conclusion: Most patients were willing to allow their consultations to be video-recorded, and with very few exceptions, to allow recordings and linked data to be stored in a data repository for future use for research and training.