The Telesafe archive: creating a database of UK primary care telephone consultations

Background

In 2024, one-third of GP appointments in England were conducted by telephone. What happens during these consultations is largely unknown.

Aim

To test the feasibility of collecting recorded GP telephone consultations with linked data and consent for future research use.

Design and setting

Retrospective observational study in seven practices in South West England.

Method

Adults who had a telephone consultation at practices that routinely record calls were invited to consent to retrieval of call audio, a 4-month electronic health record (EHR) extract and a post-consultation patient questionnaire. Practice-level consent rates were analysed using regression models.

Results

Of 28 clinicians recruited, 19 GPs had consultations with patients whose recordings were retrievable, usable, and consented for future research. Of 2,053 invitations, 123 patients consented (6.0%). Consent was lower in more deprived practices (IMD 1–2 vs 9–10: OR=0.22, 95CI=0.09–0.54). Of 101 recordings retrieved, 96 were usable and 91 had consent for future research. 86/91 were linked to EHRs and 89/91 to post-consultation patient questionnaires. Mean consultation duration was 7 minutes 13 seconds; audible typing was heard in 69% (63/91). 161 problems were discussed (mean 1.77 per consultation). Most patients were happy their consultation was by telephone (96/117, 82%), although the majority reported usually preferring face-to-face appointments (68/115, 59%).

Conclusion

It is feasible to assemble a reusable archive of GP telephone consultations with linked data. However, recruitment was low using retrospective remote consent. Future work should test alternative recruitment approaches, particularly to improve patient engagement at practices serving deprived populations.

How this fits in

• Telephone consultations now account for approximately one-third of GP appointments in England, yet the interactional detail of these calls remains under-described.

• This study establishes the One in a Million Telesafe archive: 91 recorded GP telephone consultations from seven practices, linked to EHR and patient-and clinician-reported data, with permissions for research re-use.

• Feasibility was demonstrated, but retrospective, remote consent produced low participation (6%) with lower responses in more deprived practices, limiting generalisability of estimates from this dataset.

• The archive offers a platform to examine communication quality and documentation, informing service design for safe, person-centred remote primary care.