The ‘One in a Million’ study: Creating a database of UK primary care consultations.

Around one million primary care consultations happen in England every day. Despite this, much of what happens in these visits remains a “black box”.
To establish the feasibility of creating an archive of video-recorded consultations based on a representative sample of routine face-to-face doctor-patient consultations and collecting linked data, gaining consent for use in research and training.
Design and setting:
Cross-sectional study in 12 General Practices (West of England)
Up to two general practitioners (GPs) from each practice were invited to video-record up to 20 consecutive patients over one to two days. Eligible patients were 18+ years, consulting on their own behalf, English-speaking and with capacity to consent. GP questionnaires were self-administered during the data collection period. Patient questionnaires were self-administered immediately pre- and post-consultation and GPs filled out a checklist after each recording. A follow-up questionnaire was sent to patients 10 days after the index recorded consultation, and data were extracted from medical records data after three months.
Between July 2014-April 2015, 421 (86%) of 491 patients approached were found to be 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.
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.