Box 2.

Summary of key themes in findings

Theme 1: The context for quality Increasing complexity and a system under strain Financial austerity and a loss of resilience across the system More complex patterns of illness and need Changing workforce and changing roles Infrastructure under strain Loss of in-person interactions among staff Theme 2: Delivering on quality (balancing benefits and trade-offs of hybrid services) Care and compassion versus efficient transactions Access and triage: matching supply with need and demand Long-term conditions: protocolised versus personalised care Addressing equity and inclusivity: mitigating the digital inverse care law