Remote Access to Primary Care: Theorising 'Care Navigation'.

The use of digital technology to facilitate remote access to care can increase inequalities, especially for people with complex health and social care needs. Care navigation, human input to support access, is one potential solution. We aimed to understand how care navigation is practised in the context of increasing remote access in primary care in the United Kingdom. We used the concepts of social navigation and infrastructure to analyse empirical data from a study of care navigation in general practices in 2023. Our dataset included interviews with 18 care navigators. We focused on people with additional social care needs including those being homeless or insecurely housed, refugees, asylum-seekers and vulnerable migrants, and older people requiring residential or voluntary social care and support. Our data showed the importance of people working outside of health services in a range of organisational settings. These findings allowed us to extend the concept of care navigation from a signposting and gateway role to a set of distributed sociotechnical practices. We conceptualised the problem of access as difficulty in connecting to the infrastructure of primary care. Care navigators' relational work, therefore, offered 'nodes' in the network of primary care: opportunities for interactions that supported connection.