Ethics approval and consent to participate
WEST
Provisional ethics approval was originally obtained from the NHS Health Research Authority, Yorkshire & The Humber—Leeds West Research Ethics Committee (20/YH/0261) on 14 August 2020, followed by full approval on 2 September 2020. Practices which supported the study by promoting the Germ Defence website did in doing so and have been deemed to have given implicit consent to participate. Individual patent consent was not required as the study required no deviation from usual care and clinical outcomes were assessed from anonymised routinely collected NHS patient record data. Consent was assumed from Germ Defence website usage and acknowledged in the website privacy policy.