Dr Ian Jackson, Medical Director and Clinical Safety Officer at Refero.
This time last year, I said that teleconsultation will come of age in 2020 and will be used increasingly across multiple health sectors. While I failed to predict some of the more pressing events of the year that was, there’s no doubt that video appointments became a focal point in primary and secondary care delivery, as health professionals turned to tech in the fight against Covid-19.
When speaking to my front line colleagues, I’m hearing that virtual appointments have acted as a lifeline, particularly when the UK went into the first and second national lockdowns.
Adopting video is something that St Helens and Knowsley Teaching Hospitals NHS Trust (STHK) came to independently some time ago. A successful two-year pilot saw the Trust trial video consultation technology with its Cancer Drains Outreach and Stroke Review services. The pilot allowed patients to become digitally connected with clinicians and enabled continual engagement via video consultation and messaging through a web portal, smartphone or tablet.
As we continue to navigate this pandemic, STHK is minimising footfall in the building by utilising video consultation technology.
According to NHSx, over two million video consultations have now taken place in secondary care. A survey conducted in June for the British Medical Association showed that 95% of GPs were offering remote consultations and 88% wanted to see greater use of them continue in the future. NHS Digital estimated that half of the 102 million appointments from March to July 2020 were by video or phone call.
Yet, according to its appointments data for October, 60% of GP appointments took place face-to-face, 35% were held over the phone, and just 0.49% were via video or online. The option may be there for many, but we can see there is still significant work to be done to encourage most doctors and patients to try a different approach.
At the time of writing, our hospitals are close to full capacity, and England is nearing the end of its third national lockdown. Communications technology remains a vital step forward in tackling this virus, particularly in intensive care. It is far too risky for family and friends to visit patients in ICUs. At present, most ICUs rely on apps like Facetime or Skype to connect with families of their patients. This is concerning, as governance and security considerations haven’t been adhered to, as these apps haven’t been designed for sensitive medical use. Better communication would not only benefit the mental health of families anxious for news but also encourage the patient on their road to recovery, or sadly help families understand better if their loved one didn’t pull through.
At STHK, departments have recorded that 100% of its patients who’ve had virtual appointments have said this method is their preferred choice. Video consultations have helped to determine that 70-80% of the time, a hospital visit isn’t required.
Secondary care has come under criticism in recent months for postponing many elective clinics. It is crucial to reduce footfall into hospitals, and delays are unfortunately unavoidable for the foreseeable future. But I’d like to remind NHS colleagues that there are patients who can be supported at home and teleconsultation adds to hospitals’ ability to manage these.