Report into remote consultations published

Health Innovation North West Coast has published a wide-ranging report, commissioned by NHS England and Improvement North West, into the use of remote consultations for outpatients.

The use of remote consultations has been highlighted by the pandemic as an alternative to face-to-face consultations.

Service providers have adopted such consultations – often by phone but sometimes by video – because they support social distancing and home-working and reduce footfall and infection risk in busy outpatient departments.

The report says remote consultations can deliver significant benefits to patients in the right circumstances.

Conclusions include:

• There is a common desire amongst health professionals to use remote consultations in outpatient appointments at the right clinical time and for the right patient group
• Many such consultations are done by phone. While video consultations are often more effective, there is an acknowledgement that this option is harder to do
• Several significant changes to procedures and processes must take place for remote consultations to be delivered to a consistently high standard and be sustainable

The report, Outpatient remote consultation: an appreciative enquiry, is the product of 40 in-depth conversations with 15 clinical teams in the North West Coast.

The work was sponsored by the Regional Medical Director of NHS North West, David Levy, and completed for the NHS England North West Outpatient Transformation team.

It explores the benefits that remote consultations can deliver, the barriers to its more widespread adoption and enablers for increased usage. The report also includes an innovation horizon scan, which looks at digital solutions that could underpin the necessary processes to ensure effective remote consultation appointments.

It also explores some video platform functionality enhancements, which have been used in North West procurement specifications.

Peter Jenkinson, Chief of Digital Operations at NHS England North West, said: “Health Innovation North West Coast team has carried out a piece of work that few people are in a position to do, and it has given us valuable insights into how to effectively develop the use of remote consultations in outpatient services.

“I’m hoping it will act as a spur and support tool for people in the system to think about how they can best use remote consultations going forwards.”

Carole Spencer, Executive Director for System Partnerships at the Innovation Agency, said: “One of our roles is to identify innovative ways of working. We know that remote consultations have seen rapid uptake during the pandemic but that adoption is now stalling. We wanted to support the system to understand how best to progress adoption at pace.

“We’ve spoken to a wide variety of clinical professions from the front line to learn what is working well, the benefits and how we can best tackle this large-scale system change.”

The NHS Long Term Plan, published in January 2019, sets out the ambition to increase the use of remote consultations to improve patient experience and boost digital pathways.

However, the report points out there are significant barriers to the adoption of remote consultations.

These include some process and operational changes that involve several teams and require a significant investment of time. Providing the capacity to undertake this is crucial.

The report also identifies a need for strong leadership across trusts and for remote consultation to be viewed as an operational and clinical priority. It is essential that the cultural changes that go alongside large-scale change are also recognised.

The report emphasises that patients should always be free to choose the type of appointment that they prefer, and that not all patients have equitable access to this method of care.

It identifies several next steps that should be taken to ensure the potential patient, workforce and productivity benefits are realised.

These include:

• Connecting with existing programmes to create large-scale change.
• Taking a broad, end-to-end perspective: remote consultation complements other technologies and all factors should be considered when transforming the pathway
• Involving the patient at all stages, meeting their needs and offering options

The report is the result of an appreciative enquiry, a method of tackling organisational change by identifying and spreading what already works.

You can read the full report here.