NHS England has published a new set of video consulting guides – produced by the University of Oxford – to support patients, staff and NHS trusts to implement and embed video consultations.
The collection of resources include: an illustrated A4 guide for patients in English; illustrated guides for patients in Arabic, Bengali, Bulgarian, Italian, Polish, Punjabi, Romanian and Urdu; and separate illustrated guides on video consultations for both NHS staff and trusts.
The guides for patients include visuals and clear text that explains the benefits of choosing video consultations – such as saving time or money – and outlines that the service is ‘safe and secure’.
The publications also explain the type of equipment and environment required for the consultations, followed by clear text and picture instructions on how to set up and start the video call, how to take part in the consultation, and how to end it.
Similarly, the guides for clinicians and staff also focus on the reasons for undertaking video consultations with patients, as well as tips around preparing for, starting, communicating during, and closing down a video consultation.
Advice includes sending patients emails, text messages, or letters, before any consultation to impart instructions, as well as having two screens – one for talking to the patient and another for taking notes – and testing the equipment at the start of every day.
Tips for communication during the consultation involve informing patients of when you’re taking notes and instructing patients to use their screen’s camera to show areas of pain.
In the illustrated guide for organisations – NHS trusts and foundation trusts – the document covers key concerns and questions, such as: when video consultations are appropriate; how a clinic can set up for consultations; how to conduct high-quality video consultations; explaining how patients conduct consultations at their end; and the research that backs up the use of video consultations in certain circumstances.
Notable points within the guide for organisations include that non-COVID-related consultations are appropriate for routine chronic disease check-ups, administrative reasons, counselling, triage when a phone call is insufficient, any condition where the travel trade-off favours staying at home, or if deaf and hard-of-hearing patients can lip read.
Times when its considered inappropriate to use video consultations are when assessing patients with ‘potentially serious, high-risk conditions likely to need a physical examination’, when ‘an internal examination (e.g. gynaecological) cannot be deferred’, or when co-morbidities or anxieties affect a patient’s ability to use the technology.
Setting up workflows, training, and piloting, are also covered in the guide, and involve recommendations such as contingency plans if video links fail, using appointment codes, scheduling for both planned and unplanned consultations, and test calls.
In a research summary at the end of the document, the thinking behind the guides and the recommendations are outlined, explaining that while there is ‘limited research on the use of VC in acute epidemic situations’, a ‘large body of research, most of which has been done in hospital outpatient settings, suggests that video consultations (VCs) using modern technologies appear broadly safe for low-risk patients’.
A number of organisations – such as The Health Foundation, NIHR, heif (Higher Education Innovation Fund), and the Wellcome Trust – were among the funders. While, contributors include the NHS, Barts Health NHS Trust, Near Me, and Design Science.
The guides can be accessed as a collection, here. Whilst online resources are available at phc.ox.ac.uk/research/resources/video-consulting-in-the-nhs.
