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Video consultations can improve both access to GPs and patient experience

The NHS should make better use of video consultations because they can boost patient access and save time and money for both patients and doctors, concludes preliminary research presented at this year’s International Forum on Quality & Safety in Healthcare in Kuala Lumpur (24-26 August).

Current challenges in the UK medical workforce are well known, making accessing a GP in a timely manner difficult, say the researchers (including myself) from Chelsea and Westminster Hospital NHS Foundation Trust and the Department of Primary Care and Public Health at Imperial College London.

The estimated total number of consultations in England rose from 224.5 million in 1995-6 to 303.9 million in 2008-9, with an average wait for a GP appointment of two weeks in some parts of the country. In light of these difficulties, weset up a trial video consultation clinic in two busy London general practices, with lists of nearly 10,000 patients.

Twice weekly video clinics were set up for 23 months to gauge the impact on patient access and to assess whether these could work alongside or possibly replace conventional face-to-face appointments. Initial doctor concerns included security and governance issues, while the absence of a physical examination worried some patients.

In all, 192 video consultations took place over the trial period. Only three patients didn’t attend their appointment compared with 576 no shows for face-to-face appointments over the same period.

Based on average appointment costs, this is a potential cost saving of £61,884 for just these two practices. We suggested that remote accessibility of video consultations and the reduction in travel time and delays might explain the findings.

The trial results prompted the practices to regularly offer video consultations. Traditional face-to-face appointments were available for patients with more long-term or complex health needs, to ensure that those needing more time with GPs accessed services appropriately.

“Clearly video consultations have a place in a health care system to improve access to primary care,” says the lead author Dr Mateen Jiwani. They offer an additional visual sensory component to consulting compared to telephone appointments, enabling clinicians to make safer decisions and carry out more effective triage, he added.

“With an increase in technology usage and remote socialising being the everyday norm, communicating with your doctor remotely will become a mainstay of future medical practice and self-care,” Dr Jiwani concludes. Evidently, the demand is there, he suggests.

Source: Jiwani M, Majeed A, Tahir A. The doctor will see you now....online. Presentation at the International Forum on Quality & Safety in Healthcare, 2017.

Read the news reports from Onmedica and the BMJ.

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