Video consultations. What’s needed now?
Frontline insights on how to build from the rapid roll-out of on-screen patient consultations
On this page
During the COVID-19 pandemic, improvement professionals shared their real-time learnings about rapid implementation of video consultations for patients. A short report summarises the key enablers to get up and running, and the areas to build on to secure an effective and sustainable remote service.
Project background
The rapid implementation of video consultations was a remarkable story of NHS innovation during the early stages of the COVID-19 pandemic. It brought promising signs, and notes of caution, for how video may be used to deliver health and care in the long term.
The situation has changed at lightning speed. Setting up these consultations previously took years and was rarely successful.
The huge potential and value of video consultations highlighted the importance of framing implementation as an improvement project, not just technical exercise. Staff buy-in, cultural dimensions of change and ongoing measurement and iteration all need consideration.
What we did
In the first months of the COVID-19 pandemic we invited frontline staff involved in implementing virtual consultations to share their experiences. Between March and July 2020, we heard from 50 people on their approach, challenges and success. Reflections were logged fortnightly and the common themes were explored in two webinars.
As we share more positive experiences and reflect on how challenges would be different in a face to face environment, the clinicians are becoming more open and receptive to persevering with video consultations.
The Q team analysed the themes from the learning logs and published a fortnightly summary blog to help inform ongoing implementation. We also synthesised the results with other internal and external sources, including from those leading this work at a national system level.
Explore the learning
A report and infographic summarise what we heard were the common enablers for rapid implementation during the first few months of the pandemic. The resources also set out the ongoing considerations for establishing video consultation as an effective service model.
Common enablers
- An effective mix of central and dispersed leadership, with autonomy and agency at a local and service level encouraging ownership and innovation.
- Action at all levels of the system that unblocked previous barriers.
- Clarity and a shared purpose around patient and staff safety created unity to support service change.
- Shared learning and experimentation led to iterative improvement.
Ongoing considerations
- Understand and address inequalities that affect access so that the future model of care is equitable.
- Redesign pathways to embed remote care models where and when appropriate.
- Develop the infrastructure to meet the needs of different consultations.
- Prioritise staff wellbeing, support and training as roles transform.
- Gather evidence on the long-term impact of the use of video consultations.
- Support shared learning to build sustainable models of care.
- The Health Foundation. Building the evidence base on video consultations: three priorities for further research (26 August 2020)
- The Health Foundation. Three key quality considerations for remote consultations (4 June 2020)
- Depressed lower income housebound older adults in the US (Skype, primary care)
- Young people with spina bifida in the US (Skype, primary care)
- Chronic knee pain management in Australia (Skype, primary care)
- General practice in Lothian, Scotland, UK (Attend Anywhere, primary care)
- Pharmaceutical care, Scottish Highlands, UK (Attend Anywhere, primary care)
- Diabetes outpatients in Newham, UK (Skype, secondary care)
- Paediatric Chronic Fatigue therapy in the West of England, UK (Skype, secondary care)
- Orthopaedic procedures follow up in the US (Skype, secondary care)
- Families with new born children in Sweden (Skype, secondary care)
- Oculoplastic outpatients at Moorfields, UK (Attend Anywhere, secondary care)
- Triage of dermatology referrals in Portsmouth, UK (Attend Anywhere, secondary care)
- Plastic surgery trauma service in Salisbury, UK (Attend Anywhere, secondary care)
- Scar clinics in Lincolnshire, UK (Attend Anywhere, secondary care)
- Men post radical prostatectomy in the US (Unspecified application, secondary care)
- Breathlessness management in COPD patients in the US (Skype, setting unspecified)
- Acceptance based behaviour therapy for people with social anxiety disorder in the US (Skype, therapist-led, participants recruited from college anxiety clinic)
- Psychotherapy for people with medically unexplained pain in Iran (Skype, multiple settings)
- Adolescents with poorly controlled Type 1 diabetes in the US (Unspecified application, setting and role of professional unclear)
- People with poorly controlled Type 2 diabetes in Denmark (Unspecified application, nurse led, patients recruited from both hospitals and health centres)
- Specialised palliative care in Denmark (Unspecified application, involved community nurses and a specialised palliative care team)
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