During our CSEP visits at Queen Hospital, Burton, we were impressed by their use of video consultations and how quickly they got them up and running during the pandemic.
We caught up with Consultant Haematologist, Dr Hume Ahmad to find out how he is using video consultations and if he has tips for anyone wanting to set up regular video clinics.
How are you using video consultations as part of your myeloma clinics?
I have been using video consultations for all of my clinics and appointments since June 2020.
Before the pandemic, I was looking at ways to use technology to improve the patient experience and had spoken to colleagues about using video recordings and video consultations to better support my patients. This meant the hospital asked me about using video consultations as soon as the pandemic started. Video consultations were fully operational in June 2020 and by December 2020 we had used nearly 800 video consultations for our clinic appointments in haematology.
We continued to offer face-to-face appointments where clinically required and telephone appointments for patients who were unsure about video consultations.
More and more patients prefer video consultations, not because of the reduced risk of COVID-19, but also because they are convenient and improve communications.
Which video consultation platform do you use?
My Trust uses NHS Attend Anywhere. It is a great platform that is easy for patients and their families to access and use. It is the preferred platform for NHS England.
How do you manage technical difficulties?
The video consultation platforms are very easy to use. Our user audit has found that most patients haven’t had problems using them.
If a patient has technical difficulties, I can easily switch to a telephone consultation instead.
Issues typically happen when patients are accessing the video consultation platform for the first time and to avoid this we talk them through how to connect for video appointments. We also send a patient information leaflet about video consultations with their clinic appointment letter.
What advice would you give to people wanting to set up video clinics and appointments?
Your hospital / Trust must be on board. There are three important steps to setting up virtual consultations. The first is getting approval to start video consultations. Your trust will want to make sure the platform you are using is secure and safe for patients to use. If you choose to use NHS Attend Anywhere, this should be straightforward as it is a recommended platform. The second important step is to get a budget for laptops or relevant video equipment for the consultations. Most laptops have a camera, microphone and speakers and a Trust laptop can be a quick solution.
The third step is to work with your Trust’s Patient Access team to set up a system for managing video clinic appointments.
What are the advantages of video consultations?
There are many advantages to video consultations. The most obvious advantage is that they reduce hospital visits. This was hugely beneficial during the pandemic but is also a long-term advantage for patients, especially for the elderly or those who live far or have transport issues. Video consultations also help avoid logistical problems, such as traffic jams or parking issues etc.
Video consultations also make it easier for family members to join appointments. The other day I had a call with a patient and her daughter who lives in Scotland. Had we not been able to use video consultations her daughter wouldn’t have been able to join. For me, this is an amazing benefit for patients, especially if they would normally be attending the appointments on their own.
They have also made multi-disciplinary appointments and discussions possible during the pandemic. The video consultation space lets different clinicians in different buildings or departments join one call, limiting the number of people in the room with the patient. I often dial into appointments so that the CNS can be with the patient during the consultation and spend more time with them afterwards. It also makes scheduling a lot easier.
What are the disadvantages?
Although video consultations have improved the patient experience they cannot completely replace face-to-face appointments. For instance, some patients have a clinical need to be examined in detail where they are required to attend the clinic in person.
Where possible, we also need to work around the patients and many patients need to come into the hospital for treatment or other appointments that may cause scheduling issues. On some occasions, a face-to-face appointment is the patient’s preference. And of course, there is always the risk of technical difficulties – the patient may live in an area with poor Wifi signal or there may be an equipment malfunction.
When would you not use them?
I wouldn’t use video consultations if I felt there was a clinical need for my patient to be assessed in person. Equally, I respect my patient’s wishes, if they can’t access the technology or request a face-to-face appointment.
Some people think difficult conversations should always be face to face but, during the pandemic, I found it better to have these conversations over video because you don’t need to wear masks and can see each other’s facial expressions which is very useful for effective communication. It also lets patients have more of their people with them for support because they can be in the room with them at home but may not be allowed to accompany them on hospital visits.
If you are looking for more video consultation tips you can watch our “Helping your patients get the most out of remote consultations” video.