An expert guide to video consultation

Video consultation offers considerable potential for alleviating pressures on stretched GP practices, claims Marc Schmid, director at digital specialists Redmoor Health. In this expert guide he explains how practices can safely and securely introduce video consultations, benefitting both patients and staff

The technology to deliver video consultations has been around for years, with many of us using online platforms like Skype to stay in touch with friends and relatives. There’s huge potential for this technology to be used in general practice, providing patients with a modern, accessible method of interacting with a clinician. Unfortunately, it isn’t as simple as picking up a device and using Skype.

When considering introducing video consultations it’s tempting to begin by looking at the technology platforms you can use, but this is a mistake.

Before jumping into the tech, the first thing you need to consider is information governance. How are you intending to offer video? Which scenarios will it be deployed in? What infrastructure and training do you have in place to support its introduction?

Asking yourself these questions will help to ensure that you develop a solution that’s robust, safe and secure. It will also ensure that you have the technological capacity to deliver it; you certainly don’t want to offer video consultations, only to find the connection keeps dropping out.

Every practice needs three key documents in place before introducing any form of video consultation: a privacy impact assessment, a standard operating procedure and clinical protocols. These documents will help set out how you are going to use video and ensure that, if challenged, you have deployed video in your practice safely and securely.

You will also need to run your plan past your Caldicott Guardian and notify your medical indemnity provider. It is always helpful to identify a clinical lead for video within the practice as well.

The next step is to carefully plan how you intend to introduce video consultations. The documents mentioned above will help you get to this point, but the decisions on how and where to use video consultations should be led by clinical need. Here are some examples of how practices are using video consultations to improve the patient experience and better manage demand.

Connecting GP practices to care homes

A Staffordshire GP practice is connected to local care homes using mobile devices. A total of 28 care homes have been equipped with the necessary technology as part of the programme, with the devices being used for medicine-use reviews, ad hoc consultations, palliative care reviews and virtual ward rounds.

It isn’t just the GPs who are using the system; nurse practitioners are increasingly making use of the equipment to contact patients remotely. Recently, mental health nurses were added to the programme, enabling them to offer remote consultations to dementia patients.

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The strength of this approach is that the control remains with the practice, remaining in command of the technology and how it’s used. The programme has required some workforce training on both sides, but has proved very popular because of its simplicity and effectiveness.

GP retention

Like many other areas, Lancashire and South Cumbria Integrated Care System (ICS) is eager to retain as many GPs as possible who might be considering leaving practice. To enable more flexible ways of working, the ICS is developing a remote consultation programme to support GPs who are eager to stay in practice but are struggling with the demands of travel or the pressure of long hours.

Using video consultations, GPs can provide support and advice to home-bound patients or those with mobility issues or disabilities. As well as improving staff satisfaction and retention, the ICS hopes video consultations will provide much-needed relief for front-line care providers.

Supporting patients with long term conditions

Respiratory nurses at Ashley Practice, Staffordshire, have been using video consultations with asthma patients, targeting those who struggle to attend reviews. In one example, they recently used Skype to carry out an urgent review with a farmer while he was out working.

In Burton on Trent nurses have been supporting patients with complex needs with video-observed therapy. Logging on to a video platform, they can watch patients take their medication, increasing adherence and reducing the need to chase patients who fail to attend appointments.

Patients with long-term conditions naturally need more engagement with primary care; using video consultations can be an effective way of managing their care while reducing the demand for clinic appointments.

Devil in detail

These examples show how the targeted use of video consultations can improve access to clinical support, particularly across a large geographical area. It can also reduce the time spent travelling for busy healthcare professionals.

We encourage every practice considering introducing video consultations to give it careful thought and planning; your practice needs to protect itself by adhering to information governance requirements. Be confident, also, that the technical infrastructure is in place, for both you and the person at the other end of the camera, and ensure that you have provided adequate training and support for all staff.

By investing time in establishing the solid, and some would say dull, fundamentals you can experience the transformative power of this technology.

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