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Scaling up video consultation capabilities in the NHS

In this blog NHS England and Improvement’s Hugh McCaughey and Moorfields Eye Hospital NHS Foundation Trust’s David Probert provide an update on the national drive to roll out video consultation systems. Read more on the support now being made available for the NHS to rapidly scale-up remote consultations.

You’ll be all too aware that the recent outbreak of COVID-19 is placing unprecedented strain on the NHS and will continue to do so over the coming weeks and months. Digital and technology solutions have a key role to play in our response, with telephone, video and online tools helping the NHS to provide safe and effective care while reducing face-to-face appointments. The effective deployment of video consultation tools in secondary, as well as primary, care will help not only to minimise the risk of transmitting COVID-19 but can also enable clinical staff to care for patients from home should they need to.

Transforming outpatient appointments through video

NHS England and NHS Improvement, together with NHSX, have accelerated work to transform outpatient appointments - an NHS Long Term Plan commitment - by rapidly scaling up video consultation capability within NHS trusts and foundation trusts. To encourage fast uptake, we have procured a national licence to a video consultation platform, Attend Anywhere, fully funded for all NHS trusts and foundation trusts for 12 months. Attend Anywhere is one of several video consultation platforms and we’d encourage providers to use whichever works best for them.

Moorfields Eye Hospital NHS Foundation Trust has been conducting video consultations since February this year, as part of NHS England and NHS Improvement’s national pilot trialling video consultations for outpatient appointments. Using the Attend Anywhere platform, we’ve seen very positive results with the patients involved welcoming video consultations as they get the care they need wherever is convenient to them, reducing the challenges of accessing expert care from distance. Our clinicians have also told us they find the platform incredibly easy to use, and as it is web browser based, it works on multiple devices which greatly supports our 30-site network model of care. The system is also reported as being very intuitive.

In light of the COVID-19 outbreak, we’re now rolling out the technology to more of our outpatient services. We’ve shown this can be done at pace, with our Moorfield’s Rapid Access team in Croydon seeing large numbers of patients within one week of learning about the Attend Anywhere platform. We’ve also started triaging our accident and emergency (A&E) patients by utilising our clinicians who are self-isolating to make assessments on whether or not a patient needs to attend our emergency site.

The ability to use video consultations has been hugely valuable as we work to mitigate the impact of COVID-19 on our services and provide expert support to our patients.  We encourage all of our NHS colleagues to consider how they can use video consultations to support their COVID-19 response, in any capacity, and how they can embed this practice.

Support available for implementing video outpatient consultations

Up to £20,000 is available to NHS trusts and foundation trusts to spend on hardware needed to rapidly implement video consultations, regardless of which video consultation platform they choose. A package of training and support materials is also available through NHS England and NHS Improvement’s regional teams. This includes guidance on using remote consultations in secondary care, a nationally assured Data Protection Impact Assessment (DPIA) template and a support helpdesk. NHSX has also produced helpful information governance guidance around the use of video consultations in all care settings.

Success with online and video consultation in primary care

Online and video consultation systems have been rapidly implemented across primary care. These are proving helpful for both staff and patients. Our focus in this area is increasingly on how we support both patients and general practice staff, to make sure they can get as much benefit as possible from these systems. We encourage general practice staff to view the suite of guidance materials available on the NHS England and NHS Improvement website, and to watch this YouTube video with Dr Minal Bakhai with advice and help for staff to digitally triage all patients using their online consultation system.

NHSX has also launched a new public campaign, Health at Home, on how citizens can access non-emergency NHS services from home during the COVID-19 pandemic. Messages and videos include: how to access GP services, how to have a video consultation and how to order repeat prescriptions. Messages feature across social media channels and all partners can use the campaign toolkit on Public Health England’s website to share the campaign across their channels.

The future

While we’re working at pace to support the system to adopt new technology at this time, we’re also considering how we can embed this practice long term. We have seen many examples that can and should endure post-COVID-19. 

Work is underway to explore the feasibility of using video consultations with some NHS 111 patients. Indeed, this is already being done in some areas; initial testing indicates very positive outcomes for staff, patients and the system. NHSX is leading more work in this area to consider how larger scale deployment might work.

The value of group consultations in supporting patients with long-term conditions has been widely recognised. Due to the outbreak of COVID-19, the focus is now on how video can be used to enable group consultations to continue.

These projects, along with the work we’re doing to roll out video consultations in secondary care, will be truly transformative. Embedding video consultations into everyday practice will deliver huge benefits to patients as well as improvements to how we deploy our clinical resources. We encourage all health and care professionals to embrace and engage with this change.

For more information on using video consultations in secondary care during the COVID-19 pandemic, visit NHS England and NHS Improvement’s website.

Hugh McCaughey is director for improvement at NHS England and NHS Improvement. David Probert is chief executive of Moorfields Eye Hospital NHS Foundation Trust, and lead of an NHS taskforce supporting acute providers rapidly scale up their remote consultation capabilities.