Traditional models of outpatient care are not always aligned to the needs of patients and can be difficult for them to access. This has led to high rates of non-attendance at appointments and poor patient engagement, resulting in poor health outcomes and greater use of emergency care, plus rising costs. With increasing multi-morbidity, people living longer with complications and care being more multi-disciplinary, care models need to be more flexible and responsive. 

Research has shown that using remote video outpatient consultations rather than face-to-face review with patients in hospital has the potential to address some of these issues. However, implementing such services within routine practice in the NHS is challenging. 

Barts Health NHS Trust has been exploring the use of video consultations via Skype, and the impact on patient attendance rates, patient satisfaction and efficiency savings. They have developed significant expertise in the area and have produced standard operating procedures, information governance and technical guidance documents, and protocols for setting up and running virtual clinics. 

Through this Scaling Up Improvement project, the team at Barts Health will create a virtual consultation unit. It will facilitate local spread and national roll-out of virtual consultations by supporting sites who are interested in using this type of consultation. The unit will provide: clinical, technical, management and administrative expertise; demonstration clinics so that teams can observe virtual consultations in real time; workshops; and an online forum and resource directory. The project team’s ultimate aim is to create a national network of sites who can learn from each other’s experiences.

Working with national-level decision-makers, the project team also aims to develop a national policy around the use of video consultations, including tariff, technology, governance and staff training. The team will also work with a technology provider to test the various options for web consultations.

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