Scaling up virtual consultations across the NHS Implementing, evaluating and sustaining improvements

Led by Barts Health NHS Trust, in partnership with the Nuffield Department of Primary Care Health Sciences at the University of Oxford.
Aimed to increase the use of outpatient video consultations to improve patient attendance rates and outcomes, and provide more patient-centred care.
Created a virtual consultation unit within Barts Health and formed a national network of partner sites across diverse patient populations.
Ran between November 2017 and November 2020.

Traditional models of outpatient care are not always accessible to patients or aligned to their needs, resulting in missed appointments, poor health outcomes and greater use of emergency care. Replacing face-to-face hospital appointments with remote video outpatient consultations offers the opportunity for a more flexible and responsive approach.

Having explored the positive impact of video consultations on attendance rates, patient satisfaction and efficiency savings for around 10 years, the Barts Health NHS Trust team decided to use their expertise to facilitate wider roll-out with a network of local and national sites that could learn from each other’s experiences.

To achieve this, they set up a ‘virtual consultation unit’ to support sites with resources, policy making, technical options and training. Uptake of virtual consultations increased in a range of clinical specialties within Barts Health, and across diverse patient populations at three partner sites – Oxford University Hospital, Northumbria NHS Foundation Trust, and Norfolk and Norwich University Hospitals NHS Foundation Trust.

Following an evaluation of technology platforms for video consultation, the ‘Attend Anywhere’ software was implemented, and extensive generic training resources and guidance documents for clinicians and patients were produced. Patient feedback on virtual consultations was positive overall, although the reliability of technology was identified as an area for improvement.

This work effectively supported the rapid scale-up of video consultations across the NHS during the COVID-19 pandemic, clearly demonstrating opportunities for wide-ranging transformation of outpatient pathways. A follow-on study focusing on the implications of COVID-19 for the sustainability of video consulting is underway and will investigate the resilience of this service model in the immediate and longer term.