Learning from remote consultations in general practice

Date published:

NHS Resolution recently assisted research teams from the Universities of Oxford and Plymouth and the Nuffield Trust to identify learnings and effective approaches from primary care remote consultations undertaken in general practice. This was achieved by supporting the analysis of claims data, the findings of which are being shared in a virtual forum on 27 March 2024.

As part of NHS Resolution’s aim to create closer partnerships with academics, an honorary contract was awarded to Dr Rebecca Payne, a researcher from the Nuffield Department of Primary Care Health Sciences, within the University of Oxford.

The research identified three areas to focus on in order to improve safety in remote consulting:

  1. Effective communication: This can be more challenging during telephone calls, but establishing rapport quickly, listening to and probing the patient’s story and understanding the patient’s concerns are mission-critical. Best practice includes ensuring that the patient understands what will happen next, backing up verbal advice with a text, email or letter and getting the patient to repeat back instructions. This can minimise confusion and the risk of patients getting “lost in the system”.
  2. Robust processes and support for staff: Practices should review their processes as the rapid adoption of remote consulting during the pandemic may mean processes designed for a face-to-face world may still be in use and not optimised for reviewing patients remotely. This will include ensuring staff have been provided with appropriate training and creating a work environment that minimises distractions.
  3. Tailoring to patient needs: Teams should be aware that some clinical conditions such as acute abdominal or chest pain, breathing difficulties, an unusual lump, ongoing provision for palliative care, new psychosis, and diabetic foot checks can be difficult to diagnose and treat remotely. In such cases, considering face-to-face assessments is recommended. In-person assessment should also be considered at the extremes of age when communication is difficult, when patients are not improving as expected, or when an acute condition is overlaid onto pre-existing complex illness. Patients can be empowered to ask for face-to-face appointments where necessary and the research team has produced a helpful resource to provide them with guidance on remote consultations. This can be downloaded via the following link: https://www.phc.ox.ac.uk/files/resources/how-to-get-the-most-out-of-your-telephone-appointment.jpg

On Wednesday 27 March 2024, NHS Resolution’s Safety and Learning team are hosting a virtual forum featuring members of the research team into patient safety in remote consultations. The purpose of the event is to raise awareness of the research findings. To book your place visit NHS Resolution’s Eventbrite page.

This is a great example of collaboration drawing on expertise from each organisation to enhance the quality of research and improve patient safety and experience. NHS Resolution acknowledge the real benefit of partnering with academic organisations in potential areas of quality improvement within the NHS.

Dr Alex Crowe, Deputy Director of Safety and Learning at NHS Resolution