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IN-DEPTH: OUTPATIENT CARE


TRANSFORMING OUTPATIENT CARE


The NHS Long Term Plan is the latest policy paper to call for a radical overhaul of the traditional model of outpatient care. Our clinicians are already utilising digital technologies  patient experience.


T 10 /Trust


he outpatient system is older than the NHS,” Professor Stephen Powis, NHS England medical director, wrote in his introduction to a Royal


College of Physicians report in November 2018. “It’s right we look at ways to cut unnecessary appointments, save thousands of journeys, reduce  


‘Virtual appointments’ such as medical record and diagnostic reviews, video consultations and phone calls, can help reduce hospital-based appointments without compromising clinical care. Here, we speak to four  appointments to their patients.


VIDEOCONFERENCING CARE CONVERSATIONS


About three years ago, consultant respiratory physician Dr Melissa  nurse specialist Dr Anne-Marie Russell wanted to deliver a better experience  to hospital due to symptoms such as breathlessness. After initial success with a telephone clinic, Melissa decided to try a video chat approach.


“Since 2016 we’ve been holding video consultations with a few patients a week using the Trust’s JoinMe video conferencing software,” says Melissa. “Our video appointments can be longer than a normal clinic appointment, so we can dedicate more time to conversations about managing


symptoms, fears and anxieties and care plans. It also means that relatives and carers can be more closely involved as often it is easier for them to be there by the patient’s side during the consultation.”


“For my mother this has been liberating,” says Lorraine Anderson, who helps her mother participate in remote appointments. “It means she does not have to travel or wait in clinic. We know that when a physical examination is required we have to attend the clinic, but this is reassuring rather than a hindrance.”


SUPPORTING GPS TO MANAGE CHRONIC KIDNEY DISEASE


“Many people with chronic kidney disease (CKD) in our community are stable and so can generally be best cared for by their local GP,” says Dr Andrew Frankel, consultant physician and nephrologist at the Trust. “However, there are a number of patients whose CKD is progressive or who experience changes in their kidney function. When this happens, their GP will refer them to a consultant in our service for specialist advice.”


“ It means we can avoid bringing patients to clinic unnecessarily and we can dedicate more time to patients with more complex needs who do need a face- to- face appointment.” Dr Andrew Frankel


Dr Marie Edison, Mr David Hrouda  appointments for urology patients


www.imperial.nhs.uk


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