Proceedings of the 6th UK and Ireland implementation science research conference. Implementation Sci 19 (Suppl 1), 21 (2024). https://doi.org/10.1186/s13012-024-01341-3 (P76)
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Rona Inniss 1,2, Natalie Smith 1, Susie M.D. Henley 1
1 Neurofibromatosis Centre, Guy's Hospital, London, SE1 9RT, UK
2 Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, WC2R 2LS, UK
Written 2024. Rona Inniss, Natalie Smith, Susie M.D. Henley.
The Neurofibromatosis Service provides lifelong care to patients with nerve tumour predisposition syndromes [1,2]. Attendance is typically face-to-face outpatient appointments with consultant neurologists, clinical nurse specialists, physiotherapists, psychologists, and a social worker. Covid-19 forced a severe reduction in face-to-face appointments, with remote offered instead [3,4]. The NHS long-term sustainability plan [5] aims to avert up to 1/3 of face-to-face consultations by 2029. Evidence from patients who had remote appointments during the pandemic can help us shape the roll-out of this long-term plan.
Paper questionnaires were sent to all patients with an appointment within the same 2-week period during August 2020, 2021, 2022. Response rates were similar: 26% (32/122, 2020), 22% (23/106, 2021), and 25% (26/104, 2022).
In 2020 most patients had an appointment by telephone/video. In 2021 and 2022, less than 25% did. In 2020 just over half of people wanted their next appointment to be remote. By 2021 / 2022 just under half wanted their next appointment to be remote. Patients report positive and negative experiences of remote appointments but over all three years the most popular choice was still a face-to-face appointment. Positive experiences included reduced language barriers and improved accessibility (less time off work / childcare). Negative experiences included lack of access to / confidence with technology, and perceived negative impact on relationship with professional.
To meet the UN Sustainable Development Goal of good health and wellbeing [6], and the NHS long-term plan [5] to use technology to reduce face-to-face appointments, our research demonstrates that the UK needs to improve access to and confidence in technology, whilst acknowledging the importance the patient places on the in-person relationship with their health professional.
NHS Commissioning Board. (2013). 2013/14 NHS STANDARD CONTRACT FOR COMPLEX NEUROFIBROMATOSIS TYPE 1 SERVICE (ALL AGES) (B13/S(HSS)/a). NHS Commissioning Board.
NHS Commissioning Board. 2013/14 NHS STANDARD CONTRACT FOR NEUROFIBROMATOSIS TYPE 2 SERVICE (All AGES). NHS Commissioning Board; 2013. Report No.: B13/S(HSS)/b.
Thorlby, R., Fraser, C., & Gardner, T. (2020). Non-COVID-19 NHS care during the pandemic: Activity trends for key NHS services in England. The Health Foundation. www.health.org.uk/news-and-comment/charts-and-infographics/non-covid-19-nhs-care-during-the-pandemic
Vas, V., North, S., Rua, T., Chilton, D., Cashman, M., Malhotra, B., & Garrood, T. (2022). Delivering outpatient virtual clinics during the COVID-19 pandemic: Early evaluation of clinicians’ experiences. BMJ Open Quality, 11(1), e001313. doi.org/10.1136/bmjoq-2020-001313
NHS. (2019). The NHS long term plan. NHS. www.longtermplan.nhs.uk
The United Nations Department of Economic and Social Affairs. The Sustainable Development Goals Report 2023: Special Edition. S.l.: United Nations; 2023. doi.org/10.1002/ajmg.a.36312