Before introducing an alternative to a face-to-face consultation then you may wish to think about the following:

The choice of type of an alternative to a face-to-face consultation is dependent on your rationale for using an alternative to a face-to-face consultation. Is it for convenience for patients, improved patient access or to manage demand? It is also dependent on ensuring that the alternative to a face-to-face consultation(s) you have decided to introduce are suitable for your practice and its demographics. More information on who it is for and why can be found here. 

Practice costs

• What will be the initial financial outlay?
• Do you have sufficient infrastructure?
• Are you using standard technology or a bespoke system designed for health care use?
• Were you planning on using your existing facilities and if so is the bandwidth sufficient?
• Will any additional calls be costed? (To call patients back or where the link has been lost)
• Is this commercially driven? – Will you be using a commercial product?
• Is this a funded pilot? If so, what will you do when the pilot comes to an end?
• Will the introduction require further staff training?
• Will you require funding to inform patients of the changes?

Patient related

• Are there certain patient groups that will be disadvantaged? More information on who it is for can be found here.
• How will you inform patients of the changes? – Possible options are; the practice website, letters to patients, flyers, banners in the practice, social media or word of mouth.
• What do your patients feel about video consulting? – Speaking to local representatives is useful, for example via a patient participation group.
• Is it more convenient for the patient? – Will the patient have a booked time slot?

 Benefits and Concerns

• Are you anticipating that a video consultation will be shorter/quicker than a face to face consultation? – How will you monitor this?
• What might be lost? – Accurate history, subtle non-verbal cues, patient/doctor relationship
• What might be gained? – Flexible working, more control over own workload, patients feeling more relaxed, further continuity of care, accessing patients who are otherwise unable to attend the practice.
• What will you do if the technology fails? – Produce detailed protocols for use
• How will you include the contents of the consultation in the patient records? How will you ensure that the use of video consultations replaces rather than is in addition to usual work? 

Safety and Security

• Have you considered how you will ensure that patient confidentiality is maintained?
• How will you ensure security of the patients’ details?
• Are you able to clinically assess the patient?
• Are the some types of patients and conditions for which video consulting is not appropriate? How will patients know?
• Are you using a secure system?

 We have provided some useful guidance below:

• NHSmail: a secure email service approved by the Department of Health for sharing patient identifiable and sensitive information
• Academy of Medical Royal Colleges – i-care: Information, Communication and Technology in the NHS
• Academy of Medical Royal Colleges – Ehealth Competency Framework
• GMC guidance on – Prescribing Guidance: Remote Prescribing via Telephone, Video-link or Online
• Email Consultations in Healthcare
• Health and Social Care Information Centre
• Medical Protection – Risk alert: Technology in general practice
• RCGP – Health Informatics Group

A list of companies that offer support for telephone consultations can be found here:

• Systmone
• Emis Web