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Independents' Day

Patients give thumbs up to GP Skype pilot

GPs piloting Skype consultations at a central London GP practice saw high patient satisfaction but less-than-expected demand.

Almost all patients surveyed about their experience of the remote consultation service said they ‘would use it again’ (95%).

A further 94% said they were ‘satisfied or better’ than the consultation had met their medical needs and 78% were satisfied with how long they waited for the appointment.

Although patients were warned that ‘the security of Skype isn’t 100%’, 83% also said they were happy with the safeguarding of their privacy.

GPs at the practice were also positive, reporting that Skype was better than phone consultation for making a diagnosis. However they found it was less time efficient than phone consultations, taking up 10 instead of five minutes.

However plans to extend the number of GP sessions held via Skype each week from two to five were scrapped due to a lack of demand.

The leading CCG said a broad mix of patients had used the service including working people and parents of young children. Two-thirds of patients joined the remote consultation from home but more than a quarter – 28% – skyped from their workplace.

Dr Alice Fraser, the lead GP at the pilot practice Cavendish Health Centre in Westminster, said: ‘The flexibility that remote working offers means clinicians can make more efficient and productive use of time. I live outside of London so I found the use of Skype particularly helpful as I could carry out consultations with my patients from home without having to travel to London, which meant I was able to better balance my work and family commitments. 

‘Our patients with mobility or transport problems could get a more detailed consultation via Skype than a telephone conversation might allow, so this service proved especially useful for them.’

Kiran Chauhan, deputy managing director at NHS Central London CCG, said: ‘The remote consultation service offers convenience for both patients and GPs, and the feedback from both has been extremely positive… The pilot has given us some important learning points that we will consider when rolling this out further.’

He added that an added benefit from Skype consultations was ‘alleviating pressure’ on consultation room space.

He said: ‘Long term, the service can help to increase patients’ access to appointments as it enables practices to provide additional appointments without requiring more clinical space or the associated overheads. This can also alleviate pressure on limited consulting room space, which is a particular problem in central London where estate is at a premium, as GPs can see their patients from any private location.’

Readers' comments (16)

  • What do the indemnity organisiations think of Skype consultations and any fallout there of?I think it is unsafe and there gets a thumbs down from me!

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  • The big advantage of telephone consultations over Skype consultations is one of logistics.

    If a patient phones in and asks for a telephone consultation he or she can then get on with their life and be contactable by mobile phone when the GP phones back after up to 2 hours

    At the moment very few people have the ability to be immediately contactable through Skype on their mobile phones. Consequently a Skype consultation needs to be booked at a specific time as opposed to telephone consultations.

    Eventually when mobile video consultations are as commonplace as telephone it should be possible to use this technology in the same way that one uses telephone consultations.

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  • I disagree, if you have any smartphone from circa 2009 onwards you can run skype. as long as you have a data package or wi fi a patient can be consulted in the street if they so wish.
    I'm not sure skype is clinically robust enough as a bit of techonology and secondly opens a can of worms as is very hackable by even high school kids.
    I wouldn't use it if I was a patient.

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  • It ain't safe....anyone thinks making a medical diagnosis using the equivalent of a pair of binoculars and a wilkie talkie is as good as meeting someone in the flesh is kidding themselves.

    And to those who say..."it can help in some circumstances" and "it's more efficient and cheaper" ...I say - "Pay my increased medical indemnity costs!" Thing is they won't hey...we as a profession will be carrying this cost, no one else.

    It's poor medicine and a bad idea. This is driven by eccomonics and funding issues not best practice and medical excellence. It sucks

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  • Anonymous 7.23pm

    I am well aware that one can use Skype and other video systems on a mobile telephone. The point that I am making is that very people are used to doing this. Telephones are used by just about anybody and people are very used to using them on a mobile basis. No doubt in the future people will become used to making video mobile communication, but not at the present.

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  • George Murgatroyd

    Just because certain patients aren't used to using Skype (or other systems) for consultation doesn't mean we should therefore wait until they are: if we passively wait for the majority, this will develop ever so slowly. Pilots such as these consistently show that those who have not generally engaged with technology pick it up very quickly, regardless of age or demographic, and indeed why shouldn't they.

    This sort of initiative also offers significant advantages for patients in developing countries, where 3G and smartphones are common, but qualified clinicians are not.

    As wearable tech and initiatives like Apple's Health app evolve, clinicians are likely to be able to see patients' heart rates, temperatures, etc remotely.

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  • @7.23 i think you'll find that under 25s are very aware of not just skype (bit old hat now) but facetime and vu, and the ability to communicate at a time that suits would seem to be an improvement and moving into the 21st century instead of the head in the sand approach.

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  • Harry Longman

    Good debate but look at two key points:
    1. For GPs it was less time efficient than telephone, 10 mins instead of 5, ie similar to face to face. No saving.
    2. Demand was less than expected, so patients, though "happy" are not flocking to it.
    Skype may have its place but unless the technology is a big benefit to both parties, it won't take off.

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  • "1. For GPs it was less time efficient than telephone, 10 mins instead of 5, ie similar to face to face. No saving."

    This is a short-termist approach. Patients who are more satisfied with their consultations may be less likely to return for the same issue.

    Why not invest 10 quality minutes at the outset rather than waste many rushed 5 minute telephone (or longer face to face) consults for the same issue?

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  • @2:27pm
    This is the problem with the NHS of today. We like to throw around ideas that sound nice and seem to be up to date technologically.
    The article has given us the result of the pilot. Instead of dismissing someone's opinion as 'short-termist approach' while don't you run a longer pilot and give us intelligent data so we can discuss as scientists.
    If the technology does not increase my efficiency with time management, diagnosis and management of the patient, then it is useless to me.
    If skype consultation takes at least 10minutes yet I do not have the benefit of examining the patient properly, I might as well invite the patient in for a 10minute appointment and do it properly.
    Personally, I think Skype will be only beneficial when the patient is unable to come to the surgery and I may need to have a look at a lesion (might be difficult if the camera is not of HD quality). This does not save me any time.
    This is not a head in sand opinion. I am very open to using new technology ( I love new technology) but as a clinician, it must increase efficiency both clinically and otherwise.

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