In light of the COVID-19 pandemic, the NHS is now primarily using remote reviews (via telephone or video) in order to allow for adequate social distancing, to reduce the risk of infection for both practice staff and patients1. The Health Secretary outlined that the NHS would be moving to a ‘digital first’ approach such that ‘wherever clinically and practically possible, people can access and should access primary care through phones and digital means.’2
Whether remote or in-person, it is essential that vulnerable patients who are at risk are regularly reviewed to ensure their condition is optimally managed. The Royal College of General Practitioners (RCGP) has released guidance on workload prioritisation, in which COPD patients who are at risk of the worst outcomes (patients with frequent exacerbations or hospital exacerbations, or on long term oxygen therapy) are a high priority group of patients for review during the coronavirus outbreak.
With the recent pandemic accelerating the use of remote reviews, you may have some patients who require additional support with remote COPD reviews, if they previously only had face to face reviews.
Therefore, in response to questions which your patients may now have, we have compiled a collection of resources which you can send on to your patients as relevant, to help them feel prepared and confident for their remote COPD review.
Helping your patients prepare for their remote COPD review
Going from face to face reviews to video or phone calls can sometimes feel awkward at first. Patients accustomed to face to face appointments may require additional support. To assist you in helping them prepare for and get the most out of their remote COPD reviews the following resources may come in handy:
Patient.info have published a great introductory article for your patients. It discusses a few ways about how video appointments differ from face to face ones, as well as how they may prepare for the video appointment and get the most out of it.
The Barts Health NHS Trust have put together a useful list of frequently asked questions to help patients make the most of their reviews. It addresses questions such as how to get setup for the appointment and how to communicate during it. Whilst it is aimed at patients you may also find it useful in addressing some of the question’s patients may ask you.
Supporting your patients with tech
Getting patients comfortable with using the platform is an important factor in building their confidence in attending remote COPD reviews. For common remote review software such as Attend Anywhere® or AccuRx, there are some very helpful videos available to share with patients, to help them navigate the process of connecting to their review.
Even if you are using different software at your surgery, the general principles of joining a remote review are very similar. Whilst some people respond to video directions, other prefer to read and the Barts Health NHS Trust has produced a simple set of of step-by-step instructions to help navigate your patients through the process of remote reviews. This is a really simple guide to give confidence to your patients that virtual reviews are nothing to be afraid of!
What if the technology goes wrong?
No matter how well prepared your patient is for a remote review, sometimes things can just go wrong. Whether it’s an unexpected traffic jam on the way to their appointment, or technology playing up at home. Whilst we can’t help with traffic jams, we can offer some pointers on dealing with tech issues.
Video conversations allow a more personable approach and allow you to better mimic an in-person COPD review. Regardless of the medium, it’s important to capture a phone number for patients in case the conversation gets cut off. The Barts Health NHS Trust have also pulled together a helpful document with some quickfire solutions to some common technology problems which might crop up – helpful for both you and your patient! Whilst this guide has been written with the Attend Anywhere® software in mind, many tips here can be applied regardless of the software you are using.
Helpful COPD-specific resources to use ahead of a review
If a remote review goes well, it should feel just like a face-to-face appointment for you and your patient. Whilst there may be additional challenges with technology and unfamiliarity when it comes to a virtual COPD review, your patients with COPD should still prepare for their review in the same way as before, and ensure they have their inhalers and rescue packs ready to show you and demonstrate.
One article which might be worth sharing with your patients is a series of steps which your patient might like to take in preparation for their COPD review, to help them think about what questions they would like to ask you during their review so they can get the most out of their appointment – regardless if it is happening face-to-face or remotely.
In addition, consider asking your patients to complete the COPD Assessment Test (CAT) ahead of their appointment. The CAT is a validated tool, made up of eight simple questions that explore how COPD impacts your patient’s daily life, and how this might change over time. Each question is scored from 0-5. Their total score will give you an idea of how much COPD affects their daily life, and provides an easy way to track their symptoms from one visit to the next.
The CAT can be completed online via the CAT website and printed out or emailed directly to you, and only takes a couple of minutes. This may help your patient feel more prepared ahead of your review, as the completed CAT questionnaire can provide a framework for your appointment.
It looks like remote reviews will be a key part of NHS ways of working moving forwards3, even after the end of the COVID-19 pandemic. There are a range of resources available help patients understand why they would benefit from a remote review, how they can connect with you and how they can prepare for their appointment. Therefore, whilst these virtual reviews may feel different from the face to face reviews they are used to, your patients can be supported so they feel confident and prepared to take part in remote appointments.
1. British Medical Association. COVID-19: video consultations and homeworking. Accessible
at https://www.bma.org.uk/advice-and-support/covid-19/adapting-to-covid/covid-19-video-consultations-and-homeworking (Accessed July 2020)
2. GP Online. Switch GP appointments to phone or digital where possible with 'immediate effect', says Hancock. March 2020. Accessible at: https://www.gponline.com/switch-gp-appointments-phone-digital-possible-immediate-effect-says-hancock/article/1676617 (Accessed July 2020)
3. NHS Long Term Plan 2019. Accessible at: https://www.longtermplan.nhs.uk/online-version/chapter-1-a-new-service-model-for-the-21st-century/4-digitally-enabled-primary-and-outpatient-care-will-go-mainstream-across-the-nhs/ (Accessed July 2020)