Web-based outpatient consultations in diabetes Newham University Hospital NHS Trust

The Newham University Hospital NHS Trust team implemented web-based consultations for diabetes patients attending an outpatient clinic. Their aim was to explore whether online consultations could provide more accessible and cost-effective care in the diabetes department, using readily-available, affordable technology.

The team offered online consultations via webcam to patients under the care of one consultant and one specialist nurse, where clinically appropriate and where physical examination was not required.

Who was involved

The project brought together a range of health care providers and commissioners across Newham.

Outcomes

Over a period of ten months, 89 patients signed up for web-based consultations - a patient uptake rate of 62% - and 174 webcam appointments were scheduled.

The overall 'did not attend' (DNA) rate for webcam appointments was 27%, compared to 33-50% (depending on age) for standard clinic appointments. As patients got used to the new system and the technology was fine-tuned, the DNA rate fell to 16%. The project evaluation also indicated that web-based consultations can reduce A&E attendance over time.

Patients reported that they preferred webcam consultations to face-to-face appointments, saying that they saved them time, were far more convenient and they were more likely to attend the web consultations. Staff and patients reported that the quality of care over webcam was at least as good as that provided face-to-face.

In 2016 NHS England used Skype work from the project as a case study to launch their service specs for Young People’s diabetes care. Please see the following links for more information:   

• https://www.england.nhs.uk/2016/01/19/diabetes-service-specification/
• https://www.england.nhs.uk/2016/01/19/newham-diabetes-pilot-scheme/

Challenges

The team experienced problems with the audio in their software system and had to change providers. For a project like this, the technology needs to be easy to use and highly reliable.