Patient perspectives on virtual outpatient clinics during the covid-19 pandemic in general surgery

ABSTRACT

Introduction: Outpatient care in general surgery has changed markedly in the UK in response Covid-19, with widespread adoption of telephone and video consultations for a large proportion of outpatient care. Few studies have investigated patient perspectives on these virtual clinics in the context of general surgery, with implication to the design of future services. Aims & Methods: We sought to establish the patient acceptability of telephone clinics within our general surgery outpatient service and patient preferences regarding outpatient care in the future. We contacted 201 patients, all of whom had taken part in a recent virtual general surgical appointment during the latter half of 2020, covering both new referrals and follow-up appointments. These patients were invited to take part in a short anonymous telephone survey, with 144 responses collected. Results: 87% regarded the virtual consultation as good or excellent (95% CI 82-95%), with 42% of patients displayed preference for a virtual consultation over a face-to-face equivalent, with a further 12% displaying no preference. 69% of those expressing preference for virtual clinics believed they would continue to prefer virtual appointments if the COVID-19 risk was to substantially reduce. The most commonly cited reason in those expressing preference for face-to-face consultations related to feeling more able to ask questions and contribute to care planning in-person, highlighting potential opportunities for improving the experience of virtual clinics in future. 64% of patients had access to a phone, tablet or computer that could support video consultations, rising to 72% when including those with access to the technical support of close contacts. Only 20% of patients displayed active preference for video over voice calls. Conclusion: We conclude that virtual appointments are acceptable to the majority of patients receiving outpatient general surgical care in our hospital, with a significant minority displaying active preference for remote consultations now and in the future. We propose that a patient-centred service may be best achieved by incorporating a decision aid into appointment scheduling, to take account of a patient's individual preferences, presenting surgical complaint and the current (pandemic) risk level.