Patient satisfaction survey of telephone consultations for outpatient liver clinics conducted during the COVID-19 Pandemic

ABSTRACT

IntroductionIn the wake of the COVID-19 pandemic in March 2020, NHS services were advised to restructure the delivery of outpatient clinic appointments. The emphasis being on reducing the number of hospital visits for stable patients and triage those who would benefit from a face-to-face (F2F) review which had constituted the vast majority of clinic appointment formats. We surveyed our patient cohort to assess the impact this had on their management, as well as evaluating their concerns and expectations.MethodsAn electronic questionnaire was sent out as a text, for patients to complete on their mobile phones, who underwent a telephone consultation in the hepatology clinic (April to July 2020). Questions included a mixture of multiple-choice questions, ranking questions and space for comments. Anonymised data was analysed using Microsoft Excel.ResultsThere were 268 respondents out of 1200 sent surveys, giving a response rate of 22.3%. The mean age was 56 years, with majority being females (52%) and from white ethnic background (80%). 119 patients (44%) identified themselves as high-risk group with 45 (17%) key workers and 170 (63%) adhering to strict self-isolation during the lockdown period. Alcoholic liver disease (27%) and non-alcoholic liver disease (21%) made half of the patient cohort with 15% unsure about their underlying liver condition. The majority (85%) of consultations were follow up appointments mainly conducted by consultants (79%) followed by middle grades (7%), specialist nurses (3%) whilst 11% patients unsure of the clinician’s grade. Patients answered, ‘strongly agree’ or ‘agree’ to;being assessed thoroughly (81%), their concerns addressed (84%) and opportunity to ask questions (90%). Overall patients rated their consultation as;excellent or good (85%), just as good or better than a F2F consultation (77%) and 85% would be happy to have telephone consultations in the future. Positive comments with telephone consultation included;no travelling involved or needing to take time off work, saving money on transport and parking, ease of convenience and feeling more relaxed. Limitations mentioned by patients were;lack of physical examination, issues with phone connectivity leading to interrupted consultation and a general preference for direct interaction with clinicians. Feedback to improve services was;incorporation of video consultation and alternating telephone with F2F appointments.ConclusionOur survey suggests that telephone consultation for patients with liver disease is a suitable modality for conducting outpatient clinics. It may be that those surveyed were more accepting of the new format due to the COVID pandemic, but our findings support implementing this as a future model for delivery of care, especially for stable patients on long term follow up.