FACE TO FACE VERSUS TELEPHONE CONSULTATION: RESETTING THE BALANCE

ABSTRACT

Introduction During Covid, we adopted telephone consultations for initial history taking, with in person follow-up appointments where clinically indicated. This review was undertaken to identify the proportion of patients managed remotely only and to adjust algorithms for future appointments. Methods We retrospectively audited consultations over the course of one month. We reviewed basic demographic data, along with presenting complaints and management. Results Of 176 telephone consultations, 36 (20.45%) were managed remotely. The majority were either positive on online testing (8) or chlamydia contacts (10) and received postal treatment. Of the 16 remaining, 4 were signposted to online testing, 4 received management for known herpes and a further 4 needed advice or wanted to discuss prior results. Amongst the 48/140 attendees reviewed, the commonest presentations in women were vaginal discharge (9/26), skin lesions (8/26, 4 confirmed warts) and pain (6/26). In men, 10/ 22 had skin lesions (6/22 with warts) and 6 had discharge/ dysuria. Three contacts of infections attended due to symptoms or needing additional testing, 1 patient because of insufficient bloods from home testing, and 1 following a needlestick injury. Two under 18's were assessed by telephone, both subsequently reviewed in the department. Safeguarding issues were addressed for one of these. Discussion This review has identified that very few asymptomatic patients required triage, and about 1/5 presentations were managed remotely. Younger and vulnerable patients were still signposted into service, as were those needing further examination or testing. Our future approach for blended service provision will reflect this.