Remote Consultations (RCs): a Survey of Oncology Practices and Patient Experience

ABSTRACT

Purpose: The COVID-19 pandemic brought rapid changes to NHS services and practices, including recommendations for shielding and conversion to RCs. This project was set up to explore the patient experience of RCs at NMUH, yielding both quantitative and qualitative accounts, to identify possible areas for improvement. Methods: Participants were recruited from breast, gastrointestinal and lung oncology clinics between April and June 2021. Suitable patients took part in an anonymous telephone survey conducted by an independent researcher, 48–72 h following their consultations. Three broad areas including practical aspects of communication, patient autonomy and control during the consultation and patients’ emotional experiences were evaluated. Results: 51 participants were recruited into the study (63% women, varied ethnic backgrounds, age range 41–88 years). 98% of participants reported no concerns about privacy or confidentiality, with 42–58% strongly agreeing with statements regarding autonomy. Overall, 90% (n = 46) reported RCs as being good, very good or excellent. Good aspects included feeling safer, reduced travel, flexibility and reduced waiting in hospital. The main concerns were communication challenges, inability to follow-up if they forgot something, not having family members or carers present, less personal consultations and not being examined. Timing of the appointment was a key point of dissatisfaction. Qualitative data including patient quotes provided real insight into the patient experience. Lack of key worker support was identified as a major cause of concern for patients. Conclusion: This study was practice changing. A new ‘Cover Letter’ entitled ‘How to get the most out of your remote consultation’ was created and sent with outpatient appointment letters. This project also identified an urgent need for recruitment. Overall, selective RCs should be considered as standard practice in the future, which will enable reduced cancer waiting times, unnecessary exposure of vulnerable patients and improved patient experience by minimising hospital visits.