'More Zoom medicine needed' in NHS says Hancock

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Lightning720
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I really don't agree with this. There is a reason why appointments have been face-to-face before this. If possible, appointments should always be face-to-face.

What do you think about this?

https://www.bbc.co.uk/news/health-53592678
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ecolier
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(Original post by Lightning720)
I really don't agree with this. There is a reason why appointments have been face-to-face before this. If possible, appointments should always be face-to-face.

What do you think about this?

https://www.bbc.co.uk/news/health-53592678
Interestingly I am doing a telephone clinic list now... personally it's much faster for me doing telephone clinics but for my specialty I feel that really we should have the patients here so we can examine them*.

Note - this is great for managers because the waiting list can be massively cut down by doing telephone clinics. They are fitting more patients into our regular slots (used to be 8 follow ups every 4 hours, now it's 10-12; used to be 4 new patients every 4 hours, now it's 5-6).

I haven't done a video clinic yet because none of our clinics are equipped with video conferencing equipment - it's literally a telephone clinic (calling patients on their landline from our phones). Talk about high-tech :lol:

*Depending on sub-specialty: e.g. headache = virtually no need to examine unless we are suspecting brain tumours; movement disorder = examination is of paramount importance.
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Democracy
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Wanky tech bro *******s.

I wonder, when he gets ill will he start fannying around on Zoom or will he be off to see a private doctor face to face (something even the ancient Greeks understood the value of FFS).
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ecolier
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(Original post by Democracy)
Wanky tech bro *******s.

I wonder, when he gets ill will he start fannying around on Zoom or will he be off to see a private doctor face to face (something even the ancient Greeks understood the value of FFS).
I mean when we couldn't get rid of fax machines, bleeps and Windows XP computers I don't see how video conferencing would happen overnight. All our computers are still using Intel Pentium chips from 2010...

Telephone clinics, on the other hand... I can imagine the managers :sexface:
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DiddyDec
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Hancock is a ****ing ****, the whole reason the NHS haven't technologically moved forward is because of his Government's lack of investment in it.

Some CCGs already have the analysis that shows the benefits of telemedicine on appointment numbers and the built estate but they can't get the funding to implement it.
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Nefarious
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It's not just a UK government problem tbh. The whole medical sector, across both organisational and national boundries, is highly resistant to changing and upgrading it systems. Thats why depsite having functional secure email rolled out across just about every healthcare setting for more than a decade my local trust only ditched its fax machines at the end of last year. It's why we're managing our nephrology patients on shiny brand new computers with a very good piece of software, that because it was written for Windows 95, can only be opened inside a virtual desktop which costs a fortune and is ****.

Teleclinics work well for some people and are probably going to be an important part of managing patients with long term conditions even outside of pandemics as we move forward, but plenty of my patients are fed up with them and just want to see their doctor once in a while.
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nexttime
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(Original post by ecolier)
Note - this is great for managers because the waiting list can be massively cut down by doing telephone clinics. They are fitting more patients into our regular slots (used to be 8 follow ups every 4 hours, now it's 10-12; used to be 4 new patients every 4 hours, now it's 5-6).
That's interesting - I think most of my colleagues find it takes longer. Between patients not picking up, or not being able to hear properly (especially if doctors has an accent), or the family wanting to be updated but them not having speakerphone capability so having to talk to multiple people separately it can feel like a huge pain.

I think there are other less valid reasons for their impressions too though - organising our CXRs and CTs has become a big faff as they are all scared of going to the hospital and need to be reassured its safe/worth it etc. I think consultantions have also become more complicated due to covid and fallout from actions taken earlier due to covid. And also its been accompanied by a switch to electronic clinic records, and many consultants aren't good typers especially whilst cradling a phone in their neck. None of which are the fault of telephone clinics but I think they blame them.

But then I definitely notice the huge upsides too - the diabolical parking situation here was, transiently, abolished. If I see tomorrow's clinic is crazy overbooked, or just feel like doing tomorrow's clinic today instead... I just can! And the big effort it takes make patients to come to clinic, especially those who actually required ambulances to transport them 50 miles so we could say 'you look great k thx see you in 6 months' - completely gone.

But even I, with my quick typing and southern accent, don't think they are quicker! Just about break even but more flexible I'd say.

We barely examine our patients... do you think cutting that is why its quicker for you?
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ecolier
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(Original post by nexttime)
That's interesting - I think most of my colleagues find it takes longer. Between patients not picking up, or not being able to hear properly (especially if doctors has an accent), or the family wanting to be updated but them not having speakerphone capability so having to talk to multiple people separately it can feel like a huge pain
Sure, but there is the flexibility of calling them earlier or later if you have time in your clinic slots. Also not having to examine them (can take long in our specialty) is another time-saver - it's obviously not ideal though.


I think there are other less valid reasons for their impressions too though - organising our CXRs and CTs has become a big faff as they are all scared of going to the hospital and need to be reassured its safe/worth it etc. I think consultantions have also become more complicated due to covid and fallout from actions taken earlier due to covid. And also its been accompanied by a switch to electronic clinic records, and many consultants aren't good typers especially whilst cradling a phone in their neck. None of which are the fault of telephone clinics but I think they blame them.
Yes agreed.

We do not get notes for clinics now, it's all online.

I type fast (in fact I literally type up my clinic letter while I am talking to the patient) but I can imagine plenty of one-finger-typing consultants struggling.


But then I definitely notice the huge upsides too - the diabolical parking situation here was, transiently, abolished. If I see tomorrow's clinic is crazy overbooked, or just feel like doing tomorrow's clinic today instead... I just can! And the big effort it takes make patients to come to clinic, especially those who actually required ambulances to transport them 50 miles so we could say 'you look great k thx see you in 6 months' - completely gone.
Same. We cover a huge area (as you can imagine for a relatively niche specialty) and people come from places that can be up to 4-5 hours travel.


But even I, with my quick typing and southern accent, don't think they are quicker! Just about break even but more flexible I'd say.

We barely examine our patients... do you think cutting that is why its quicker for you?
Probably. The managers must be thinking the same because they have added more patients to our usual 4 hour lists. It's most specialty too, from what I have gathered.

P.S. DNAs used to be a curse (for the managers) and a blessing (for the doctors to catch up) but they are now happening much less often. People do still not pick up but it's so much rarer.
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nexttime
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(Original post by ecolier)
We do not get notes for clinics now, it's all online.
People still go through the effort to get them... then I ignore them becuase all info is on the system why would I need them?

Until the IT systems crash anyway.

I type fast (in fact I literally type up my clinic letter while I am talking to the patient)
Yeah same - some of the consultants don't do that because they think its rude? Don't agree, and the time saved is worth it anyway!

Probably. The managers must be thinking the same because they have added more patients to our usual 4 hour lists. It's most specialty too, from what I have gathered.
Interesting that managers determine your workload, though I guess it makes sense when you've got a monstrous waiting list! Our consultants just have to see everything they are referred within like 3 weeks no managers involved!

P.S. DNAs used to be a curse (for the managers) and a blessing (for the doctors to catch up) but they are now happening much less often. People do still not pick up but it's so much rarer.

Yeah that is another difference - our DNAs were rare before (except in say germ cell follow ups i.e. the young guys...) and have gone up due to not answering phones.
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ecolier
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(Original post by nexttime)
People still go through the effort to get them... then I ignore them becuase all info is on the system why would I need them?

Until the IT systems crash anyway.
We have soooo many clinic rooms these days - similar to the car parking situation, prior to COVID-19 there was a constant battle between specialties for rooms but now? All the consultants are doing their clinics in their offices so the rooms are for us registrars to do our paperwork. It seems like I am the only one to be still doing (telephone) clinics in the clinic!!

Yeah same - some of the consultants don't do that because they think its rude? Don't agree, and the time saved is worth it anyway!
I am saving the time to dictate and to check / verify the letters. Win-win situation (especially when I leave the trust, no one has to verify the letters for me because I typed them).

Interesting that managers determine your workload, though I guess it makes sense when you've got a monstrous waiting list! Our consultants just have to see everything they are referred within like 3 weeks no managers involved!
Jealous.

Our managers literally determine the lists for us.

When we had other specialty registrars (the occasional stroke, elderly care sub-specialising in PD etc.) doing our clinics, they will create a list for them.

You'd be surprised (or maybe not, seeing the competence of NHS managers) to see how often PD patients are booked into the stroke reg's list; epilepsy and MS patients into the Elderly/PD reg's list etc. Anything to get the patient waiting list number down eh?

Yeah that is another difference - our DNAs were rare before (except in say germ cell follow ups i.e. the young guys...) and have gone up due to not answering phones.
In our neck of the woods, our DNA rates have always been really high (20-30% average) so phone clinics are helping. It also helps that I literally trawl through the computer system if I can't find them and call numbers listed 10 years ago (which actually worked!).
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nexttime
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(Original post by ecolier)
We have soooo many clinic rooms these days - similar to the car parking situation, prior to COVID-19 there was a constant battle between specialties for rooms but now? All the consultants are doing their clinics in their offices so the rooms are for us registrars to do our paperwork. It seems like I am the only one to be still doing (telephone) clinics in the clinic!!
One final difference: This is the opposite here too! Our clinics often involve an ANP or prescribing pharmacist seeing patients who will need support, which is better face to face. But moreover, the oncology specialist nurses really want to be there for especially new patient reviews, so you can't really do it from an office. Then to make things worse: our main clinic area used to be a ward, so the structure is a main hub with all the computers and phones, then clinic rooms with nothing. So actually the whole clinic area has like 4 phones!

People have had to increase their flexibility and not help ANPs in person or not have specialist nurses there, plus we've gained the use of our charity's office so overall it isn't a problem, but its certainly not better either!
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