1) The document discusses strategic plans to increase the use of virtual appointments through video to help restore NHS services and reduce backlogs as directed nationally. 2) Data is presented on the percentage of virtual vs face-to-face appointments by specialty for different regions, showing variation between specialties and trusts in uptake of virtual appointments. 3) Interviews were conducted with NHS staff across roles and specialties to understand the reasons for the differences in uptake of virtual appointments and identify barriers to wider adoption. A separate report from patient interviews also provided feedback.

1. @innovationnwc

2. Peter Jenkinson
Chief of Digital Operations NHSEI

3. Strategic national direction is to increase use of video appointments
An enabler to supporting restoring services, reducing backlogs
Planning guidance; exploit the potential of digital technologies to
transform the delivery of care
LTP priority that patients will be able to access virtual outpatient
services
Support productive use of clinician time – clinics finishing late, reduce
travel
Alignment with wider digital pathway transformation

4. North West – virtual by specialty
Was there an
underlying
reason for
the drop off
in virtual
activity?

5. North West – % virtual & % recovery by specialty
Top % Virtual Ratio Specialty: 50%
%
Activity Face to Face Virtual Activity Face to Face Virtual Recovery
Ophthalmology 597,936 99% 1% 334,328 88% 12% 56%
Trauma & Orthopaedics 490,723 99% 1% 317,906 64% 36% 65%
Clinical Oncology (previously Radiotherapy) 257,094 98% 2% 215,471 71% 29% 84%
Gynaecology 269,559 97% 3% 189,188 70% 30% 70%
Dermatology 260,579 100% 0% 182,341 63% 37% 70%
Cardiology 257,338 98% 2% 184,052 59% 41% 72%
Ear, Nose & Throat (ENT) 250,453 100% 0% 158,863 51% 49% 63%
Medical Oncology 202,870 97% 3% 190,946 64% 36% 94%
Urology 201,682 100% 0% 154,650 50% 50% 77%
Clinical Haematology 156,894 96% 4% 120,576 51% 49% 77%
Grand Total 2,945,128 99% 1% 2,048,321 66% 34% 70%
Urology
All Trusts
Yes 2020
Yes 2019
North West - Top 10 Specialties (by Total Activity excl. Other)
Why was there a spread of
usage across specialties?

6. Trust
Top % Virtual Ratio Specialty: 63%
%
Activity Face to Face Virtual Activity Face to Face Virtual Recovery
49,378 98% 2% 32,964 73% 27% 67%
38,212 100% 0% 25,408 88% 12% 66%
22,346 100% 0% 15,228 73% 27% 68%
20,994 100% 0% 16,543 77% 23% 79%
15,979 81% 19% 10,075 62% 38% 63%
13,517 88% 12% 8,250 60% 40% 61%
12,594 100% 0% 8,114 62% 38% 64%
11,274 92% 8% 8,254 79% 21% 73%
8,430 99% 1% 9,120 51% 49% 108%
10,336 100% 0% 6,377 37% 63% 62%
Grand Total 203,060 97% 3% 140,333 71% 29% 69%
xxx
North West Baselines - Top 10 Trusts (by Total Activity)
Specialty: Gynaecology
Apr-Oct 2019 Apr-Oct 2020
Why was the virtual activity here
so different from here?

7. On-going review of virtual outpatient activity that captured appointments delivered
by
Telephone
Video
What we saw was variation in uptake
Across specialties
Across Trusts
Whilst generic lessons were available from a national survey identifying good
practice and blockers, this didn’t help us understand the differences in the North
West
What we hoped for was to begin to understand some of the underlying reasons for
this variation and gain recommendations in taking virtual appointments forward
sustainably

8. Ed Millensted – Head of Programmes
Charlotte Hall – Programme Manager

9. To surface the key characteristics of successful adoption
To understand the barriers to wider adoption and why variation exists
To act as a reference source to inform system strategy development
and trust planning
To stimulate strategic thinking around remote consultation as one
part of large-scale pathway redesign
To stimulate thinking around the development of remote consultation
within personalised care

10. 40 x facilitated conversations held – 90 mins each
15 x different Trusts across mainly C&M, L&SC but also GM
Range of professions and specialties consulted
CNIOs, CCIOs, CIOs, specialist nurses, consultants, clinical directors, outpatient
dept mgrs, operational managers
Oncology, psychology, acute medicine, breast, orthopaedics, dermatology,
therapies, MSK, genetics, mental health

15. The Innovation Agency commissioned
Healthwatch Together to hear first-hand
experiences from patients and these are
reflected throughout the report.
Conversations with over 50 people
Diverse range of groups spoken with e.g.
learning disabilities
Headlines
Digital poverty and accessibility
(hearing/visual impaired)
Not feeling suitable for certain conditions
If always remote care patients feel less cared
for
Healthwatch Report can be accessed clicking here

18. Develop national
guidance to
enhance clinical
confidence
Exec & Clinical
leadership is
essential to
implementation
strategies
Opportunity to
address digital
exclusion
Opportunity for
large scale
change
programme
Opportunity to do
things differently
and be innovative
Share and learn
from others
Leverage existing
and future funding
to drive and
sustain change
End to end
pathway view of
patient journey
Patient choice