June 2020 Update – Support for practices to Get on Board with Implementing Virtual Group Consultations
We have been implementing Group Consultations throughout practices in City & Hackney. With the current Covid-19 pandemic, we have had to put our second phase of face-to-face training on hold for now (please see link to our last update). We are now shifting our focus to exploring the use of Virtual Group Consultations for LTC care.
The Covid-19 pandemic has undoubtedly placed more pressure on healthcare services, and we have encountered challenges in Primary Care, with a greater proportion of interactions having to occur remotely in order to keep staff and patients safe. This has made provision of routine care challenging, as well as making it more difficult to provide continuity of care for our patients. City & Hackney’s current LTC strategy has shifted towards addressing how to deliver remote provision of routine care in order to prevent a backlog of patients, reduce acute admissions to hospital, and to help us to reduce risk in patients who are at high-risk of developing complications following Covid-19 infection.
Virtual Group Consultations is being considered as a possible solution to the question of how we provide patient-centred, effective and efficient care, remotely. Virtual Group Consultations follow the same framework as Group Consultations, but are held over a software platform. In City & Hackney, we are using Microsoft Teams, which has also been approved in terms of security features by NHS England. As this is a relatively new consultation model, there is currently a lack of data in the UK to support Virtual Group Consultations. However, globally, many services are switching to virtual group models in order to sustain routine care during the pandemic. We will aim to collate data to evaluate outcomes, but for now we can extrapolate many of the likely benefits from the evidence that supports use of Group Consultations - please see https://www.groupconsultations.com/evidence/ and https://www.groupconsultations.com/c-h-p-p/ for a link to a video sharing experiences from your City & Hackney colleagues who have already tried out Group Consultations.
For a link to the BSLM webinar series on global experiences of Virtual Group Consultations, see https://www.groupconsultations.com/vgc/.
The Virtual Group Consultations model has great potential to address many of the challenges posed by the current pandemic. A group setting, although online, will address current problems with loneliness and isolation by helping patients to share their experiences with each other and their clinicians. For clinicians, this model adds some variety to the working week, but importantly offers the opportunity to reconnect ‘face-to-face’ with patients and provide patients with support and reassurance about Covid-19. As with Group Consultations, Virtual Group Consultations will be able to provide the opportunity for practices to help deliver patient-centred LTC care, including Time to Talk consultations for eligible patients, Care Planning and Structure Medication Reviews. This model can be adapted to suit each individual practice’s areas of needs, and to optimise use of different Healthcare Professionals – this model can be used for LTC reviews, Covid-19 triage, review of symptoms post-Covid, review of vulnerable/shielded patients by a Social Prescriber, etc. For smaller practices, Virtual Group Consultations will be easier to run, as a clinical room does not need to be freed up for these sessions.
Some clinicians have expressed concern about this consultation model promoting the Digital Divide. Virtual Group Consultations are not a one-size-fits all model, and so will not be suitable for all patients. However, patients are currently more motivated than ever to get online, and this model has been used in vulnerable and socially-deprived groups with great success in the USA (see the BSLM webinar series). Additionally, as clinicians will be seeing 6-15 patients at one time in a Virtual Group Consultation, this model has the potential to free up time for other clinicians to concentrate on the more complex patients who need 1:1 or face-to-face consultations. City & Hackney are continuing to think of ways that we can help with Digital Inclusion for our patients, so watch this space!
Virtual Group Consultations Pilot
City & Hackney Group Consultations Project
Dr Katharine Towers
C&H CCG Clinical Lead for Group Consultations