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London mental health trust doctors use Skype for patient consultations

South West London and St George’s Mental Health NHS Trust doctors use Skype so patients can stay at home to attend outpatient appointments

South West London and St George’s Mental Health NHS Trust is using Skype to give patients an alternative to face-to-face appointments.

The trust is in the process of rolling out Skype consultations across its sites, meaning that, instead of having to come into hospital for an outpatient appointment, patients can video chat with their clinicians from the comfort of their own home.

The aim of the project is to make it easier for patients to attend appointments –, especially those unable or reluctant to leave their house for physical or mental health reasons, or those who can’t get away from work.

The head of communications and engagement at South West London and St George’s Mental Health NHS Trust, Ranjeet Kaile, told Computer Weekly that, because clinic appointments are held during the day and patients often have to take a lot of time off work, "did not attend" (DNA) rates were creeping up as people missed or cancelled their appointments.

“Skype has helped reduce travel costs for patients and meant that clinicians are able to add more appointments – and it has reduced DNAs, as patients can video chat when it’s convenient for them,” he said.

He added that the aim was not to take away the opportunity to see a clinician face-to-face, but rather to give patients another option if they want it.

“It’s really about making sure we can be as flexible as we can to suit our patients’ needs and that we always offer them the alternative. It helps save time for both clinicians and patients,” Kaile said.

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From pilot to roll-out

When the trust first started piloting Skype for Business in October 2014, it was intended for the trust’s staff to use to communicate with each other internally. The mental health trust has staff across different sites who often needed to attend meetings with each other.

Although some staff members were initially shy about appearing on video, they soon saw the benefits of not having to travel to a different site to attend a meeting.

Using Skype – first in a pilot with a small amount of staff members before rolling it out to the rest – the trust realised that it could make a difference to patients as well.

The trust began to pilot Skype, particularly with its deaf services, which covers a large part of the country. Using Skype meant patients didn’t need to travel for hours to get to their clinic appointment, Kaile said.

It also reduced the need to book a British Sign language interpreter for a remote consultation and staff working with the deaf community could communicate directly with patients who use sign language as their first language.

For mental health patients it has meant not having to leave the house, or avoid telling their work that they had to take time off for a psychiatrist appointment.

Although many mental health services use phone appointments, video chatting means the clinician can see and read a patient’s body language and facial expressions, making it easier to see how they’re doing, Kaile explained.

Patients are “vetted” by clinicians before being offered Skype appointments to make sure it is suitable for their needs, he added.

The trust is now rolling it out across the trust. “We have 100% absolute commitment from our clinicians,” Kaile said.

“We are also putting in place training and workshops to make sure people are comfortable using it.”

The Department of Health and NHS England is encouraging more digital interaction with the NHS, such as video chat, apps and online records. Last year, health secretary Jeremy Hunt said that within the next financial year, a quarter of smartphone users will be able to access NHS services and medical records, book appointments and arrange repeat prescriptions using a suite of health apps.

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So incredibly much of every day is wasted getting to and from meetings that could have been handled far better with a simple, quick, free Skype call. While face-time is often essential, it's often totally unnecessary. 

We finally have the video phone we dreamt about. With better sound than we ever imagined. With crisp, clean, hi-res video that constantly grows better. It's encouraging to see London's doctors and patients finally using it. So what are we waiting for here...?
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This is a great step in making the consultation process more efficient. I suspect what we’re waiting for is for someone else to face any liability issues that arise from not having direct, face-to-face consultations.
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When my wife attended a routine check during her pregnancy she got a pretty bad flue at the clinic. We did question why showing up is needed if no inspections were required, and the answer was - it's the money. They charge you for the visit. Switching to Skype may hurt someone's financial interests.
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