How to ensure remote consultations work for your patients

Promote and support equity and inclusion

• Understand the needs of their population and proactively put in place safeguards to optimise equity of access to healthcare and inclusion
• Utilise public and patient evaluation, co-design pathways that acknowledge the needs of the local population, taking steps to promote inclusion and equitable access to services

Find out more

• NHSx What Good Looks Like – this resource draws on local learning to build on established good practice to provide clear guidance for health and care leads to digitise, connect and transform services safely.

Optimise digital inclusion

• Develop strategies to optimise digital inclusion – for example, provision of equipment, training and support or signposting to other organisations who may provide training and resources to patients. For example, AgeUK – Loneliness and Digital Inclusion - a variety of digital inclusion projects including one-to-one support; classroom-based services; one-off drop-in or larger community awareness sessions
• Work with patients and staff to develop inclusive pathways that should ensure:
  – No individual should be automatically excluded from digital services because of any presenting condition, medical history, literacy, background, age or other demographic characteristic
  – The technology offered is flexible enough to suit the individual’s need 
  – The performance and usability of technology for patients and staff is evaluated
  – Technical support is available where required to patients and staff. This should include giving clear information to the patient and staff about what to do should the remote consultation platform/ internet connection fail 
• Support teams to utilise continuous service evaluation and improvement strategies to ensure pathways meet the needs of the population and can be effectively applied into practice (see evaluation section below for full summary of service evaluation)

Find out more

• NHS Digital – This guide to digital inclusion is aimed at local health and care organisations to help them to take practical steps increase access to digital services for all in their communities.  

Promote a personalised and flexible approach

• Provide training and resources to support staff competence and confidence in: 
  – Undertaking remote approaches appropriately as part of a hybrid model
  – Utilising shared decision making and personalised care
• Develop clinical pathways that support a flexible hybrid approach. The pathways should: 
  – Acknowledge that types of intervention may be less feasible when delivered remotely, for example if hands-on examination is needed, and dependent on the type of technology available 
  – Acknowledge that efficiency and effectiveness of different types of intervention may vary according to whether delivered remotely or in person and the type of technology available 
  – Promote a flexible, clinically reasoned approach allowing for different methods of consultations depending on the individual’s clinical needs across the same episode of physiotherapy 
  – Encourage and support innovative ways to use technology to improve access to services

Promote and support equity and inclusion

• Develop an understanding of the population that they support to help identify if any patient groups are being inadvertently excluded or disadvantaged by service pathways
• Feedback to colleagues and leads when a barrier or opportunity to improvement of the service is observed

Find out more

• Frontline article on knowing your population
• The King’s Fund Health Inequalities Framework is designed to help all allied health professionals to think through and understand health inequalities and the steps we can all take to work towards improving these

Contribute to optimising digital inclusion

• Continue to develop an understanding of and engage with digital strategies to promote digital inclusion. Join the CSP's online community DIPG to find out more about the exciting opportunities and challenges that technology offers members of the physiotherapy profession and patients.
• Support patients to access resources that can improve their confidence and understanding of remote approaches. 

Find out more

• NHS Digital has useful resources to help develop your understanding of digital inclusion, what big the issues are in your area (Digital Heat Map) and guidance supporting your patients to get the best out of remote consultations.
• Plymouth Telerehab Toolkit – Advice and resources to support patients and professionals using remote consultations
• Nuffield Department of Primary Care and Oxford University – Guidance and resources for NHS patients and clinicians to support online consultations

Promote a personalised approach

• Improve confidence and competence in the use of in-person and remote methods of consultation
• Be open and confident to use personalised care – avoiding personal preference/biases in favour of shared decision making

Find out more

• The Plymouth Project has developed a telehealth training checklist to help practitioners identify areas where they would like more training, resource or support
• Frontline article: Personalised Care is Everyone’s Business
• The Personalised Care Institute provides free courses suitable for all health and care professionals, regardless of profession or seniority to develop skills in personalised care, including a module on shared decision making 

Promote a flexible approach

• Take a flexible approach that is responsive to patient need throughout the physiotherapy episode of care . This means adjusting your consultation approach (remote or in-person) throughout the episode of care using shared decision making, the purpose of the consultation and the required resources to undertake the session successfully to define the method of service delivery for the next session

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Evaluate and share your services successes and challenges

• Collect and share data illustrating the patient experience, satisfaction and preferences to influence and shape the development of your service
• Share your successes, challenges and innovative methods of working with you colleagues but also with the profession
  Join the CSPs online community DIPG to find out more about the exciting opportunities and challenges that technology offers members of the physiotherapy profession and patients

Find out more

• Read the CSP advice pages on creating and using data meaningfully
• Read about other’s work in the CSP Innovations Database