Before introducing an alternative to a face-to-face consultation you may wish to think about the following:

Getting it “right” is dependent on your rationale for using an alternative to a face-to-face consultation? Is it for convenience for patients, improved patient access or to manage demand?

Measures of success from a patient perspective

Are your patients aware of the availability of alternatives to a face-to-face consultation?

You could assess this through a quick survey of patients seeking to book an appointment and through discussion with your patient participation group.

Are patients using an alternative to a face-to-face consultation?

Assuming that patients are aware of the types of consultation offered in the practice, some patients can be sceptical about the use of alternatives to face to face consultation, particularly when this involves an investment on their part. Things to consider are; is the system fit for purpose? Has the gatekeeping increased or decreased? do patients need further guidance/help to use the alternative type of consultation? And is this something patients here want? More information can be found here. The level of use of alternative consultation types should be monitored through regular audits of the practice computer system. This will only be possible if different appointment types have been recorded systematically and reliably. A clear standard operating protocol is useful to make it clear who should record what.

Does an alternative to a face-to-face consultation lead to repeated consultations?

Repeated consultations should not necessarily be seen as a negative outcome, however, if the issue has not been dealt with satisfactorily then the patient may initiate a second consultation.

The number of consultations overall, and of different types, can be monitored on a monthly basis to see whether anticipated changes in consultation numbers have occurred.

Does an alternative to a face-to-face consultation affect patients’ satisfaction toward their GP and the practice?

Although some patients may feel that an alternative to a face-to-face consultation is heightening their satisfaction with their GP or the practice, many will just see it as another feature of their healthcare experience. It is worth noting, however, that even if an alternative to a face-to-face consultation is not time saving it may have other benefits for the patient. Patients views will be reported in the national GP patient survey, and you should be alert to changes in your patients’ satisfaction levels after changing your appointment system.

Does an alternative to a face-to-face consultation disadvantage certain groups or increase consultations in ‘hard to reach groups’?

There is a concern that only certain groups will be able to or will want to use an alternative to a face-to-face consultation. More information on who is it for can be found here.

Guidance on how to measure this can be found here.

Measures of success from a staff perspective?

Does an alternative to a face-to-face consultation impact on staff, if so how and why?

Some staff reported benefits to their ability to manage their own workload, some were less positive and some were ambivalent accepting that although there may be challenges this was countered by the overall benefits. This was often dependent on their role. More information can be found here.

If staff members find that an alternative to a face-to-face consultation has a negative effect on their working patterns then they are less likely to promote and use the alternative to a face-to-face consultation. However, lack of use may be related to a misunderstanding around the rationale for using it, who is should be used with and for what or a lack of confidence in using the technology. Therefore maintaining an open and continued dialogue is crucial, alongside adequate training and the production of protocols to guide use. More information can be found here.

Guidance on how to measure staff impacts can be found here.

Measures of success from an organisational perspective?

Has an alternative to a face-to-face consultation achieved its objectives?
This will depend on the rationale for the introduction of an alternative to a face-to-face consultation. This can be defined as being more efficient to manage demand, or increase access. Therefore the areas to measure might include the overall number and type of consultations,

Is it cost effective?

Has it cost more than anticipated and were there any unanticipated costs? What was the total cost, taking into account any change in staff hours as well as set up and maintenance costs for the new system. If the new system has led to additional costs has it enabled you to reduce expenditure in any other part of the practice to compensate for this?

Is it safe?

Has it raised issues of information or clinical governance? Have there been any adverse events related to the use of an alternative to a face-to-face consultation? Further guidance on safety and security can be found here.

Guidance on how to measure this can be found here.