Convenience for patients
Before deciding to introduce an alternative to a face-to-face consultation you may wish to consider:
- What exactly is the problem you are trying to solve?
- Whether the use of an alternative to a face-to-face consultation is the best solution to your problem?
- That this is not a replacement for the face to face consultation but complementary
- An alternative to a face-to-face consultation is a learning process, it might take time to embed and could develop organically which might include finding more uses than originally expected.
- Commercial interests are at play and people are selling products.
- Is this driven by the availability of funding to trial something for free?
- You might require support and guidance from other institutions such as the Medical Defence Organisations (MDOs) and Clinical Commissioning Groups (CCGs) or Health Boards
Rationale
One reason that some practices consider introducing an alternative to a face-to-face consultation is the desire to be a modern practice responding to the expectations of busy, time-poor patients. Or it might be to provide health care for patients who are unable to attend the practice for a multitude of reasons such as living in a remote location or other barriers to attending the practice. Either way, it will be important to think about whether this is going to a change in overall practice workload or just a different working pattern.
If this is the reason that you are considering introducing an alternative to a face-to-face consultation then you may wish to think about the following:
- That each rationale is not mutually exclusive.
- Who is driving the change; is it individual practitioners, local/national (centrally mandated such as 5 year Forward View)/or commercial drivers?
- Is the whole team behind this, or is it driven by just one or two enthusiasts?
- Which alternative to a face-to-face consultations are you considering/would provide the best medium in your situation? Why is this the best approach to doing what you are trying to achieve?
- What kinds of consultations do you envisage will be managed using an alternative to a face-to-face consultation for?
- Can you afford it/what is the cost?
- Do you have the appropriate infrastructure/would you need to make changes?
- Is this likely to lead to an increase or decrease in existing GP work? How will you know?
- How will you record/integrate the consultation in the patient records?
- What impact will it have on your staff?
- What about information governance?
- What about clinical governance?
- Is this what your patients want?
- How will you inform patients?

In terms of the practice we’ve been looking at better improving access for patients and also changing access to be more convenient for GPs and other clinicians.
I think we were just trying to be modern when we introduced it.
So the only reason for having it is because physically we’re separated and we don’t go out there every day.