Changing the ways we access health and care services

The Covid-19 crisis is having a profound impact on the way in which everyone in Camden lives their lives. For those who rely on health and care services there have been sudden and significant changes to the way those services work. Hospital appointments have been postponed and other services have been forced to make a sudden shift online.

Anyone who has sought a GP appointment during lockdown knows that many appointments have been replaced by a telephone call from a doctor who will assess whether a visit to the surgery is needed. Patients have all been encouraged to order repeat prescriptions online with collection direct from a local pharmacy. Some services are even using remote video methods to see patients while keeping both patients and healthcare personnel safe.

Healthwatch Camden has been asking local people about their experiences of these changes. We’ve heard from over 200 people who used health or wellbeing services online – or by telephone – since the COVID-19 outbreak, and most people shared very positive feedback.

One elderly patient told us:

I rang the GP surgery and the receptionist said a doctor would call me back which he did – within an hour. He was very helpful on the phone and we decided I didn’t need to go in to see him.”

And Jane, who lives with multiple long term and debilitating conditions, said:

My issues are recurring so it’s usually very daunting and a physical strain to get to the GP. I often put off going as I don’t have the energy to get there. But this time they did everything over the phone. It was really quite liberating not to have to go in person – it’s made me feel like I’ve got a little bit of control back over my own care. I wasn’t expecting that.”

A teenage boy reported:

I just rang up and they said I could go and collect my prescription from the chemist. I didn’t have to make an appointment or anything. I couldn’t believe how easy it was!”

Where a traditional phone call has not been enough, some patients have been able to see their GP via video.

“My GP consultation was by WhatsApp video. The service was excellent, as usual.”

We also heard some positive feedback about hospital appointments shifting to remote methods.

I had a consultation over the phone with UCH. It’s actually better than before! Now I don’t have to go to UCH and wait around. I hope in the future my consultant does this phone consult in the future. I don’t think we need to leave our house ever again, it really really worked. I was amazed. I congratulate UCL and Moorfields for adapting the way that they have. Moorfields is a long way for me on the bus.”

But not all hospitals or services adapted in the same way. Some people have questioned why more routine hospital appointments for long term conditions could not have been conducted remotely rather than being cancelled indefinitely.

A phone call or an online meeting was all I needed. Instead my next appointment has been moved from 1 April to September. I’m sure not all the consultants were busy on the Covid-19 wards!”

However, people have made it very clear that health services delivered over the phone or online are not right for everyone and everything. Some people feel excluded and intimidated by the need to perform tasks online when they are not confident using a device or the internet. And some live with communication support needs that make it harder to use some technologies.

For example, we were contacted by a d/Deaf patient who pointed out that a call back from a GP is no good if you cannot hear the phone ring.

I had to explain to them to use NGT (typetalk) to call back as they did not provide a British Sign Language interpreter via the online service. The service was okay but I was disappointed there was no BSL interpreter.”

For others it’s the quality of the care that suffers. We are hearing that remote services are not adequate for people seeking mental health support or for children with complex needs.

“There’s been Zoom groups and telephone calls to replace mental health day services but they’re only twice a week and it’s too hard to keep well, worse than normal much worse.”

 “For children with severe disabilities, video or phone consultations cannot replace face to face ones.”

Online is no replacement for face to face doctors.”

Many patients have been willing to adapt to different ways of getting support, whilst the current situation demands it, but want to make it clear that the quality of service is not the same.

I have been seeing my therapist using online video calls rather than in person. I have got used to it, though it is certainly not the same as being there in person.”

“Not the same but better than nothing.”

Healthwatch Camden will be sharing the views of patients with GPs, hospitals and other NHS providers in Camden and making the case that, in the rush to make the most of the benefits of online and remote access, services must ensure no patient gets left behind.