DAWN: Diabetes Appointments via Webcam in Newham

Abstract

The diabetes service at Newham, East London, exemplifies challenges faced in the National Health Service with increasing demand, pressure to improve efficiency, high non-attendance rates and poor health outcomes, reflecting the complex lives of many patients with long-term illness. Perceived lack of control, poor engagement with inflexible services and poor self-management are common with these patients. Early evidence from our work so far suggests that web-based appointments can be used as part of outpatient services to improve patient experience and provide better access to effective care, with the potential to improve longer-term efficiency. By using readily available video conferencing software (Skype), our service model can be easily replicable across the majority of outpatient care. Further work is now being done to explore the impact of online consultations on improving patient self-management, particularly for those patients labelled "hard to reach". Br J Diabetes Vasc Dis 2015;15:123-126

Advantages and limitations of virtual online consultations in a NHS acute trust: the VOCAL mixed-methods study

“…[8][9][10][11] Guided by the brief, we sought to examine in depth any changes in the dynamics of the clinician-patient interaction and communication in virtual consultations in three clinics spread across two clinical areas (the Adult/Young RESEARCH CONTEXT AND RELEVANT LITERATURE NIHR Journals Library www.journalslibrary.nihr.ac.uk Adult Diabetes and antenatal Diabetes clinics in the Diabetes service, and the Hepatobiliary And Pancreatic Cancer Surgery clinic in Cancer Surgery, enabling comparison across different conditions, clinics and teams), the appropriateness and satisfaction of staff and different patient groups using virtual consultations (including young adults, older people and those from ethnic minority groups) and the ways in which wider organisational-and national-level environments shape virtual consultation services.…”

“…Following publication [9][10][11] and presentations across the UK about the service, the team in Newham have received over fifty requests for further information (often accompanied by requests for visits and assistance) from trusts across the UK. With a focus on making the best use of the accumulated experience at Barts Health NHS Trust, and being keen to ensure the application of our findings in practice, we have secured an Economic and Social Research Council Impact Acceleration Award and a Health Foundation Scaling Up Improvement grant to help us to extend and apply the research that we have undertaken in the VOCAL study.…”

“…Following proof of concept work with NHS Choices, we were funded by the Health Foundation 8,9 to explore the scope and feasibility of video outpatient consultations in the diabetes clinic in Newham. The Diabetes Appointments via Webcam in Newham (DAWN) project documented 62% acceptance rates across all ages, a reduction in DNA (from 40% to 23% at the end of year 1) and small efficiency savings of £63K.…”

“…The Diabetes Appointments via Webcam in Newham (DAWN) project documented 62% acceptance rates across all ages, a reduction in DNA (from 40% to 23% at the end of year 1) and small efficiency savings of £63K. 8,9 Our subsequent project on Diabetes Review, Education And Management via Skype (DREAMS) was also funded by the Health Foundation , and explored Skype-supported video consultations in 'hard-to-reach' patients with diabetes mellitus. 10 As well as improved clinical outcomes, DREAMS showed improved engagement and better self-management among regular users.…”

MyDiabetesMyWay

“…36 Since January 2011, clinics in Newham (England, UK) have been trialing Skype consultations. 38 Early indications reported reduced HbA1c levels, uptake across a spectrum of ages and ethnic groups, fewer accident and emergency attendances and modest efficiency savings. Those in employment or education or with carer responsibilities reporting greatest benefits.…”