The Impact of Remote Urology Outpatient Clinics during the COVID-19 Pandemic

Abstract

Introduction: The coronavirus (COVID-19) pandemic of 2020 had a major impact on NHS services. From the 23rd of March 2020, the Urology Department in Basingstoke initiated telephone-led consultation clinicsinstead of face-to-face outpatient appointments, in accordance with U.K. guidance.Objectives: To evaluate patient experience and satisfaction following the introduction of remote (telephone) consultations during the COVID-19 pandemic.Patients and methods: The first 200 remote patient appointments between the 30th of March 2020 and the 16th of April 2020 were sent a postal questionnaire (19 questions relating to their experience and level of satisfaction with the interaction). Telephone consultations were conducted by 6 consultants, 3 registrars, and 2 specialist nurses. The patients were not prewarned to expect a questionnaire after the remote ap-pointment. The associated cost saving resulting from a switch from face-to-face appointments to remote telephone appointments was also calculated.Results: 100 out of the 200 patients responded within 1 month (response rate 50%). A total of 44% of the patients were new referrals, while 56% were follow-ups. Overall, the feedback was positive regarding the telephone consultation, with 88% rating the care received as excellent or very good. In addition, 90% would recommend a telephone consultation to family and friends. However, 35% would prefer in the future to have another telephone consultation rather than face-to-face consultation, with 46% preferring a face-to-face appointment in the future and 19% unsure. For new patients, the proportion wishing to have a face-to-face appointment, in the end, was unsurprisingly higher than it was for those undergoing a follow-up (39% vs. 7 %). In these 2 weeks, the cost reduction to the NHS from shifting from face-to-face consultation to telephone consultation was estimated to be £6500.Conclusions: Telephone urology clinics are a satisfactory alternative to face-to-face appointments for many of our patients now and beyond the COVID-19 pandemic. They are efficient, cost-effective, and feasible to undertake urological consultation and can be implemented successfully in selected patients. The feedback from this questionnaire would suggest that priority should be given to face-to-face appointments for new patients and for complex follow-up appointments. Telephone follow-up appointments, however, are a good approach for the majority of patients.

Citizens’ perspectives on relocating care: a scoping review

“…While eight studies are from 2013, most studies were published quite recently in 2019 ( N = 7), 2020 ( N = 6), 2021 ( N = 16), and 2022 ( N = 9). Relocating care from the hospital to eHealth is the form of relocating that is most often examined within the studies identified ( N = 28) [ 26 – 53 ]. This is followed by relocating from the hospital to self-care ( N = 15) [ 54 – 67 ] and care at home ( N = 13) [ 30 , 68 – 80 ].…”

“…This was true for all forms of relocation [ 27 – 30 , 32 – 34 , 38 , 41 , 42 , 45 , 47 , 49 , 52 – 54 , 58 – 60 , 65 – 67 , 69 , 70 , 73 , 78 , 82 , 84 – 86 , 88 , 90 , 93 , 94 ]. Citizens think of relocating as convenient because in most cases it saves travel time [ 26 , 29 , 53 ]. It saves costs [ 26 , 69 ].…”

“…Citizens think of relocating as convenient because in most cases it saves travel time [ 26 , 29 , 53 ]. It saves costs [ 26 , 69 ]. It avoids stress due to factors such as transport problems, busy traffic, travelling while you are sick, or long sojourns in waiting rooms [ 26 , 53 , 73 , 93 ].…”

“…It saves costs [ 26 , 69 ]. It avoids stress due to factors such as transport problems, busy traffic, travelling while you are sick, or long sojourns in waiting rooms [ 26 , 53 , 73 , 93 ]. When relocating to self-care it was very often mentioned that it is an advantage to have more flexibility [ 30 , 86 ].…”

“…Within the articles about relocating from the hospital to eHealth, 23 articles out of 28 provided the preferences of respondents towards the location of care. In ten articles there was a preference for eHealth [ 28 , 32 – 34 , 42 , 44 – 46 , 50 , 53 ] and in six articles a preference for the hospital [ 26 , 31 , 36 , 39 , 43 , 48 ]. In four articles, citizens expressed a wish for a combination of eHealth and face to face contact [ 37 , 47 , 49 , 52 ].…”