A remote future? Healthcare in an online world

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The British public’s preference is clear: when accessing NHS services, they want to be seen face to face.

In a nationally representative online poll*, BritainThinks and the Richmond Group of Charities asked respondents whether they would prefer face-to-face or remote appointments across a range of scenarios.

When thinking about seeing a physiotherapist, a mental health professional, a specialist for the first time, or having a check-up with a specialist on an existing condition, people were more likely to say they would prefer a face-to-face appointment.

Our research suggests this preference is rooted in fundamental questions about the quality of remote care: 68% of those we polled said they don’t feel healthcare professionals would be able to assess their condition as effectively remotely.

This is borne out in focus groups and in-depth interviews with patients and the public: one patient described an online appointment where the physiotherapist struggled to diagnose them without a physical exam. Another patient with a mental health condition talked about feeling that they needed to be “a bit more formal over the phone... you have to put your face on for a video call... that makes it a bit less honest”.

Beyond quality, there are also worries about sharing sensitive issues (such as those related to sexual health) remotely, as well as widespread concerns about access for those who might not have the digital skills or resources to join a remote appointment.

However, the research also points to occasions when remote appointments might be tolerated. One such occasion is a routine GP appointment, for example, to get a repeat prescription. In our poll, this was the only type of appointment where more people said that they would prefer remote ( 37% versus 29% face to face). From a patient perspective, this is a rare, low-stakes appointment: they know what is wrong with them and what they need.

Remote appointments are also more likely to be accepted if they can be made to fit seamlessly into patients’ lives, thereby maximising the clear convenience benefit for busy parents who don’t want to have to drag their children with them into the doctor’s surgery, or those with packed work schedules.

Currently, however, processes in many areas aren’t sufficiently streamlined to offer this: people told us in interviews of being given slots several hours long when they might receive a call. Having a remote appointment and then a follow-up, in-person appointment is also a bugbear: “I had a telephone appointment and was called in... we went over the same thing. It would have been so much easier if I just went in to begin with,” one participant said.

Ultimately, many of the people who participated in the research suggested that they would like to see a blended future, where patients can choose how to engage with healthcare, based on their personal circumstances: “I think [remote appointments] would be a good option in future; it shouldn’t replace physical, but it’s a good option.”

As we look beyond the pandemic, there is a lively debate taking place about the way in which the NHS should provide care in future. Through this work, the public has made its views clear; it’s now up to the NHS to listen and deliver a service that is built around the needs of the people it serves.

* 2,104 people surveyed online between 26 and 28 February 2021.

Anastasia Knox is associate partner at BritainThinks

• Across qualitative and quantitative research, patients express a strong preference for face to face
• Routine GP appointments are the only appointment type tested where more people would prefer a remote rather than a face-to-face appointment
• The NHS Long Term Plan contains a commitment that by 2023/24 every patient in England will be able to access a digital-first primary care offer.
  

THIS ARTICLE WAS FIRST PUBLISHED IN THE JULY 2021 ISSUE OF IMPACT.