Covid sparks boom in digital hospital outpatient appointments

Digital healthcare service Attend Anywhere was introduced across the country at the end of March after NHSX chief clinical information officer Simon Eccles called for its rapid expansion.

There has been a major push to boost digital healthcare services across the country in order to support the national response to coronavirus. Much of primary care has already switched to working virtually. Undertaking hospital outpatient appointments digitally has been identified as a way of keeping patients safe by removing their need to travel.

There have now been more than 79,000 consultations with Attend Anywhere. The number of consultations started at around 200 per day, but has rapidly increased to more than 6,000 per day.

There are, of course, other digital outpatient systems in use - but none with the official backing of NHSX or, therefore, the speed of spread.

Acute trusts have taken up the main bulk of the appointments on Attend Anywhere, carrying out 44,000 on the platform, while community and mental health trusts have carried out more than 20,000. 

However, there is significant scope for even greater uptake in the coming months. NHS England figures show that around 40 per cent of the 185 NHS organisations which have Attend Anywhere are still “inactive”, as they are holding fewer than 10 consultations per day.  NHS sources say there is usually a “lag” between an organisation being set up with the platform and it being used regularly. 

The platform - which originated in Australia - was widely used in Scotland before coronavirus spread across the UK and it was being used in Wales. Around 40 NHS organisations in England were also piloting Attend Anywhere as part of the national outpatient transformation programme, with NHS Scotland, although they had “very limited” activity. 

Following instruction from Mr Eccles at the beginning of March, the NHS signed a 12-month contract with Attend Anywhere to provide digital services across all trusts that wanted the technology. HSJ asked NHS England how much the contract was worth. Trusts were also given £20,000 of capital funding to provide any additional equipment that was needed. 

In 2018-19 there were approximately 8m outpatient consultations each month in the English NHS.

The rollout of digital across the NHS has been rapidly accelerated since the outbreak of coronavirus in the UK, with the procurement of digital tools fast-tracked for GPs surgeries.

Data released by NHS Digital showed that GPs moved swiftly to change their practice model in the face of covid-19. The proportion of appointments conducted face-to-face nearly halved and the proportion of telephone appointments increased by over 600 per cent from 1 March to 31 March as GPs moved to keep patients out of surgeries except when absolutely necessary.

However, concerns have been raised over the limitation of remote appointments, particularly in mental health services. Royal College of GPs chair Martin Marshall raised concerns that video appointments could make it difficult for doctors to diagnose and manage patients’ conditions during the pandemic.