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ALMOST one in four outpatient appointments in Scotland is now being carried out by phone or videolink.

Virtual hospital consultations have replaced many face-toface appointments in an effort to stop the spread of Covid-19 and help protect vulnerable patients from infection.

Experts believe the pandemic has changed the way healthcare is delivered for good, with the number of less-personal, remote appointments expected to grow. But there are concerns that this may actually be increasing workloads for doctors.

Campaign group Age Scotland said it is also worried remote appointments will marginalise older patients and prevent many from being properly diagnosed. In

the week ending December 20, 2020, almost 19 per cent of appointments were conducted via telephone and almost 5 per cent were by videolink.

These types of appointments were uncommon before the pandemic, but have made up about a quarter of outpatient activity since it started.

Age Scotland chief executive Brian Sloan said: ‘It’s good news that people are able to access outpatient appointments in a way that is most convenient for them, meets their needs and cuts down on travel when it is unnecessary.

‘However, we hope that with the growing use of remote appointments the needs of each patient are put first. It is important they feel comfortable with how appointments are conducted and are confident in articulating their symptoms.’

According to Public Health Scotland figures, in the week ending January 19, 2020, just before the pandemic hit, there were 95,580 face-to-face outpatient appointments, 345 telephone appointments and 234 video appointments.

But in the week ending

December 20, 2020, there were 56,488 face-to-face appointments, 14,310 phone appointments and 3,861 video calls.

Scottish Lib Dem health spokesman Alex Cole-Hamilton said: ‘NHS staff have moved mountains during the last 16 months. I am very grateful to them for offering a virtual and remote option when possible.

‘Unfortunately, in some cases, video appointments are not enough. The Scottish Government will need to ensure everyone gets access to appropriate treatment.’

Before the pandemic, virtual appointments were only used occasionally in some remote areas. But they are now more likely to be used in routine follow-ups for those with chronic conditions who are stable, particularly to discuss test results. Advantages can include less travel, making it more convenient, particularly for those who are frail or anxious about visiting hospitals.

But disadvantages can include problems with communication, for example if the patient has hearing problems, and concerns about the quality and safety of the clinical consultation and the ability of the medic to establish a rapport with the patient.

Dr Lewis Morrison, chairman of the British Medical Association in Scotland, said: ‘Greater use of remote or digital consultations can be beneficial for some patients and some specialties, but not all.

‘The perception that they save time for both patient and doctor is not always the case and they can, in fact, seriously increase workload and lead to duplication and multiple, not single, contacts. But they do clearly work better for some.

‘Protecting vulnerable people from Covid by using remote appointments has until now been a consideration. But we must balance this against the need to see people face-to-face for clinical reasons, or where it best suits the patient’s needs.’

The NHS in Scotland uses Near Me, also known as Attend Anywhere, a secure video consulting service which requires the patient to have a computer or smartphone and an internet connection.

The system can be used for outpatients, medicine consultations with pharmacists, GP appointments, mental health appointments, maternity and minor injury assessment. Users also include those with diabetes and those being followed up after cancer surgery.

A Scottish Government spokesman said the ‘blended’ model would continue, even once the NHS gets to normal.

He added: ‘The use of virtual appointments has increased in response to Covid-19, which has given people greater choice over their appointment, reduced the need for unnecessary travel and ensured the right care can be provided in the right place.

‘However, face-to-face appointments should always be available where remote consultations are not appropriate for the individual or their condition.

‘Health boards will continue to maintain a blended model of face-to-face, video and telephone appointments as they continue to remobilise services and ensure patient safety remains a priority.’

‘Beneficial for some, but not all’ ‘Can increase the workload’