Using video consultations for children and young people

Chris Bound is a children and young people diabetes lead clinical nurse specialist at Imperial College Hospital, London

Over the last 18 months in my role as a children and young people (CYP) clinical nurse specialist, I’ve learnt a huge amount about how we can exploit digital platforms in healthcare and continue to provide a high level of patient-focussed care. I’m lucky to work in a specialist area which sees an abundance of fast moving technology, which can be used to help people living with diabetes to alleviate the daily burden of their condition. I also work in an agile team which embraces innovation and thinking out of the box to provide holistic care for our patients.

During the COVID-19 pandemic, we sought out the digital platforms which work best for the families we care for, and also looked at different ways of providing traditional face-to-face care if a digital tool wasn’t appropriate. This included group cooking sessions on Zoom, online insulin pump starts and education and online workshops for young people transferring to adult services (including a video tour of the adult clinic and introduction to key members of staff). We’ve seen a reduction in patient reviews thanks to people having the confidence to monitor their conditions at home using various digital tools, which is resulting in fewer missed appointments.

I recently sent around a survey to our local CYP teams looking at which platforms clinicians are using for consultations. The feedback shows that there is still a lot of anxiety about information governance and myths about what can be used, and in which situations. As we have seen during the pandemic, video conferencing and consultation tools can play an essential role in how we carry out health and care appointments. The NHS encourages the use of video conferencing to support the delivery of care to patients and service users, including children under the age of 18, and NHSX has published this useful guidance which should help anyone in doubt. For more information about using digital platforms for consultations I’ve also included some useful links at the end of this blog.

One of my patients, 12-year-old Oliver, loves the convenience and efficiency that virtual consultations have brought and doesn’t feel that these have negatively affected his relationship with his care team. His mother has told us that she does miss the energy and positivity which she gets from seeing us face to face, which is more difficult to replicate on virtual platforms. I wonder whether this suggests a generational preference, based on being tech-savvy versus tech-naïve? I think that ultimately, some people just have different preferences, and we need to ensure that everyone has a choice in how they’re treated.

As we now move towards the ‘new normal’, I feel it's imperative that we maintain the momentum of progressing digital healthcare at the same pace as over the last 18 months. We seem to finally be catching up with other industries! But we still have a way to go - and it's everyone’s responsibility to ensure we continue moving forward.

I’ve recently been seconded one day a week for the next year as a ‘children and young people digital champion’, made possible with funding provided by the St Mary's Hospital Children's Fund. Part of my remit is to support the development of an ‘11 to 25 Hub’, which is a one-stop-shop of videos and patient stories, podcasts and written materials for young people, their parents and health care workers. The hub provides resources to assist in the often complicated process of transitioning through children’s services to adult services. I hope this will support young people to have a planned, smooth and seamless pathway to adult services and those involved in healthcare transition to have the knowledge and skills to make this happen.

I’ll also be looking at how we use technology within CYP services - engaging stakeholders locally, as well as listening to young people about what’s important to them with regards to using technology in a healthcare setting.

I’d say it’s clear that we need some local and national guidance to ensure we don’t lose momentum in using technology in CYP services and to give people the confidence to use these vital tools to keep our families engaged. More importantly, we need to concentrate on delivering the care that children and young people deserve, with the choice of methods of delivery and platforms so they can use what suits them best.

Further reading

Principles for conducting virtual consultations with children and young people

‘The paediatrician will hear you now’: making virtual outpatient consultations work for children and young people

Virtual Consultations: Young People and Their Parents’ Experience (PDF)

How Microsoft Teams can support your clinical practice during the pandemic