Doctor video-link bid to reduce pressure on A&Es

SCOTTISH doctors are assessing child patients via video link in a move designed to cut down on the rising number of over-anxious parents clogging up A&E departments with children who do not require emergency treatment.

Four NHS health boards have taken part in a pilot project that saw GPs and doctors in rural and community hospitals contacting an on-call paediatric consultant via video conferencing who then assessed a child.

Medical experts warn that in emergency departments across Scotland, children’s wards are filled with parents who are anxious about their child’s health. They say video conferencing can offer parents and GPs reassurance and cut down on unnecessary emergency department admissions, as well as offering a faster and improved quality of care for those that are seriously unwell and in need of urgent treatment.

But critics want more funding for frontline services in hospitals, rather than asking patients to rely on new technology.

The paediatric unscheduled care project, co-funded by the NHS and Scottish Government, saw dedicated on-call paediatric consultants provide 14 district general and community hospitals in rural Scotland, many of which are led by general practitioners, with access to a paediatric consultant 24 hours a day by video conference. NHS Grampian, Shetland, Orkney and Western Isles all took part.

Following the pilot, emergency admissions for children fell by 25 per cent in the areas using the scheme. A working group has been set up to look at expanding the scheme.

Professor James Ferguson, consultant surgeon in emergency medicine, NHS Grampian and National Clinical Lead, The Scottish Centre for Telehealth and Telecare, led the project.

He said: “Scottish Government data shows the number of attendances at A&E for children is sky rocketing, especially for the under-fives. A lot of it is worried parents and really unwell children are rare. We are now seeing so many children filling up A&E and, rather than coming to hospital, why don’t we use digital technology to see and assess the child, or adult, in their home?

“This has been a test to see if it would work, and it did.”

Ferguson said the video conferencing could prove especially useful for rural communities.

He said: “In a lot of cases, particularly from rural general hospitals and remote GP practices, people undertake major journeys just to be told they are alright.

“With video conferencing, we can virtually see the patient, see the parents, make better judgements and offer them reassurance.

“For many patients, it is not always necessary to see them face to face.

“It also means that we would improve the care of patients that are very seriously unwell by starting treatment earlier.”

Ferguson said that during the pilot, at least, a quarter of patients avoided unnecessary hospital transfers.

He added: “We can apply this model to adults, and improve the care of elderly people. We are looking at the moment at the best ways to get the most out of such a service.”

Professor George Crooks, medical director, NHS 24, said: “The aim of the Paediatric Unscheduled Care pilot was to provide 24/7 access to a consultant paediatrician via video link to rural general hospitals in Highland, Grampian, Orkney and Western Isles. This was facilitated by NHS 24 which provided a dedicated single point of contact service.

“NHS 24 recognised the many benefits that a programme of this type could offer rural general hospitals, including the ability to provide specialist triage support which could enable a child to be safely treated locally, therefore reducing inappropriate long distance transfers to another hospital.”

Scottish Conservative health spokesman Jackson Carlaw MSP said his party would prefer more investment in front line services.

He said: “We do recognise that this is a tricky issue and video conferencing may reduce pressure on our casualty wards. However, the Scottish Conservatives believe that the setting up of recovery centres and more staff resource could also work well in reducing A&E admissions.”

A Scottish Government spokesperson said: “Unscheduled care is a priority for the Scottish Government and we are pleased this project has been evaluated as a success.

“This is an example of how appropriate use of technology can improve access to health services.”