Video consultations in UK primary care in response to the COVID-19 pandemic

The COVID-19 pandemic has necessitated a rapid response from UK primary care services and has prompted practices to consider implementing alternative methods of remote consultation to minimise face-to-face visits. The recent guidance from Greenhalgh and colleagues¹ regarding the use of video consultations in primary care is therefore timely and has important practical implications.

The guidance offers a useful summary of situations in which video consultations may be appropriate for either ‘COVID-related’ or ‘non-COVID-related’ consultations and provides tips on which patients may not be suitable for video consultations. The authors also outline the steps involved in setting up a video consultation service and provide advice on how to perform an effective video consultation.

What is apparent from reading the guidance and its associated BMJ article² is that there is a paucity of high-quality data regarding the efficacy and safety of video consultations in primary care, particularly in the context of acutely unwell patients. An area that warrants further research is the utility of video consultations for remotely performing physical examinations. Moreover, the relative advantages and disadvantages of video versus telephone e-consultations remain unclear.³

However, given the exceptional circumstances we find ourselves in, it is our view that implementation of technology to facilitate alternative methods of remote consultation, including video consultations, needs to happen urgently to enable primary care practitioners to provide ongoing care to patients who are unable to attend in person. At our practice, we have started performing video consultations via encrypted video link from smartphone to smartphone.

As highlighted by Greenhalgh and colleagues,^1,2 video consultations may offer advantages over telephone consultations in specific circumstances but should supplement, rather than replace, existing services. Managing the risks versus benefits of patient attendance versus non-attendance in primary care is complex and will likely continue to change based on our developing understanding of COVID-19 and as guidance from leading public health bodies is updated. The welcome guidance from Greenhalgh and colleagues¹ is the best we have to act on until further information becomes available on the efficacy and safety of video consultations in the context of the COVID-19 pandemic.