Halton Haven Hospice had a long-term vacancy for a consultant post, which the local NHS Trust was not able to cover or fund. The hospice realised that covering the costs of a full-time consultant and their secretarial support was not financially sustainable.
After a period of internal consultation, the hospice started working with Supportive Care UK to access online support from specialist palliative care consultants via video call.
Outcomes
The remote consultants lead twice-weekly ward rounds, including one multidisciplinary team meeting, and provide clinical supervision for doctors at the hospice. They are also included in the rota for out-of-hours support covering the community and inpatient unit. Staff at the hospice can call them for help in case of emergency.
All information about patient care is stored online and shared securely.
The hospice has received positive feedback from both staff and patients and has made savings of £50,000 per annum as a result of using the online consultant services.
Facilitators, challenges and advice
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Key facilitators
When considering using remote consultant services, the hospice’s senior leadership team consulted staff, patients and carers, making them aware of the challenges they were facing finding in-person consultant cover.
A doctor on the clinical team who had been working at Halton Haven for over ten years took on the role of Clinical Director, enabling the hospice to keep its specialist provider status, despite not having an on-site consultant.
Staff were determined to provide the best possible specialist palliative care and believed that employing remote consultants was the best way of doing this.
Staff at the hospice report that the remote consultants are committed to patients and interested in and respectful of different models of care.
Challenges
Some services that refer patients to the hospice raised concerns that the move to virtual consultant services would put people at risk. As a result, referrals to the hospice inpatient unit dropped and people struggled to receive the care they needed. This experience led several staff to leave the hospice.
Over time, the hospice has been able to prove that it is able to provide safe and high quality palliative and end of life care.
Tips and advice
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Ensure that all information sharing complies with Data Protection legislation.
As far as possible, maintain continuity in the in-person team. This is very important for patient confidence and quality of care.
Be compassionate. Ensure that you understand the additional pressures that may fall on staff when shifting to digital models and provide them with appropriate support and supervision.
When implementing change, make sure you are fully committed to improvement and understand why the change is necessary. This will help you persuade ‘naysayers’.
Future development
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The hospice reports being very happy with the virtual consultant service and intends to continue using it in the future. Other hospices have approached Halton Haven to ask for advice on implementing their own virtual consultant services.
