Rona Inniss is a Clinical Nurse Specialist at Guy’s Hospital, London, and a HEE/NIHR ICA Pre-doctoral Clinical and Practitioner Academic Fellow. Rona is interested in researching healing and healthy environments. She changed career after studying and working in architecture, gaining her nurse registration at King’s College University. She started at King’s College Hospital NHS Trust as a staff nurse, and then a Parkinson’s Research and Clinical Nurse Specialist, before joining the neurofibromatosis team at Guys in 2016. Rona wants to improve the experiences of healthcare environments by evaluating patient, staff, and visitor experiences.
The Neurofibromatosis Service provides lifelong care to patients with nerve tumour predisposition syndromes [1,2]. Attendance is typically face-to-face outpatient appointments with consultant neurologists, clinical nurse specialists, physiotherapists, psychologists, and a social worker.
Covid-19 forced a severe reduction in face-to-face appointments, with remote offered instead [3,4]. The NHS long-term sustainability plan  aims to avert up to 1/3 of face-to-face consultations by 2029. Evidence from patients who had remote appointments during the pandemic can help us shape the roll-out of this long-term plan.
Paper questionnaires were sent to all patients with an appointment within the same 2-week period during August 2020, 2021, 2022.
Response rates were similar: 26% (32/122, 2020), 22% (23/106, 2021), and 25% (26/104, 2022).
In 2020 most patients had an appointment by telephone / video. In 2021 and 2022, less than 25% did.
In 2020 just over half of people wanted their next appointment to be remote. By 2021 / 2022 just under half wanted their next appointment to be remote.
Patients report positive and negative experiences of remote appointments but over all three years the most popular choice was still a face-to-face appointment.
Positive experiences included reduced language barriers and improved accessibility (less time off work / childcare). Negative experiences included lack of access to / confidence with technology, and perceived negative impact on relationship with professional.
To meet the UN Sustainable Development Goal of good health and wellbeing , and the NHS long-term plan  to use technology to reduce face-to-face appointments, our research demonstrates that the UK needs to improve access to and confidence in technology, whilst acknowledging the importance the patient places on the in-person relationship with their health professional.