Making the most of remote consultations – a guide for patients (*rolling blog)

It is increasingly common for clinicians to carry out consultations with patients over the ‘phone or on the internet.

If you have time to prepare for the consultation here are some suggestions. This is part of our patient led clinical education work. The aim being to help all patients / users of health and care services lead on their own care.

In some cases, you may be talking to someone who has never met you, so preparation is key.

Here is some general advice:

Preparation

1. Write it all down beforehand if you can, as it’s difficult to remember otherwise.
2. Take some observations if you are able. Temperature blood pressure heart rate other measurements, including your feelings, mood and areas such as sleep & appetite. If the problem is something visible (like a rash for example) send pictures & monitor changes over time.
3. Tell them how you are different from your norm.
4. Tell your story of why you are calling, in your own words.
5. Be honest and remember mental health and physical health are equally important. Inseparable in fact.
6. Ask if you don’t understand anything.
7. Don’t be afraid to check that the clinician has followed what you are saying.

It’s important that you are allowed time at the outset to tell your story in your own words, to be able to share your ideas, your concerns and what you are expecting for the consultation. If you are speaking to someone who doesn’t have access to your medical history, they will also go through this with you in detail.

This checklist will help you prepare for the consultation and lead to an agreed plan for what to do next. Think particularly about what you would like to have happen. This is a question you may well be asked.

Your clinician will also need to refer to your medical history. If they have this to hand they may check that it’s up to date with you. Often they may not have this information and will have to go through your history with you. This is vital in order to ensure you come up with an appropriate and safe plan for your care. Click here for a second short blog on giving a history.

Medicines and treatments (of any kind)

Consultations often involve medicines and treatments. Because of this it’s important that you share details of all medicines and related substances you take, not just those that are prescribed. This includes herbal medicines, over the counter medicines, supplements and anything borrowed or bought over the internet. It’s vital to be honest, as interactions can be very serious, sometimes fatal. Your clinician will not think badly of you if, for example, you don’t take a prescribed medicine or are trying something else. Statistics show that at least 50% of people don’t take their medicines as prescribed. That’s 50% of the whole population with mental or physical illnesses, not just a specific group of people.

Remember a medicine isn’t always the answer, share with the clinician details of non-medicine related treatments and approaches you take, and how well this works.

This chart shows the information you need to share. Very importantly this includes details of any allergies or sensitivities and how these affected you.

What happens next – The plan

Finally, many consultations do not result in a medicine, or specific treatment, being prescribed. Some may result in a medicine or treatment being stopped, changed or reduced. Sometimes it’s a case of ‘watch and wait’. The most important thing is that both the patient and clinicians have agreed on plan, know how to monitor progress and what to do if things change.

What’s important is that:

1. You have agreed a plan
2. You know what tests are needed (if any) and they are arranged
3. You know what referrals have been made and when to expect to have these consultations
4. You know the signs of improvement or the signs of deteriorations to look for
5. You have information on the problem and access to more in a format you prefer
6. You know when & who to contact if things deteriorate
7. You know the signs to look out for and when to call 999
8. Everyone involved in your care shares this information

Summarised in the chart below:

*This is a rolling blog. I welcome all suggestions for amendments, deletions and additions from everyone. Please email steve@carerightnow.co.uk

I am grateful to my friends and colleagues who helped me put together this information.

Steve Turner is a nurse prescriber, now retired, & former Associate Lecturer at Plymouth University. Steve shares health information from the Twitter account @MedicineGovSte using hashtags: #TeamPatient #TeamNHS Author: Steve Turner

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Version: 1

Revision History:

30.06.2022 – Changed to reflect that the author is now retired.

27.04.2020 – added a note about taking and sending pictures (‘Preparation’ point 2.)