The long road to patient co-production in telehealth services

Increasingly, patients are involved in setting up new healthcare services, from consultation through to designing and running services, with the aim that they better reflect patients’ needs.

Consultations with service users preceded new telemedicine initiatives in rural Wales and Scotland, for example. Consider outpatients in Caithness county in northern Scotland, who face a six hour round trip to Raigmore Hospital in Inverness for appointments.

NHS Highland covers 32 500 km², from Caithness in the north east to Kintyre on the west coast. It is the largest and one of the most sparsely populated Scottish health boards, and was crying out for a telemedicine service to make specialist care more accessible and cut long journeys.

The NHS Near Me video consulting service launched last year,1 and 10% of Caithness’s hospital outpatient appointments are now provided by phone call or video conference, either from the patient’s home or from a local clinic. The service covers 19 clinical specialties, including haematology and psychology, with more planned. It has expanded throughout NHS Highland and is being tested in Skye.

The project received £28 500 (€32 000; $36 000) additional funding from the Health Foundation think tank to work with patients before, during, and after introduction of the service to ensure it met their needs. The project lead, Clare Morrison, and her colleagues spent six months collaborating with patients, clinicians, and other staff to design the outpatient clinic service at Caithness General Hospital, linking patients there to specialists elsewhere.

Morrison told The BMJ, “The main benefit of co-production is to design a service that works for patients. …