Telephone consultations to manage paediatric outpatient clinics during the COVID-19 pandemic: a service evaluation

Abstract

North West Wales is predominantly rural with a relatively small population spread over a large geographical area. The rapid development of the COVID-19 pandemic led to a radical re-thinking of how to provide continuing paediatric outpatient care in the face of a lockdown. The solution adopted was to use telephone consultations. This study took place during the summer of 2020, after the first lockdown had been relaxed. The purpose of this study was to evaluate the acceptability of telephone consultations as an alternative to conventional paediatric outpatient appointments and assess whether it could continue to have a useful role beyond the pandemic. Two hundred ninety-five telephone surveys were conducted with respondents, most of whom were carers of paediatric outpatients. Questions explored the child’s underlying condition, respondents’ attitudes towards the service received, social factors including distance previously travelled to the hospital and whether they would find ongoing telephone review acceptable or not. Sixty-one percent of respondents expressed a positive interest in ongoing telephone consultations. They commented particularly on compatibility with work commitments, childcare arrangements and travel times. Those travelling more than 1 h were particularly positive in their support. Respondents expressed the continued need for face-to-face review if the child’s condition changed acutely. Telephone consultations are an acceptable means of improving clinic punctuality, accessibility and convenience for families in rural areas, with ongoing potential beyond the pandemic. Careful consideration is required of the individual’s needs and requirement for physical examination when extending the use of telephone consultations.