Dr Nicola Roberts
Research and Education Sub-committee, The Association of Respiratory Nurse Specialists (ARNS)
Since the start of the pandemic the NHS has had to adapt at lightning speed, this has meant fast innovation in the way we deliver care to replace face to face consultations.
Before COVID-19 there was a steady increase in the use of virtual and telephone consultations in healthcare. This has rapidly evolved further since the start of the pandemic. For those working with respiratory patients, like asthma and COPD, this has included changing to email, video and telephone consultations.
Programmes like pulmonary rehabilitation are being delivered in a virtual way, empowering patients to use their own home and resources to participate. Alison Hughes, a respiratory nurse specialist and ARNS Vice Chair adds: “Feedback from our service shows that more than 80% of participants felt more confident exercising at home after the course, only 30% of participants had accessed healthcare virtually prior to attending the classes”.
It is important that changes to delivery of care made during this pandemic are evaluated to ensure that healthcare professionals are supported to adopt new ways.
Schemes such as “virtual wards” are playing an important role, these projects have reduced the time spent in hospital for those with COVID-19, allowing them to be monitored at home1. The Academic Health Science Networks and Patient Safety Collaboratives are supporting the implementation of COVID-19 virtual wards and the widespread use of pulse oximeters (oximetry measures oxygen in the blood using a small fingertip monitoring device) within our local health and care systems.
Maria Parsonage, a respiratory consultant nurse states “Some people with COVID-19 are at greater risk of becoming rapidly unwell and using community pulse oximetry in those assessed at risk of deterioration can often be lifesaving”.
Face to face support is still available
It is important to highlight where needed, face-to-face care with a healthcare practitioner is still available, these digital and virtual innovations are not appropriate for everyone. Joanna King, a respiratory nurse consultant, says: “Remote consultations are valuable, helping to keep close contact to a minimum, with recognised benefits such as speed of access, more flexibility in appointment times and less travel. However, it’s not suitable for all, I had one patient who hung up accidently three times and another who had hearing difficulties making it challenging for some.”
There are also issues around training and confidence as healthcare professionals learn to use these new technologies. This way of working is very new and different. It is important that changes to delivery of care made during this pandemic are evaluated to ensure that healthcare professionals are supported to adopt new ways.
1 Thorton J. The “virtual wards” supporting patients with covid-19 in the community BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m2119 (Published 05 June 2020)