Near Me Video Consultations ‘Stalling’ Due To Digital Inequalities

The Covid 19 pandemic has resulted in more home working, a reassessment of how we work and for many the loss of employment.

For our Health and Care sector there had to be a rapid shift in the delivery of services, with some being paused, so that the NHS could respond to the increase in patients with the virus and its effects.

The Near Me Video Consulting Service saw a rapid acceleration in roll out. This meant that patients would still receive consultations during lockdown. But Near Me also exposed the significant inequalities in our communities including poor connectivity.

An independent report by Oxford University researchers and commissioned by the Scottish Government has published its findings and recommendations.

Near Me, which uses online video to connect patients with GP surgeries and hospital consultations was being used to a very limited extent but when Scotland went into lockdown over a year ago it was decided to ramp it up. An additional £1.6million was provided by the Scottish Government to scale up the ‘virtual’ services.

From March to June 2020 the number of consultations conducted via online video surged from 330 a week to 17,000. Orkney, from a slow start, had the highest per head use of Near Me over the period from February to September 2020.

Evaluation Report

Using new ways of communication with patients was a steep learning curve for health and care professionals in Orkney but the eHealth IT Team held a lot of virtual training sessions.

The Home – Hub appointments enabled people to receive their consultations in their own home instead of travelling to Aberdeen. That is always a considerable journey for islanders to make particularly when they are anxious about their health anyway. But with flights to Aberdeen down by 80% and to reduce transmission of the virus, having virtual video consultations was a good way forward. Nick Morrison reported on his own consultation last year for The Orkney News. Remote Consulting with NHS Orkney

The service was hailed as a great success in Orkney : Success of ‘Near Me’ Virtual Consultations in Orkney

And overall patients and health and care professionals have confidence in the system and found it beneficial.

There were problems and one of the biggest barriers is the poor connectivity that we have in parts of Orkney. But there were others.

Lack of privacy – this can be with a professional working from their own home and/ or the patient not having privacy in their home setting. Not everyone has a room where they can be on their own, uninterrupted and go on a video online call.

Access to mobile and computing devices – many people do not have suitable equipment in their homes. At the start of lockdown some Care Homes in Scotland did not have the devices needed to access this service. In Orkney although the new Balfour hospital was well equipped there was a delay in getting equipment out to GP surgeries and communities.

A lack of basic IT skills.

There are also concerns about the quality of care with video consultations and for some users – language barriers

Near Me did reduce the risk of the spread of infection and this was a comfort not just to health professionals but to members of the public too.

Liam McArthur, the LibDem candidate for the Orkney constituency in the forthcoming Scottish Parliament elections commented on the Oxford University Near Me Report and the barrier to access from poor connectivity in many parts of the islands.

He said:

“The last year has really exposed the damaging impact that inadequate access to reliable and fast broadband has for those living and working in our islands.  This report shows the impact poor broadband coverage has in the delivery of health and care services.

“The response of patients and staff who have been access Near Me technology is very positive. It clearly has made a real difference, particularly given the restrictions in place over the past year.  However, the report also demonstrates that some of those in Orkney who might benefit most from this service have been unable to access it at all due to poor connectivity.”

No other candidate for the Orkney Constituency has so far provided The Orkney News with comment on the independent report on Near Me. If they do so we will, of course, publish their reactions.

Near Me Activity by month and setting for Orkney

The above table of Near Me activity in Orkney shows how the service rapidly increased in use. Travel costs a lot of money when appointments have to involve travelling inter island and to mainland Scotland. Being able to access some services in this remote way is a big saving financially for the NHS and for patients.

And for Scotland as a whole you can see how these virtual video consultations increased last year.

The innovation that took place in Orkney, and across Scotland, that enabled the Near Me service to do its work so well whilst keeping people safe relies on good and reliable internet connectivity.

There are indications that provision of the service has ‘stalled’. Partly as a result of the return to face-to -face consultations. But of significant concern is the inequality of access due to poor connectivity or affordability.

In May there will be a start made on laying subsea cables to many of Scotland’s islands with the actual cables going down in Spring of 2022.

This is part of the Scottish Government’s £600 million Reaching 100% programme (R100), the £384 million North Lot contract. It will improve connectivity to:

  • Colonsay, Iona and Lismore in Argyll and Bute Council
  • Eigg in the Highland Council area
  • Eday, Flotta, Hoy, Rousay, Sanday, Shapinsay and Stronsay in Orkney Islands Council
  • Fair Isle, Unst, Whalsey and Yell in Shetland Islands Council

BT plc has been contracted to deliver all of the R100 contracts and Openreach will lead the infrastructure build, including the 16 subsea cables in the North Lot.

Commenting on the R100 roll out Minister for Energy, Connectivity & the Islands in the Scottish Government, Paul Wheelhouse said:

“The role of digital connectivity in our everyday lives has never been clearer as we tackle the pandemic. The new subsea cables will ensure these 15 island communities have access to futureproofed, resilient, reliable connections – something that will make a huge difference to both residents and businesses there. It will help improve the quality of life for both current and future islanders, while also benefitting visitors once inbound tourism can safely return.

“Scotland has some of the most challenging locations anywhere in Europe for providing telecommunications infrastructure and this alongside our interventions on mobile connectivity, demonstrates we are taking innovative steps to provide superfast access to some of the hardest-to-reach areas.

“We have also developed plans, in parallel with main infrastructure investment, to ensure our 100% superfast commitment is met with our Scottish Broadband Voucher Scheme. This will ensure that everyone can access and benefit from this world-leading digital capability.” 

Reporter: Fiona Grahame

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