Helping patients get the most out of remote appointments

Poor quality of appointments can contribute to a lack of trust in healthcare professionals and the healthcare system, so strategies to improve appointment quality are critical for efficient and effective remote kidney care.

Before the start of the appointment: personalise the call

  • When you receive the call from the patient, start by checking their identity.
  • Introduce yourself and any other practitioners, including their name and discipline.
  • Ask the patient if they have anyone present to support them and confirm that they are happy for them to be involved.

During the call

  • Explain the purpose, structure and expected length of the appointment.
  • Establish the patient’s expectations and what they hope to achieve during the consultation.
  • Make use of screen sharing and chat/message boxes to share information and resources. Ask the patient if they would like any follow-up information by email or post.

Shared decision making: Ask 3 Questions

Patient choice and shared decision making are central to patients’ sense of empowerment and control over their healthcare. Giving them space to raise their concerns and questions is key.

The ‘Ask 3 Questions’ method could be helpful and aims to help patients get answers to three key questions when asked to make a choice about their healthcare.

  1. What are my options?
  2. What are the pros and cons of each option for me?
  3. How do I get support to help me make a decision that is right for me?

Ask 3 Questions is based on Shepherd HL, et al. Three questions that patients can ask to improve the quality of information physicians give about treatment options: A cross-over trial. Patient Education and Counselling, 2011;84: 379-85.

An Ask 3 Questions patient leaflet and poster are available online.

At the end of the appointment

  • Verbally summarise the consultation and next steps.
  • Don’t simply say, “Come back if things are worse” – instead, clarify what worse looks like and be specific and time-framed (for example, “I would be concerned if in two weeks’ time X symptom is happening more than once a day").
  • Offer the patient the opportunity to clarify anything and ask questions.
  • Tell the patient what to do / who to contact if they need help.
  • Inform them you are going to end the consultation before signing out.

After the appointment

  • Send any follow-up resources to the patient as would do if the appointment had been face-to-face. This could include an email summary of what was discussed, maintaining confidentiality (check your local information governance policy).
  • Consider capturing patient feedback on the video consultation to improve your service (download our Patient Feedback Form template (Word document) as a guide).

More remote care resources

The NHS Online patient facing services section of the Good practice guidelines for GP electronic patient records includes Remote consulting guidance (updated June 2023).

The Redmoor Health website offers guides, demonstration videos and advice about running video group clinics.

Remote consultations: qualitative feedback from patients

A lot of the time it’s as if they’re reading off a list, they’re not talking to me, they’re talking to a transplant patient who they know nothing about...
They rang to say my transplant had failed and I wasn’t prepared to hear that.
It’s hard to [ask for clarification] with some people because they can be very brisk. And, even though they say, ‘Have you got any questions?’ the way they say it is not actually inviting you to say any of them.
I had a lot of questions, especially when you’re virtual, if you’re either not getting any straight answers or if you feel like you’re taking someone’s time up, if you hear any sigh, any pause, anything like that, you’re not going to continue with your questions, even if they’re important to you.
Trying to educate myself on things has helped because it means I feel more on a level footing when it comes to understanding what they’re saying, because otherwise they’re just reading off a computer screen to me… because I want to have control.
The doctors didn’t give me the proper time. They just said we will see your case and give you a report. They were just not giving me a convincing answer, they just said we will see you on a follow-up or something, then you can speak with my trainees.