Health Innovation Networks (HINs) and their respective regional NIHR Applied Research Collaborations (NIHR ARCs) came together to evaluate new ways of working which emerged during the pandemic. The Oxford and Thames Valley project looked at virtual outpatient clinics following a transient ischaemic attack or mini-stroke. Tracey Marriott, our Director of Clinical Innovation Adoption, led this work in our region. Here she explains the project and its potential long-term impact …
Every year 46,000 people have a transient ischemic attack (TIA) or mini-stroke. This leaves them more vulnerable to a full stroke. Swift access to high quality treatment is vital to cut this risk and reduce pressure on health and care services further down the line.
Historically, patients who find themselves in this situation are referred to an outpatient clinic to determine the severity of the TIA or mini-stroke and how best to treat it. During the Covid-19 outbreak these appointments, along with many others, were delivered remotely – usually by phone – instead of face-to-face to reduce the risk of spreading infection.
Following the pandemic some places reverted to in-person clinics while some continued to operate remotely and others offered a mix of these models. We explored all of these across the South East through the NHS Insights Prioritisation Programme (NIPP). We interviewed patients and clinicians about their preferences and the barriers to effective working which they identified, and we considered how each service model impacted health inequalities.
Some patients think they are getting a lesser service if it’s not face-to-face and are willing to travel a long way and juggle complicated personal arrangements to achieve this. The role of carers is important in virtual models particularly around communication. Many clinicians also value being in the same room as the patient. But virtual and hybrid models could offer optimum service levels too, particularly when discussing the outcome of investigations and potential diagnosis.
The pandemic forced us to think and act differently. We’re now more open to harnessing the potential of technology. The key to the best possible outcome is ensuring the right professional can respond promptly and effectively in line with the patient’s wishes. All these models have a role in achieving this, supported by a clear framework which addresses issues we identified such as clinic capacity and imaging requirements.