RCS produces best practice guidance for consent and virtual consultations as telephone and video calls increase in COVID-19 pandemic

The Royal College of Surgeons of England (RCS Eng) has published best practice guidance on conducting virtual consultations, as new data shows the vast majority of surgeons have used telephone or video conferencing facilities to treat patients during the pandemic.^[1]

Virtual consultations, involving a telephone or video call between surgeon and patient, have been used in several surgical specialties prior to COVID-19, such as virtual orthopaedic fracture clinics (follow up clinics for patients who have broken a bone) as they are relatively common in the NHS. They have, however, played a particularly significant role during the current pandemic which is likely to continue in the post COVID-19 era and in future pandemic planning.

The RCS England surveyed members earlier this month to establish whether or not elective surgery has been able safely to re-start, what challenges remain and how surgical teams have adapted to the new environment.

The results show that the vast majority 91% of surgeons surveyed, reported that they had used telephone or video conferencing facilities to undertake patient consultations and outpatient clinics during the pandemic, helping to ensure that patients have only had to attend hospital when absolutely necessary.

Furthermore, 83% of survey respondents said they had conducted team meetings (including multi-disciplinary team meetings) remotely. Increasing the use of these systems beyond the COVID-19 outbreak could make a valuable contribution to improving efficiency in the NHS.

The RCS Eng has produced new guidance to support surgeons with virtual consultations: ‘Consent to treatment, while COVID-19 is present in society’ and ‘Virtual consultations’. The two pieces of guidance are intended to be read together.  The first sets out the main principles of the consent process and provides advice on what additional information should be included in conversations with patients while COVID-19 is still prevalent in society.  The second is a best practice guide for surgeons on how to conduct virtual consultations with their patients, either via phone, or video. Such consultations could include pre-operative assessments, discussions between surgeons and patients about the benefits and risks of their surgery, and gaining the patient’s consent to proceed with treatment. It explains how a virtual consultation can be organised and structured; and can be adapted to individual hospitals and practices.

Professor Cliff Shearman RCS England Vice President, and Emeritus Professor of Vascular Surgery at the University of Southampton said: “Virtual consultations have been crucial in the current and ongoing effort to prevent the transmission of COVID-19 by reducing the need for patients to travel into hospital. They allow surgeons to speak with patients who are unable to travel, or to make contact with patients at a difficult time when many might be concerned that their face to-face appointment has been cancelled. 

“Virtual consultations may also encourage patients to seek medical help at times when it appears that many are keen to avoid hospital attendance due to their concerns about possible infection.  They can also enable surgeons to carry out clinical work remotely, and support hospitals to meet increased demand, for example if there is a local outbreak and staff are off sick.

“Despite the possible benefits of virtual consultations, their widespread implementation comes with a series of challenges both practical and clinical, as they replace the face-to-face conversations between patients and surgeons that normally take place during the outpatient clinics.  The guide provides practical advice for surgeons and managers for delivering virtual consultations with surgical patients.”

Notes to editors

1. The best practice guidance ‘Tool 4: Virtual consultations’ can be viewed here.

2. The best practice guidance 'Tool 5: Consent' can be viewed here.

3. The Royal College of Surgeons of England is a professional membership organisation and registered charity, which exists to advance surgical standards and improve patient care.

4. For more information, please contact the RCS Press Office:

• Telephone: 020 7869 6047/6052
• Email: pressoffice@rcseng.ac.uk
• For out-of-hours media enquiries: 020 7869 6056