Use of Attend Anywhere
At the time of our evaluation, Attend Anywhere was being used for a wide range of conditions and clinical services. Three different service models were in use:
- Hub-home: Clinician connects from clinic to patient at home.
- Dyadic hub-spoke: Clinician in specialist 'hub' centre connects to patient in remote 'spoke' health or care site without additional staff member present (e.g. in an unstaffed kiosk).
- Triadic hub-spoke: Clinician in specialist 'hub' centre connects to patient in remote 'spoke' health or care site with an additional staff member (nurse, GP, healthcare support worker [HSW]) present.
In all the above models, the specialist clinician occasionally consulted from home.
Video consultations via Attend Anywhere were occurring in all 14 local Health Boards and at the Golden Jubilee National Hospital (NHS Scotland's National Waiting Times Centre). Two boards, Highland and Grampian, had both been 'early adopters' and accounted for 62% of all activity in 2019, but use of Attend Anywhere was still at an early stage in most Boards. The Attend Anywhere service in Highland was strongly branded as 'NHS Near Me' from the outset; the 'Near Me' branding was subsequently applied across the whole country.
In 2019, almost 7000 consultations were conducted via Attend Anywhere across approximately 35 different clinical specialties involving 180 clinical departments and 64 GP services; 91% of this activity was in secondary (i.e. hospital care). Attend Anywhere has also been used by a number of third sector organisations to provide advice, support, counselling and palliative care to service users. This includes two services in particular: Rape Crisis Grampian (159 consultations during 2019) and MS Revive (which supports people affected by multiple sclerosis: 120 consultations).
We observed many examples of up-and-running video consultation services using Attend Anywhere, and heard predominantly positive comments from staff and patients, who described various advantages of video consultations over conventional face to face appointments, although some clinicians had concerns about video consulting in general. However at the time of our study (up to Mar 2020), the proportion of Attend Anywhere activity in relation to other outpatient appointment activity (i.e. face to face and telephone appointments) still appeared to be relatively low. In the highest-using health board, video consultations were estimated to be 1-2% of overall board activity. Across all health boards, many services were still at early stages of implementation, and there was great variation in terms of levels of activity. Approximately 130 clinical departments (70%) had conducted five or more video appointments during the 12-month collection period.