Month: August 2023

The Impact of Virtual Consultations in Primary Care

Virtual consultations have increased in healthcare in recent years, especially since the onset of the COVID-19 pandemic. While telehealth offers many benefits for patients, such as convenience and increased accessibility, questions surrounding its impact on the quality of primary care persist. Our recent systematic review “The Impact of Virtual Consultations on the Quality of Primary Care” offers valuable insights into this timely and topical issue in healthcare delivery.

The primary goal of the study was to evaluate how virtual consultations are influencing the quality of primary care. The study was comprehensive, covering various diseases and utilizing six databases for identifying studies. It employed a rigorous screening process to ensure that only pertinent data was included.

Key Findings

The review included 30 studies comprising 5,469,333 participants. The results were quite revealing:

1. Effectiveness: Virtual consultations were as effective, or even more so, than traditional face-to-face consultations for managing certain conditions such as mental illness, smoking, and excessive alcohol consumption.

2. Patient-Centeredness: Four studies showed positive impacts on patient-centeredness, although patients felt a decrease in perceived autonomy support when engaging with healthcare providers virtually.

3. Efficiency: Virtual consultations might reduce waiting times, decrease patient costs, and lead to fewer follow-ups in secondary and tertiary healthcare settings.

4. Patient Safety: Unfortunately, data on the impact of virtual consultations on clinical safety was found to be extremely limited.

5. Equity: The evidence is mixed regarding the equitable use of virtual consultations. They seem to be favoured more by younger, female patients, and disparities were observed among other demographic groups depending on contextual factors.

Areas for Further Research

The study identified several gaps in the existing body of evidence. Specifically, there is a need for more robust data regarding patient safety, equity, and patient-centeredness. The researchers stress the importance of utilizing real-world data and clinical trials to ensure that virtual consultations are both effective and inclusive.


While the systematic review brings optimism about the effectiveness and efficiency of virtual consultations, it also flags important areas where more research is needed. A tailored approach, based on more comprehensive data, is crucial for informing future policies in virtual primary care. By focusing on these areas, healthcare providers and policymakers can aim to offer a more balanced, equitable, and safe healthcare delivery system for patients.

Direct access to cancer diagnostics: the promise and perils of bypassing GPs

The Secretary of State for Health and Social Care, Steve Barclay, has confirmed the UK government is considering plans to allow patients in England to bypass their GP and directly access some diagnostic tests for suspected cancer. The clinical and cost-effectiveness of these new diagnostic pathways must be compared with alternative solutions such as investing more in core NHS general practice services. My article in the British Medical Journal discusses some of the key issues and challenges in implementing this radical new policy.

Electronic health records: The importance of implementation and training

A new article in the British Medical Journal from Carol Chan, Ana Neves and myself looks at the importance of implementation and training in the use of electronic health records (EHRs) in healthcare. The introduction of EHRs has been one of the most significant changes in how healthcare is delivered in recent decades. But while EHRs have brought many benefits to the NHS, for patients and clinicians, they have also created substantial challenges that must be addressed.

Addressing the health needs of refugees and asylum seekers

The health risks to refugees and asylum seekers has become very topical with the identification of Legionella on the Bibby Stockholm barge Refugees and asylum seekers will often come from countries that have high rates of infections such as tuberculosis and hepatitis B / C (among others).

Refugees and asylum seekers will also often not be vaccinated to UK standards. A comprehensive health screen is essential when they enter the UK to identify and treat any infections they might have (as well as other significant medical problems such as diabetes and mental health issues).

It’s also essential to offer any missing vaccines to bring them in line with UK vaccination standards; and address any physical and mental health problems they have; and ensure they have access to good NHS primary care services to deal with new and ongoing medical problems.

Legionella is sometimes found in the water systems of larger buildings, particularly those with older systems where water can pool at the temperature at which Legionella can multiply quickly. Suitable action to deal with the water system is needed when Legionella is identified to reduce the risk of Legionnaire’s disease to people using and living in the affected building.

The poorer the quality & maintenance of the water system, the more likely Legionella will be found and the more difficult it will be to control. Older people, those with chronic lung disease or other serious medical problems such as diabetes, and weak immune systems are at highest risk of serious illness from Legionella.

The accommodation for refugees and asylum seekers can be environments where infections spread rapidly, because these sites are often crowded and the people living in them will often congregate together. This poses a threat to both the health of the residents and the wider community because infectious and parasitic diseases such as Covid-19, gastroenteritis and scabies can then spread quickly among the residents. Appropriate surveillance, medical care and public health interventions are crucial to mitigate these risks.

The Increasing Impact of Heatwaves: A Global Health Challenge

The harsh reality of climate change is becoming increasingly apparent, with extreme temperatures emerging as an increasing global phenomenon. One of the most conspicuous manifestations of this climatic shift is the occurrence of heatwaves. These bouts of extreme heat aren’t just uncomfortable, they also pose significant health risks and can increase death rates; particularly amongst the most vulnerable people in societies – such as the elderly, children, and individuals with pre-existing health conditions.

Heatwaves don’t just affect the health of individuals; they also put enormous strain on healthcare systems. In times of extreme temperatures, the influx of patients seeking medical help for heat-related illnesses increases drastically. Often, other factors linked with extreme heat, like water shortages and poor air quality, exacerbate the situation, leading to an even greater health crisis.

The ability to effectively manage these health threats often comes down to the resources and infrastructure a country has in place. Countries with advanced infrastructures are typically better equipped to handle these challenges. They can provide the necessary healthcare, deploy strategies to keep the population cool, and improve the urban infrastructure to mitigate the impact of high temperatures. .

However, for lower-income countries, the picture isn’t as bright. In such countries, which regularly experiences high temperatures and have less developed infrastructure, the challenge is significantly more daunting. It’s much more difficult for these nations to provide the level of healthcare required during a heatwave or to put strategies in place to protect the population from the extreme heat.

This makes it even more imperative for such regions to establish robust measures to mitigate the health impacts of climate change and extreme heat. The strategies needed are wide-ranging – from improving their healthcare systems and response to heat-related illnesses, to launching comprehensive climate adaptation and mitigation policies. These actions are not just necessary, they are urgent, because when it comes to heatwaves and the health threats they bring, we are all feeling the impact.