Can telehealth help to deliver sustainable and equitable paediatric services in Northern Scotland?

Abstract

Northern Scotland needs more equitable and sustainable paediatric unscheduled care. Rural hospital emergency departments are primarily staffed by GPs or junior doctors outside normal working hours. Achieving equitable access to paediatric specialist advice is challenging. The Paediatric Unscheduled Care (PuC) Pilot Service was driven primarily by the Scottish Centre for Telehealth and Telecare. The Centre for Rural Health undertook an evaluation of the activity during the first six months. We evaluated the experience of consultations, rates of patient transfers to specialist centres, consultant views, satisfaction with videoconferencing technology and quality of care. The PuC Telehealth Service pilot attempted to provide a single point of consultant led paediatric contact for Rural General or Community hospitals across northern Scotland, by providing non-specialist physicians and families with fast and appropriate access to specialist assessment and support via video conferencing. This pilot aimed to use telehealth as a contribution to integrated care and embed PuC into existing working practice within the rural hospitals. We assessed the progress of the pilot against its objectives, using mixed methods during the evaluation including both quantitative and qualitative data collection, an economic analysis and literature review. Although the PuC model was popular with families and junior physicians, it proved expensive and concerns emerged about where clinical responsibility lay. Recommendations for sustaining equitable paediatric unscheduled care will be made.This abstract was presented at the Innovative Solutions in Remote Healthcare - 'Rethinking Remote' conference, 23-24 May 2016, Inverness, Scotland.