SAFEGUARDING SHOULD BE A KEY OUTCOME MEASURE WHEN EVALUATING VIDEO CONSULTATIONS IN PAEDIATRICS.

Abstract

Adaptation of clinical work in response to the COVID-19 pandemic has involved an increase in utilisation of video and telephone consultations. The continued post-pandemic use of such working methods is tempting for several reasons including: decreased travelling time for families, accessibility in rural areas, the availability of clinic rooms and likely cost-savings. To date several studies have reported on many outcomes evaluating virtual consultations, including clinical outcome measures and patient satisfaction/acceptability, with promising results.1 Unfortunately, child protection cases may have increased during the COVID-19 pandemic,2 despite a relative reduction in referrals for child protection medical examinations.3 This raises the possibility of vulnerable children not presenting to appropriate services. Face-to-face consultations have previously allowed for general examination, observation of parent–child interaction and objective measures of growth and development that are not currently possible through video consultation. Thus, in-person reviews may identify sentinel stigmata of physical abuse, neglect and objective measures of health such as height and weight. This is one reason why the Royal College of Paediatrics and Child Health has given pragmatic guidance regarding safeguarding during video consultations.4 To review the evidence for the safety of video and telephone consultations in general paediatrics, we performed a literature search of medical databases (Pubmed, CINAHL PLUS and EMBASE) as per Table 1 (Appendix). The search term ‘COVID’ was deliberately excluded, to recognise other situations in which telemedicine has been used and to maximise search results. No studies were identified examining the possible negative consequences of virtual consultations with respect to safeguarding concerns, neglect, missed cases of child abuse, or similar. Evidence is needed to ensure that new ways of working in paediatrics such as the use of video consultations do not place vulnerable children and young people at increased risk compared to traditional face-to-face consultations. We urge that future studies should include appropriate outcome measures to address this essential question. This study was unsupported. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS or the RCPCH. Appendix S1: Supporting Information Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.