How to ensure remote consultation services are safe

The second part of CSP guidance on remote consultations covers how you can mitigate risks and provide a safe service to your patients

To optimise safety – governance, policy and standard operating procedures should include: 

  • High quality referral and triage processes to inform initial decisions 
  • Safety risk assessment and strategies to mitigate risk – including physical and safeguarding considerations and escalation plans for unexpected events 
  • Urgent referral pathways for in-person assessment and/or investigation 
  • Information governance including confidentiality and data protection with particular focus on the challenge of privacy/confidentiality in the patient’s home or other environment 
  • Infection control measures and risk assessments based on government and local advice considering the vulnerability of patients and staff 

To support this, organisations and service leads should:

Implement governance, policy and standards with a safety focus

  • Governance, policy and standards should be developed using staff feedback and public and patient engagement with a continuous evaluation and service improvement focus
  • They should explore the clinical safety of any platforms and/or devices and the environments being used to deliver clinical services

     

Assess interoperability of systems

  • Data should be able to flow safely, appropriately and efficiently between systems used to deliver clinical services
  • Ensure systems and processes are set up to support the collection and evaluation of safety data. Data should include: 
    – Safety issues and adverse events 
    – Monitoring the safety of hybrid models of service delivery  

     

Support the workforce to develop knowledge and competence in hybrid service delivery

  • Help staff to develop knowledge and competence in following the policies, standard operating procedures and data collection to support hybrid models of service delivery. Learning and development needs must be reviewed regularly

     

Support the wellbeing of the workforce (ensure psychological safety)

  • Monitor and proactively support the wellbeing of the workforce, recognising that new models of working will present different challenges that will evolve as practitioner’s develop confidence and competence in undertaking a hybrid approach or when utilising unfamiliar virtual platforms 

     

Utilise collaborative working in service development

  • Engage with the physiotherapy workforce and with patients/the public to explore the perception of risk with different consultation approaches. Work on ways to promote patient engagement, and develop strategies and information to support shared decision making 

     

To support this, the physiotherapy workforce should:

Develop a practical understanding and application of organisational governance, policy and operating procedures

  • Be able to explain and apply governance, policy and standard operating procedures to patients as part of shared decision making, feeding back to your organisation when these are not meeting the needs of your patients or if the service is not correctly resourced

     

Engage with service development including quality improvement (QI) opportunities and feed into service development

  • Support safety, continuous evaluation and improvement by being actively engaged with service development and QI

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Collect safety data, and report and act on concerns

  • Be actively involved in the collection and sharing of data, and act on recommendations following any safety issues or adverse events, utilising the appropriate pathways to escalate concerns

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