Virtual consultations in the lung cancer pathway – what works for patients and healthcare professionals?

When the COVID-19 pandemic hit, healthcare professionals across the NHS went to extraordinary lengths to keep patients as safe as possible. This was especially important in lung cancer, where patients are at particular risk of complications of coronavirus due to their underlying condition and the immunosuppression associated with many treatments.

The move from in-person to ‘virtual’ consultations was essential, but – until now – we have been unsure how this shift during the first wave of the COVID-19 pandemic has affected both people living with lung cancer and the hospital clinical teams looking after them. This is especially relevant because virtual consultations have been suggested to have the potential to speed up the diagnostic treatment pathways.

The findings of a new report endorsed by the Roy Castle Lung Cancer Foundation, UK Lung Cancer Coalition, Lung Cancer Nursing UK and the British Thoracic Oncology Group – and based on surveys of lung cancer patients, their carers’ and the clinical community – are an important insight into the use of virtual consultations in lung cancer care.

Among the findings, the surveys revealed that ‘virtual’ really meant ‘telephone’ for most patient appointments – with very few conducted via video. Many health professionals felt video consultations were not convenient for them, for example, they were unable to share scans with patients, they had not received any relevant training or were unable to access to the right equipment. In addition, as the first wave subsided, many secondary care lung cancer services quickly moved back to face to face consultations, demonstrating the need and importance of human interaction.

The report considers that further research is needed into the use of virtual consultations involving patients who do not have computer access, or feel confident in using them – and healthcare professionals should be provided with training to support both communication and technical aspects involved with delivering of virtual consultations. In addition, given the often, late stage, diagnosis and urgency that comes with it, there is a need for lung cancer-specific best practice guidelines which go beyond current general clinical guidance for the management of remote consultations.

It is likely that virtual consultations are here to stay – and will increase as a means to deliver care in the future NHS as a whole.  The report states that, in the right circumstances, and with the necessary infrastructure and support for healthcare professionals, video and telephone consultations could offer lung cancer patients quicker access to the expertise that is required in delivering some aspects of their care. However, virtual appointments will complement but never replace face to face appointments.

Martin Grange – Chair, UKLCC

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