Newham Hospital’s Skype appointments trial revolutionises attendance rates

Appointments for some diabetes patients at Newham University Hospital are being carried out using th

Appointments for some diabetes patients at Newham University Hospital are being carried out using the tele-conferencing software Skype. Picture: PA/Peter Byrne - Credit: PA Archive/Press Association Ima

In the second of our series exploring the £6million yearly cost of missed appointments at Newham University Hospital, EMMA YOULE finds out how technology is being used to tackle the issue head on

Newham University Hospital. Picture: Sandra Rowse

Newham University Hospital. Picture: Sandra Rowse - Credit: Archant

A trailblazing service offering patients at Newham University Hospital consultations via Skype has seen a dramatic fall in the number who miss appointments.

The hospital was one of the first in the country to use web video technology for clinical care and has seen a sharp decrease in rates of non-attendance as a result.

The number of diabetes patients who fail to attend their appointment - costing the NHS time and money - has fallen from 33 to 11 per cent since Skype consultations were introduced in 2011, in a pilot study that has attracted national attention.

Former health minister Simon Burns said in 2012: “I’m glad to see the NHS is using simple ideas such as texting patients before an appointment or seeing them via Skype.

Dr Shanti Vijayaraghavan, diabetes and endocrinology consultant at Newham University Hospital, is le

Dr Shanti Vijayaraghavan, diabetes and endocrinology consultant at Newham University Hospital, is leading the trial - Credit: Supplied picture

“These could have a dramatic impact and I want to see more hospitals making use of them.”

The service has shown how technology has the potential to help the cash-strapped NHS reduce the £225million yearly cost of missed appointments.

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Our investigation has revealed 104 patients a day fail to attend consultations at Newham University Hospital, costing an estimated £6million a year in lost income for the hospital. Patients who forget to attend also increase waiting times for others.

The decision to make diabetes clinics available via Skype followed a successful pilot with young diabetes patients aged 16 to 25 years.

The study showed the number of patients who did not attend fell from 40 per cent to 16 per cent.

It was set up by diabetes and endocrinology consultant Shanti Vijayaraghavan in 2011 using a £75,000 grant.

“The rates of non-attendance sometimes get to be quite high in these patients because they require frequent follow-ups and people aren’t often able to take time off work or college, or women have childcare problems,” she said.

“A lot of our patients don’t speak English and require a family member to bring them for appointments.

“We had a problem, so we started looking at the role of non face-to-face contact.”

The clinical drawback of Skype appointments is that patients cannot be physically examined.

But the study also revealed a number of benefits to the patient, such as reduced anxiety over travel costs or having to take time off work.

“People felt that they were able to engage better online and felt more in control of the process,” said Dr Vijayaraghavan, who has worked at Newham University Hospital since 1996.

“They basically felt they were better able to discuss certain problems.

“It also helps to build a better relationship with the patient, you can see what they look like in their home environment, you get a feel for the kind of lives they live.”

The pilot also showed efficiency gains as doctors’ time was used more productively.

The team at Newham University Hospital is now working with NHS England to agree governance around the use of Skype for clinical care and the service could be adopted more widely in the future.

“Patients have said that Skype clinics are more convenient and support them to integrate diabetes care into normal everyday life, work and university, which made it much easier to manage,” said a hospital spokeswoman.

Do you have a story for the Investigations Unit? Contact reporter Emma Youle on 020 7433 0122 or