Since 2011 the DAWN scheme has reduced appointment ‘do not attends’ (DNA’s) from 30-50% to 16% by allowing young patients to have appointments over Skype

NHS Skype appointments increase clinic attendance

Since 2011 the Diabetes Appointments via Webcam in Newham (DAWN) scheme, which helps young people keep on top of their diabetes care, has reduced appointment ‘do not attends’ (DNA’s) from 30-50% to 16%

The pilot DAWN scheme has rolled out Skype appointments to all patients as part of a four-year trial for diabetes patients aged 16-25 years.

The service is offered by the Diabetes team at Newham University Hospital, Barts Health and supported by East London NHS Foundation Trust and Newham Clinical Commissioning Group.

Desiree Campbell-Richards, research nurse at Newham University Hospital who has worked on DAWN, said: “By giving young people the choice of using Skype we saw some patients who had disengaged with us come back to clinic.

“It wasn’t just about flexibility for the young people but about their confidence in the service and feeling able to have an honest connection with the clinicians.”

The scheme, which started off with young people but has now rolled out to all age groups, offers a regular clinic appointment on Skype for those patients who do not require physical examination. There is also a facility to seek advice through Skype messaging.

Data security and confidentiality regulations are made clear in the appointment agreement and patients are encouraged to consider their own privacy, according to the NHS.

The DAWN team have produced guidance for use of Skype in clinical care with support from their ICT department, using NHS guidance.

Desiree said: “There haven’t been many issues and the patients are mindful of the appropriate use of Skype.

“We wrote to all patients and asked them if they wanted to use Skype, then held focus groups to understand why some patients had previously disengaged with the service but had embraced the use of Skype and what they told us was very interesting.

“It wasn’t just more convenient but being able to integrate diabetes care into normal every-day life, work and university, made it much easier to manage.

“They didn’t want their life being managed by clinical appointments but they can use Skype out and about with friends, at work or at university. It’s quick and easy; if they had a question before they could wait months to ask it at their next clinic but with Skype they can get an answer within hours.”

The Young Adult Diabetes Service at Newham has around 215 patients between 16 and 25 on its records. The NHS said that all patients with internet access are offered the option online contact via Skype.

Shanti Vijayaraghavan, diabetes and endocrinology consultant at Newham University Hospital, said: “We are very pleased at the results we have had so far and I am increasingly offering it to all of the patients attending my diabetes clinic.

“It means we can keep in touch with a number of patients who might otherwise have become disengaged and present later with complications.

“While we understand there will always be a percentage of people who do not attend any type of appointment, we are keen to offer more flexible outpatient access which is better able to accommodate patient needs.”


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