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Virtual visits in palliative care: about time or against the grain?
  1. Joseph Paul Hawkins1,
  2. Craig Gannon2 and
  3. Jennifer Palfrey2
  1. 1 Palliative Medicine, St Raphael’s Hospice, Cheam, UK
  2. 2 Palliative Medicine, Princess Alice Hospice, Esher, UK
  1. Correspondence to Dr Joseph Paul Hawkins, Palliative medicine, St Raphael's Hospice, Cheam SM3 9DX, UK; Joseph.hawkins{at}nhs.net

Abstract

While the additional value from adding the option of virtual visits is not in question, numerous issues are raised around how to decide between face-to-face and virtual visits in individual cases and how best to set up such provision within an organisation. With only limited palliative care-specific literature and no time to set up and evaluate pilots, we had to get on and set up a prototype ‘virtual visits’ model, retro-fitting guidance and a supporting ethical framework. We looked at the issues spanning clinical, ethical and logistics domains; identifying areas of benefit as well as drawbacks, some specific to the rushed implementation because of COVID-19’s infective risks and the ‘rules’ of lockdown, but many are generic areas to help guide longer term service design. Unsurprisingly, it appears clear that a ‘one-size-fits-all’ mentality is a poor fit for the individualised needs of the heterogeneous palliative care population. Virtual visits have great potential even if they are not a panacea.

  • clinical decisions
  • communication
  • education and training
  • ethics
  • home care
  • hospice care

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bmjspcare-2020-002498

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    Footnotes

    • Contributors The authors of this article have each reviewed the other authors work and co-contributed as editors internally to the piece. JPH and CG wrote the majority of the article with JP writing the conclusion and providing additional references.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; internally peer reviewed.