Patients' perspectives on telephone outpatients during a pandemic.

The COVID-19 pandemic required rapid adaptation of healthcare provision to ensure patient and staff safety. The Freeman Hospital provides tertiary urological services for the North East of the UK. In response to the COVID-19 pandemic, face to face outpatient appointments were switched to telephone appointments in line with government advice [1].

This study aimed to assess patient satisfaction with remote appointments at the Freeman Hospital during the COVID-19 pandemic.

One hundred seventy-three patients were contacted consecutively. Those who did not answer within two attempts or declined participation were excluded. One hundred patients were successfully contacted, with a 58% response rate. All the patients were contacted within 1 week of their telephone appointment, to minimise recall bias.

Participants answered a nine-question survey. This was based on validated patient satisfaction surveys [2]. Appointment convenience, ease of communication and overall satisfaction were assessed. Six of the nine questions were yes/no answers, and the remaining three questions used a Likert scale (1–5), where 1 was not at all satisfied, and 5 was very satisfied.

Results and questions asked are summarised in Table 1.

Table 1

Summary of results

	Yes/No
Question	Yes	No	Don’t Mind
Is this your first telephone consultation?	48%	52%
Have you had a face-to-face appointment with the urology service before?	81%	19%
Were you clear at the end of the consultation about the plan going forward?	92%	8%
Did everything go as you expected?	88%	12%
Would you be happy to engage via telephone clinic in the future?	94%	6%
Do you think you would have preferred a face-to-face appointment?	47%	36%	17%
	Likert scale*
	5	4	3	2	1
How would you rate the convenience of the telephone consultation?	68%	26%	1%	0%	5%
How would you rate how you were listened too?	77%	15%	7%	1%	0%
Overall, how satisfied were you with the telephone consultation?	77%	17%	2%	4%	0%

*5 — Very satisfied, 1 — very dissatisfied

The rates of satisfaction were subdivided into patients with or without previous experience of face-to-face appointments. In both groups, 94% were very satisfied or satisfied. More patients with previous in person appointments were very satisfied, 77% vs. 63% without.

The median age of respondents was 67 (range 21–91). Higher satisfaction was reported amongst those older than 67 (n = 49), 86% were very satisfied and 14% satisfied. Of the participants 67 or younger (n = 51), 69% were very satisfied, 19% satisfied, 4% ambivalent, and 8% not satisfied. More patients over 67 would have preferred in person appointments than those under 67, 53% and 41%, respectively. Between age groups, similar proportions preferred telephone clinics, (33% vs. 31%, > 67 vs. ≤ 67 years old), 14% and 19%, respectively had, no preference.

Other studies reflect high patient satisfaction with telephone consultations undertaken throughout COVID-19 [3-10].

In conclusion, whilst COVID-19 necessitated a shift to telephone consultations, this study supports that telephone clinics are a valuable means of patient contact. Patients rated convenience, communication and satisfaction highly, and the majority of patients would engage in future telephone clinics.

It is recommended that initial assessments and new patient clinics are performed face to face, whereas routine follow-up appointments may be optimum candidates for telephone clinics.