Video Consultation Best-practice and Recommended Setup

We have collated below some guidance on using video consultations at your surgery. This is intended to provide what we have found is the best way to run these consultations logistically whilst enabling you to deliver the best quality care in line with your clinical judgement and guidance.

Please note: We are not able to advise on any clinical elements of how to hold a video consultation. We advise that you enquire about any queries you have in relation to this with your ICB.

Below is our recommended setup for any video consultation kit. This is aimed at providing the best possible video and audio quality.

Your setup should be in line with our technical specifications.

If you are using a laptop, the inbuilt webcam will be sufficient for the purpose of video calls.

The Remote Consultation solution supports any USB webcam that is compatible with your computer.

We recommend that your webcam supports the highest possible quality so that when internet speeds at both ends of the call are sufficient, your webcam is able to provide a clean, crisp image. A resolution of up to 720p or higher is advised.

Where it is possible, mount your webcam to the top of your screen. This angle will:

We recommend that you use a headset when holding video consultations. This will provide you with the best audio for hearing the patient, and provide the best quality of microphone for patients to hear you.

The Remote Consultation solution supports any headsets that are compatible with your computer. You may find that USB headsets may be the best option as you simply plug into a single port and will most likely be plug-and-play.

Make sure that you are comfortable with the audio settings on your computer so you can adjust your volume, mute your microphone, or select the right sound output (to stop sound coming out of your computer speakers or laptop).

Ensure your practice's IT team reviews our technical specifications for Remote Consultation to confirm your broadband can handle video traffic. If connection speed is an issue, contact your CCG. To maintain speed, disconnect non-essential devices from the practice Wi-Fi.

We recommend a stress-test: have all clinicians likely to make simultaneous calls perform test video calls while staff also access records and action scanned documents to check for performance issues across systems.

We use the stable, industry-leading Nexmo platform. If internet speed slows (yours or the patient's), video quality will decrease to protect audio quality, allowing the call to continue.

Clinicians working from home must also ensure sufficient broadband speed, considering what other family members are using the internet for (e.g., no streaming or online gaming on 10-20Mbit lines during calls). For faster, more reliable connections, plug the laptop directly into the broadband hub rather than using Wi-Fi.

To avoid any suggestion that a consultation is not confidential, you need to think carefully about where you are holding video consultations.

If a clinician is working in a surgery, video consultations are best held in a consulting room. This ensures the best privacy for the patient, and provides confidence when it is seen that the call is happening in a private space.

When holding telephone consultations, it is possible that these could be held in an office environment where conversations cannot be over-heard, and where patients can be confident that they are not being over-heard.

It is recommended that video consultations and telephone consultations are held in a private room, such as a home office or spare room.

It will be important that you are not interrupted during consultations to ensure that patients feel that consultations are confidential.

Make sure to only start the video call once you have your headset on and are fully ready to hold the call. This will provide the most professional quality to the start of the call, so the patient does not hear/see you fumbling with equipment.

Greet the patient as you would any normal consultation or telephone consultation and follow your usual clinical approach to discuss the health issue the patient has. It may also be advisable to ask the patient if it is still convenient to hold the video consultation now.

When you are ready to end the call, simply say good bye to a patient as you normally would and click the red End Call button.

When you are in a call, there are options available to you to control the call, should you need to.

The Mute option is very useful should you need to quickly sneeze or cough. Where possible, you should advise a patient that you are going to put them on mute while you refer to something. This ensures that the patient is informed as to what is happening on the call.

The Stop Video button is useful for pausing the video in case you need a moment of privacy, or you don’t want a patient to see something – this could be someone needing to come into the consulting room, or when referring to something from a shelf. Again, you should advise the patient that you are going to do this, so that the patient does not think that there is an issue with the video feed.

When asking for patients to show you any symptoms they have, be aware of the video quality. Visual clues like how people move, shapes, etc will likely be very useful.

However, it may be that viewing rashes, wounds, and other issues that rely on a crisp, high resolution image may not be as suitable to be viewed using a video feed, due to the nature of the constantly moving image and current video technologies.

If you need a clearer image, we would suggest having an NHS mail account that patients can send photos to so you can make a clinical judgement.

There are a great number of technology solutions available to support patients remotely. This makes it far easier for patients, limits potential contact with other individuals, and can help patients who self-isolate:

If you have any questions or you feel that this article could be improved, please feel free to give us some feedback by emailing help@iplato.com.