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This was published when the organisation was the Royal Pharmaceutical Society.

How remote consultations are used

• Information provision – signposting information remotely.
• Triage – e.g., NHS 111, Pharmacy Clinical Assessment Service or triaging appointments in a GP practice.
• Consultations – e.g., minor ailments, medication review, discussing treatment options and providing information.

There are pros and cons for using the various methods of remote consultation. For example, video calls make it easier to develop rapport but may be more difficult for patients to use compared with telephone. For more information on the pros and cons, see these reviews in the BMJ and BJGP.

When remote consultations are not appropriate

Examples include:

• Lack of patient access or ability to use technology.
• Impaired capacity to participate, e.g., dementia.
• Red flags identified during triage suggesting a need for urgent medical attention.
• Insufficient access to required information such as records or resources.

This GMC guidance summarises some of the key issues with a flow chart and a prescribing case study. More on examples where video consultations may or may not be appropriate – see page 3 of this guide on BJGPLIFE website.

Practice considerations

It’s important to use your professional judgement and consider the following when prescribing for people remotely:

• Can you distinguish when a person may need a physical examination, clinical investigations or monitoring, and when and where to signpost them?
• Is there a process for when you can refer a person to a medical prescriber while working remotely?
• You should feel both competent and safe to prescribe. To help you gain this confidence, you can:
  • Self-reflect.
  • Make a list of all the additional skills and training you require, such as improving history-taking skills (see our prescribing guidance and resources page).
• How do other prescribers prescribe in this environment? To find out:
  • You can discuss remote prescribing with other pharmacists and prescribers.
  • A workplace mentor may help, or you could use our mentoring platform to find a mentor.

Learning resources

• CPPE e-learning programme: remote consultations.
• NHS Education Scotland – learn about remote consulting.
• VitalTalk – making healthcare communication skills learnable.
• To support these conversations, good communication is essential. Develop your confidence with practical tips and information in our consultation skills pharmacy guide (link to be added soon) and our consultation skills e-learning module.

Consultation and communication tools and tips

• Follow the CONSULT model – Read the PJ learning article on Remote consultations: how pharmacy teams can practise them successfully to find out more.
• Watch this YouTube video on Poor web-side manner and how to fix it.
• Watch this YouTube video which gives you five top tips to remember when starting out.
• UCL partners non-face-to-face (virtual) clinics: examples and resources – setting up and guiding patients through remote consultations.
• Answering questions from patients, including the ‘CALMER’ mnemonic for advance planning conversations (BMJ).
• Different types of ‘talk’ in video consultations – see Box 1 in this BMJ Leader article: Guidance on the introduction and use of video consultations during COVID-19: important lessons from qualitative research.
• NHS online consultations implementation toolkit – checklists, evaluation and more.
• Use of remote general practice consultations to mitigate psychological harm – see Box 5 of this BMJ Practice Pointer: Mitigating the psychological effects of social isolation during the covid-19 pandemic.
• Pharmaceutical society of Australia Telehealth Medication Review: Assessment of safe storage and disposal of medicines.

Further information and reading

Journals

• BMA Online digital remote consulting role – Updated June 2024.
• BMA Working remotely, and remote consultations – 4 June 2020.

Resources

• GMC Remote consultations – flowchart and FAQs.
• GPhC guidance for registered pharmacies providing pharmacy services online – February 2025.
• Health and Care Professions Council (HCPC) – High level principles for good practice in remote consultations and prescribing.
• Specialist Pharmacy Service (SPS) – Using PGDs in remote consultations.
• NHS England resources on modern general practice.