Evaluating the experiences of teleconsultations for children and their parents

My Topol fellowship problem / project:

The rapid roll-out of teleconsultations in response to the Covid-19 pandemic was a remarkable feat in a time of great need. Now is the time to evaluate remote services set up during the pandemic and identify in which groups they are effective.

Children are often a group that get forgotten or left out in research. Not just little adults, there is a paucity of research looking at teleconsultations in children with skin disease, even in eczema, the most common childhood skin condition. Eczema is one of the most common reasons for referral to paediatric dermatology and, being a chronic condition, usually requires multiple follow-ups. A national survey distributed to dermatologists across the UK showed a significant shift towards provision of teleconsultations in this group throughout the pandemic. Paediatric dermatology is increasingly difficult to access, due to closure of services and a shortage of paediatric dermatologists.  Children with eczema may therefore benefit from the option of teleconsultations, which may provide increased convenience and less time missed from school.

However there is little evidence to inform their implementation and special considerations surrounding communication, child protection and consent in this patient group.

There are lots of unknowns surrounding the use of teleconsultations in children, but at the heart of any technological intervention is the patient. In rolling out teleconsultations during a pandemic, the patient and parent perspectives have been overlooked and this now needs to be addressed. This project aims to better understand patient and parent experiences of teleconsultations for paediatric eczema follow-up through qualitative interviews. I aim to identify the benefits, disadvantages, barriers that exacerbate health inequalities, costs incurred by patients and preferences for different consultation types. Through understanding patient experiences and views in depth, I will be able to identify themes that can then be explored on a wider scale through a national patient survey. These insights will be fundamental to the planning of future dermatology services and form feasibility work towards a potential clinical trial comparing the effectiveness of teleconsultations with face-to-face consultations in this patient group.

I am a ST5 dermatology trainee based in the West Midlands. I graduated from the University of Sheffield in 2012 and completed my foundation programme and core medical training in the Wessex and East of England deaneries respectively. I have interests in paediatric dermatology and clinical research, and participated in the UK Dermatology Clinical Trials Network trainee groups programme in 2021, through which the idea for this project was developed.

My other professional interests include teaching and I completed a Postgraduate Certificate in Medical Education from Cardiff University in 2017. I also have an interest in history of medicine and am the trainee representative on the British Association of Dermatologists Historical Subcommittee.

Outside of medicine I am a mum to two children, with not a lot of time for much else!