PEOPLE with long-term conditions and mental health problems such as anxiety are among those who would benefit most from video consultations with their GP, a study has found.

However, there were warnings that "repeated connection problems" can blight the experience, with doctors stressing that it should not be rolled out widely until it can be integrated with existing NHS computer systems.

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Although internet-based video calls with FaceTime or Skype are increasingly common, use of this type of technology in primary care is still rare in the UK.

A pilot scheme at six GP practices in the Edinburgh and Lothians region trialled how useful a digital platform called 'Attend Anywhere' would be for doctors and patients.

Working people reported advantages such as time saving and not having to take time off work to attend an appointment.

One 54-year-old patient said the opportunity for a video consultation had enabled him to avoid a three-hour round trip from his city office to the GP's surgery, instead just spending 10 to 15 minutes speaking with his GP over the computer in a quiet place at his work.

Another patient, 58, who suffers from agoraphobia said she was often driven to cancel appointments because she could not face leaving the house. She said the video consultation was much easier because "my stress levels weren't sky high".

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It is the largest trial in Scotland to date looking at the potential benefits of video technology in general practice.

A total of 45 patients took part aged 22 to 76, and drawn from GP practices chosen to represent a range of list sizes, varying rurality and patient demography.

The findings are published today in the British Journal of General Practice.

Although the feedback from patients and doctors was broadly positive and a majority of GPs said they would use video consultation again, the trial highlighted pitfalls of relying on web-based communication.

There were complaints that the time lag for dialogue over the internet "caused a degree of talking over and affected the consultation".

Technical problems were also an issue.

"Problems with the technology sometimes disrupted the consultation process," said the study authors. "A number of VCs had to be transferred to telephone because of these disruptions.

"Clinicians reported feeling awkward when issues such as the video freezing on their or the patient’s screen or poor audibility occurred."

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GPs also said they would not want to deliver bad news or discuss more sensitive health issues, such as sexual health problems, by videolink for this reason.

One clinician quoted in the study anonymously said: "When holding of a hand [is needed], giving of tissues, sharing the cancer diagnosis.

"You are still quite removed at the end of a video line and heaven forbid if the technology were to let you down, that would be just ghastly."

While there were overall time savings for patients because they no longer had to travel to and from a health centre, GPs said that - with the exception of avoiding house calls - video consulting would be "time neutral".

For patients, being allocated a video appointment slot did not necessarily mean that the saw their doctor on time.

Instead some found themselves waiting in the web portal's "virtual waiting room".

One patient, a 41-year-old male, said this created "that apprehension" that he had not set up the device properly.

A doctor added: "The virtual waiting room was a good idea but the slightly awkward thing is I don’t know whether they [the patient] can see if you’re running behind.

"When you’re in a [surgery] waiting room, you can see other people coming and going."

Compared with over-the-phone consultations, doctors said video was "more formal and focused" and enabled them to pick up visual clues from body language and facial expressions, making it easier to identify "something else going on" with a patient.

Although face-to-face consultations were generally considered by doctors and patients as the "gold standard", clinicians said video would be especially useful "for psychiatric consultations where formal physical examination is not required" and in "chronic illness management, blood test results, and medication reviews".

The research was funded by the Scottish Government’s Chief Scientist Office and led by Edinburgh University, in collaboration with the universities of Exeter and Warwick.

Professor Brian McKinstry, of the University of Edinburgh’s Usher Institute, said: “Our study showed that there is real potential for video-consulting particularly for conditions where a visual examination can be helpful for example when assessing people who have problems with anxiety and depression and have difficulty getting to their general practice”