Key messages and general tips

Take-home messages and tips for telerehab practitioners

Key messages with links to further guidance

Family members and carers often have an important role in remote consultations
They can provide practical, technical and emotional support. This support is even more crucial for patients with severe physical disabilities, cognitive or communication impairment, or sensory disorders. See our how-to guide for practitioners

Physical assessments can be done remotely
It is possible to carry out a number of physical assessments remotely, including those of physical function and impairment. Try also to make use of patient self-reported outcome measures. See our remote measures and assessment tools section

Technology is at the centre of telerehabilitation
Technology is a wonderful tool but it can present challenges! Try to become familiar with the technology you will be using and encourage your patients to do the same. See our section on technology for video consultations and assessments

Technology isn't always inclusive
Promoting technology use and improving skills are important. However, for people who cannot, or do not want to, access technology, alternatives should be offered. See our digital skills section for information and resources on reducing digital exclusion

Observation is key
Carefully observe the environment and use ‘clues’ based on what the patient says and does to inform your care plan. See our how-to guide to video consultations for practitioners for practical tips

Clear and open communication is vital
Think of remote appointments as ‘think aloud’ sessions. Every decision and observation should be discussed openly with your patient. Our how-to guide for practitioners includes communication tips

Keep safety in mind but avoid being too risk averse
The patient’s safety should be at the front of your mind. Conduct a careful risk assessment but try not to be overcautious which may restrict the effectiveness of your assessment. See our information governance and safety section for further guidance

Knowing when to use video consultations versus other methods
Use your clinical experience and judgement when deciding on the most suitable consultation mode. Video consultations may be useful for uncomplicated follow-ups and exercise demonstrations, but less suitable when specific and detailed testing is required

Patients with special needs
For patients with special needs (such as cognitive, communication, visual or hearing impairments), remote assessments or interventions might still be feasible, but you will need to consider whether any adaptations and additional support are necessary

The importance of person-centred care and patient preference

As with any health and social care intervention, finding ground on what the problem is, and mutual agreement on its management, is vitally important to ensure telerehabilitation is useful. Although information governance and data protection need to be carefully considered (see our information governance and safety section), the patient’s preferred choice of platform (e.g. Zoom, FaceTime, WhatsApp) should be acknowledged.

Patients should be able to decide how they interact with healthcare. Remember that not all patients will be suitable for, or will want, a video consultation:

Always keep the patient’s needs as number one – which medium is best/most appropriate for them as individuals in their current situation.

Physiotherapist, Musculoskeletal

An advantage of telerehabilitation is that it enables care and treatment to be tailored to the individual.

In the video below, Professor Diane Playford and Dr Clive Acraman talk about the importance of ensuring person centred-ness in remote consultations:

Telerehabilitation has particular advantages for people with physical disabilities

Some of the patients we spoke to said they preferred remote appointments as they did not have the physical effort and stress of travelling to the hospital. This meant they felt less tired and were able to do more (like demonstrating exercises) during the appointment.

Many patients feel more comfortable in the familiar environment of their own home, where they can easily access the supporting equipment they regularly use (such as mobility aids). Video-based consultations allow the practitioner to see how the patient is managing their condition at home. It can also be easier for family members and carers to be involved in the consultation.

Be realistic, adaptable and plan carefully

Have an open mind but be realistic about what you can achieve in a remote consultation. Remember that telerehabilitation does not always save time, and be aware of the limitations of the situation and your own limitations.

Be adaptable and have patience – you might need to change your way of working and might experience unforeseen technical issues, but that is the nature of the virtual consultation!

Remote consultations require careful planning and preparation. You need to allow time for clinical reflection and full documentation, as you would in any face-to-face consultation.

Telerehabilitation is an adjunct to face-to-face care

Telerehabilitation is not suitable for every person, but it is an additional option and a useful adjunct to in-person care. Remote consultations are a valuable tool as part of the whole package of care.

Although telerehabilitation is a useful tool, it can never replace face-to-face consultations.

Physiotherapist, Stroke Rehabilitation

Many of the people we spoke to believe that a hybrid approach with a combination of telephone, online and face-to-face consultations is likely to be the future of health and social care.

Telerehabilitation is here to stay

"Having seen how much we can do remotely, I think remote consultations will be used a lot more now. It’s here to stay I think." General Practitioner

"There are many positives of now having this modality. It will be a lasting positive legacy of COVID." Physiotherapist, Neurological

"My expectation of going into telerehab at the start of lockdown was that it would be difficult, but my experience was that we had very good outcomes, patient satisfaction was very good." Physiotherapist, Musculoskeletal/Rheumatology

"We've been talking about telerehabilitation for so long and COVID has made us step up to the plate." Physiotherapist, Stroke Rehabilitation

"COVID has stimulated a huge change in practice for health professionals, patients, and their carers or families." Physiotherapist, Musculoskeletal/Rheumatology