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OP38 Sustainable Hepatology and the role of the “Virtual Nurse”
  1. Catherine Wood,
  2. Elizabeth Farrington
  1. Royal Cornwall Hospital, UK


Introduction Cornwall is a geographically large and isolated county in the Southwest of England with a dispersed and rural population of 568,210. There are limited transport options and costly lengthy travel times for patients to access the single acute hospital. The number of deprived neighbourhoods in Cornwall is increasing and the financial implications of accessing specialist healthcare widens the health inequalities already experienced by patients with liver disease. The local NHS trust declared a climate emergency in 2020 and have been committed to developing innovative solutions to deliver sustainable healthcare with an aim to achieve the NHS Carbon Net Zero 2030. The development of a full-time Virtual Hepatology Clinical Nurse specialist post aimed to reduce CO2 emissions from travel, deliver sustainable healthcare, widen the reach for accessing specialist hepatology services and address the historic challenges of nurse recruitment due to the geography of the county.

Approach and Method An outline and rationale of the innovative role was published in a nursing journal and the full-time role was advertised nationally. Following a virtual interview, an experienced Hepatology nurse was appointed to the position who resided 280 miles away from Cornwall. Virtual working and delivery of outpatient clinics via a virtual platform with telemedicine as an alternative was initiated. Home delivery of IT equipment and access to local NHS and primary systems enabled remote requesting for clinical diagnostics. To maintain GDPR an electronic shredder was provided.

Outcome/Results Development of this role has provided 32–36 weekly, clinic appointments and a total of 1000 patients have been reviewed over 9 months. This has reduced waiting times for new patients and follow-up appointments. Patient feedback has shown high levels of satisfaction, for accessibility, quality of care, reduced travel costs and time away from work and improved patient choice. Widening the reach of the service has improved engagement from deprived communities and reduced C02 emissions.

Discussion The role of the Virtual Hepatology CNS has the potential to be replicated globally and promotes sustainable health. Virtual nursing has had a positive impact upon patients, the environment and enabled recruitment of specialist staff. It has been well received locally and internationally in the field of sustainable healthcare. Future work will include promoting digital healthcare, the development of digital health education for patients, a virtual training programme for student and registered nurses and patient centred projects that support self-care and patient empowerment are currently being developed.

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