The Changing Face Of Cf Paediatric Physiotherapy Homecare: Virtual Versus Reality

Introduction: The RBH paediatric physiotherapy cystic fibrosis (CF) homecare service has been an integral part of our CF management for 17 years The service is well valued and achieves a high satisfaction rating Families value the importance of a homecare service for communication, expert knowledge, support and understanding in an environment that minimises disruption to daily life (Dixon E J Cyst Fibros 2015;14(S1):S125) In March 2020, the COVID-19 pandemic led to the “shielding” of people with CF (PWCF) and National Guidance stating “ people with CF stay at home at all times and avoid any face-to-face contact Routine reviews will no longer be conducted face to face” (UK CF Med Assoc) Physiotherapy home visits (HV) were rapidly converted to virtual visits (VV) using appropriate technology, approved by NHSx (Skype, WhatsApp, FaceTime etc) As the impact of the pandemic is becoming more fully understood, services will need to evolve to meet the needs of service users within the restrictions of effective infection control It is essential that PWCF and their families are at the centre of that redesign Method: An electronic questionnaire was emailed to 53 families that had received a VV between 18 3 20 and 2 6 20 37 responses were received (70% response rate) Analysis of the equivalent time frame in 2019 was carried out Results: With no travel time 20% more VV were possible Cancellation rates/did-not-attend rates were equivalent Mean visit time was reduced by 16 min 100% of parents felt either very satisfied (89 2%) or satisfied (10 8%) with the speed at which the appointment was arranged 100% of parents felt that the VV lasted the right amount of time;most appointments lasting either 30 min (59 5%) or 30-45 min (37 8%) All parents felt comfortable talking via video, 2 parents felt that their child was shy and 1 reported that their child would not talk at all 100% of parents felt that the call was either very successful (62 2%) or successful (37 8%) Elements that made a VV more successful than a HV were: Can be done more frequently, less travel time for staff, can be arranged more quickly, preferable during a pandemic Factors that made a VV less successful were: Physiotherapist can\u0027t always hear things properly eg, child breathing/huffing;can\u0027t always assess equipment properly eg, PEP, nebuliser technique;VV is dependent on technology working properly, not effective for teaching new techniques In the future, 86 5% (32) families would like a combination of home and virtual visits, only 8 1% (3) requesting virtual visits only and 5 4% (2) home visits only Parents also commented that the VV was more effective if their child had a good relationship with the physio, with another speculating that more frequent VVs may stop the need for antibiotics Conclusion: VV are deemed both effective and satisfactory in the correct context, with defined outcomes Clear criteria, agreed by both clinician and families, have emerged to determine when the physiotherapist should visit in person Reliable technology is key to a successful VV and such visits impact positively on the environment In summary, as a parent stated;“both kinds of appointments are beneficial to the wellbeing of anybody with CF, as this is such an important part of keeping the CF person well ”