Table 4 Context for the consultation

Pathway

I’m not a particularly confident driver so I always go if I can avoid motorways and busy roads I do. Early in the morning that’s quite difficult because you’ve got all the people, well, you used to have all the people going to work and going to school. It would be the driving that would put me off an early morning one. I would rather leave home about nine when the traffic’s died down a bit [3BV03]

But midday, physically it’s just because they have to keep in mind travelling and everything, that’s the only reason they want to have it midday, like one, two o’clock. Like I always wanted to have my appointment after two o’clock just because of the travelling. [3BV04]

it (longer appointments) makes it more worthwhile. If you’re just perhaps going to be just checked up on what exercises you’re doing and then going, you’ve got to get there, park, get up the hill, which is a job in itself, and then wait around and then you’re only going to be five or 10 min and then you’re out again’ [3BF02]

Definitely I’ve had appointments where I felt that the clinician has been so thorough and made sure that they have done a thorough check and gone down every avenue to rule out things. You just feel that. You feel a bit better in yourself, because you feel that they’ve really been thorough … they give you time to ask questions or answer questions. It’s not rushed. [3BF05]

You haven’t got quite so many obstacles with travelling if it’s in the middle of the day, it’s not so bad. But if you’re in the rush hour or you have a day at work you’re tired and just want to get home and so on. [3BF02]

I would prefer when it’s physical, yeah, face-to-face because anything can happen within six months. [3BF04]

I don’t know what the number is but there’s definitely a number around six or eight you don’t get more than. Dare I say if you’re using them up on phone appointments and then you end up with say four phone appointments and two physical appointments, that would just be silly and a waste of time [3BF07]

If I get the organised transport, the hospital transport, they require turning up four hours prior to that appointment even though it takes two hours. So sometimes I have been up at two/three in the morning ready for an early appointment, and then by the time I get there, having taken my morning medication, I am in a mess because it’s either not taken at the right time or … So yeah, that’s very difficult for me, and yes we have tried to change appointments to the middle of the day, sort of early afternoon if possible, and sometimes we’ve managed it. [3BV06]

If I have appointment at 8:30 in the morning I have to leave my house at five o’clock or six o’clock in the morning and it’s a long journey for me. Because of the pain it would be really good if the physiotherapy team can call me and just carry on from that. [3BV04]

Is it really worth it? Is it worth me going all that way to go for 15 min? I’m going to be seen for 15 min … it’s not going to be a thorough appointment. I won’t be seen. I won’t be checked properly. How is that possible for me to have 15-min appointment and then just go? You feel cheated, I think. [3BF05]

It’s easy for me to get to and yes, it wouldn’t cost me that much by public transport. I can see why, if distance and cost was a major impact for a 15 min or half an hour appointment, then maybe you would prefer to have a virtual. [3BF03]

People prefer to have first thing in the morning at home because then they have the whole day, or later in the evening when they can actually fit and have it either at the start of the day or the end of the evening, that’s why. [3BV04]

Clinical

So I think it’s worth having a face-to-face, but it’s also worth seeing someone who has the expertise, do you know what I mean? [3BF07]

I’m in no pain. It isn’t like when I saw you that day. I was in bloody agony. So I needed a human being to physically see it and make it better. That’s what I think [unclear]. Do you know human beings rely on human beings as well? Unfortunately Zoom and COVID and everything will make us less human I’m afraid, potentially. [3BF01]

Honestly, I’ve had my dodgy back since I was 15 and I’ve seen a lot of people. Honestly, I think for me, it’s too complicated to do over the phone, over the video. That just might be me, but I can also see other people with other problems where I’m actually thinking well, we probably could get away with that more so. [3BF07]

But when I could barely walk the other week, it was never - I could never have done that - I would have felt that I was getting - I wouldn’t - it wouldn’t have felt right for me because he couldn’t have made me better virtually. [3BF01]

I would just feel isolated. I would begin to feel isolated, and you become cut off from the outside world. You could just sit at home and have everything done at home and all your phone calls virtual, not face to face and everything. But where does that leave you with human interaction, social interaction? You’re just isolated. [3BF05]

Even if I’m in a car and I decide to drive, one day I got caught on the XX [motorway] coming to XX [hospital] and was stuck there for nearly two hours. Again, my pain levels were ridiculous for the rest of the week because it’s got a knock-on effect. It’s tough. That’s generally the thing that causes the problems. [3BV01]

We’ve hit traffic accidents; we’ve hit loads of stuff on the way. So it is really difficult. Then really, i need a good hour of recovery before I see anyone when I gets there [laughs], to even being able to speak more coherently, if you know what I mean. Because pain takes over my speech and thinking process. So that’s really quite significant when you’re having a face-to-face; how much pain you are in to be able to communicate properly, if that makes sense [3BV06]

Day-to-day activities is one of the areas that I do struggle with, but I’ve managed to find things to overcome it, and virtual is one of those things that help me to overcome the difficulties that I have with day-to-day living. [3BV01]

I think I’d be more comfortable that way (having the camera off). I don’t like being viewed; I think … Yes, I don’t logically think I mustn’t look in a mirror. There’s always obviously a mirror in the bathroom but I’d never go and look at myself in a mirror, only when I’m washing my hands or whatever and the mirror’s there … Yes. When I was a bit younger I never ever wanted my photo taken. [3BV02]