Near Me is NHS Scotland’s video-free online consulting service. It is safe, secure, and easy to use with nothing to download. There is no need to create an account and no information is stored. It improves access by enabling appointments from a range of settings including from home.
It has evolved to enable access across the public sector. Recent additional functionality includes Group Consultations (launched in June 2022) and easily switching from a phone consultation to a video (Consult Now).
The big picture is that we will shortly pass two incredible milestones with over two million Near Me video calls made since it was introduced in 2016 and an estimated 72 million-plus patient miles travelled saved. (From our post Near Me call surveys people have told us they save on average 36 miles of travel per call.)
To give that some scale it is 477,710 miles to the Moon and back and so savings from use of Near Me mean we could complete that journey 150 times!
Why is this important?
I turned to NASA’s Website Climate Kids Meet the Greenhouse Gases! | NASA Climate Kids to find a simple explanation about the link between patient miles and the impact on the environment. For many decades experts have been worried that human activities (such as those caused through the use of transport) is adding too much of these gases to the atmosphere. For example, we burn fossil fuels to generate electricity, to keep buildings warm, and to power cars. During this combustion, waste gases are released including carbon dioxide (one of the main greenhouse gases).
NHS Scotland’s climate emergency and sustainability strategy: 2022-2026, published in August 2022, sets out plans to reduce its greenhouse gas emissions. One of the commitments is to reduce the need to travel and the number and length of journeys taken by car. Actions highlighted are:
- Plan services in the community using the principles of 20-minute neighbourhoods
- Explore options for the better integration of care to reduce the number of separate appointments and journeys
- Refresh and modernise our Homeworking Policy, and
- Support the continued use and expansion of Near Me and other forms of digital care where clinically appropriate as part of a patient-centred approach
Specifically, it highlights that “domestic transport is the sector which produces the most greenhouse gas emissions in Scotland”
Therefore, anything that can reduce travel by domestic transport may be more convenient, save money and be good for the planet. Edge Health in their study of outpatient video consultations in England between March 2020 – March 2021 concluded that 76 million patient travel miles saved 14,200 tonnes of greenhouse gas emissions. Therefore 5,352 miles travelled creates one tonne of greenhouse gas emissions.
This means in Scotland the two million Near Me calls appointments have prevented 13,452 tonnes of greenhouse gas emissions from entering our atmosphere – the same as driving a small car 77.1 million miles or the electricity used in 13,452 medium sized houses for a year, according to estimates.
Another notable statistic in the NHS Scotland Climate Emergency Sustainability Strategy is “54% of journeys are under 5km (3 miles)”.
In England, Todd et al 2014 published an article on the Open BMJ describing that much of the population lives within a 20-minute walk of GP premises. An area-level analysis of the accessibility to general practice and community pharmacy services in England by urbanity and social deprivation. (BMJ Open 2015;5:e007328. doi: 10.1136/bmjopen-2014-007328 https://bmjopen.bmj.com/content/5/5/e007328)
On average most people will take about 20 minutes to walk one-mile. This will obviously vary and will depend on several factors including weather, safety, people with injuries, disabilities, or feeling unwell. Many others might have caring responsibilities. For some this will make walking to an appointment, not reasonable, and where the option of a video at home is an attractive alternative.
Our Deep Dive research into Primary Care carried out last year told us that in some GP practices, Near Me video calls are used for up to 30 per cent of consultations.
It also highlighted in a medium-sized urban practice 1,370 appointments on average are provided each month. If 30 per cent were carried out by video this would equate to 411 appointments. If each of these 411 Near Me appointments saved a return journey of two miles this would equate to 1.8 tonnes of Greenhouse gases for a single practice. Scaled up across our 900-plus practices in Scotland this could bring about a reduction of 1,620 tonnes per year.[MT1] [MT2], the same as driving a small car nine million miles or the electricity used in 1,620 medium sized houses for a year.
Since November 2022, the Scottish Government is compelling each Health Board to publish an annual report. This will be required to be approved by its Chief Executive and summarise their progress against the aims and targets set out in “A Policy for NHS Scotland on the Climate Emergency and Sustainable Development” (DL (2021) 38) and the actions set out in the Climate Emergency and Sustainability Strategy 2022-26.
Wider adoption of Near Me would enable boards one way to demonstrate their progress and provide choice and convenience for people accessing their services.
- What would be the positive impact on the health of the local population with fewer Greenhouse gas emissions in the atmosphere?
- Should there be a public health responsibility for health and care professionals or a moral obligation to offer the choice of Near Me video calls?
- Can we move to start capturing clinician miles travelled and the associated impacts on time, money and environmental benefits