Medefer virtual consultations - Frequently Asked Questions

Even before the start of the Covid-19 pandemic in March 2020, healthcare waiting lists on the Isle of Man were lengthy, and with no clear plan in place to focus on reducing these. This was only exacerbated further by the pandemic. When Manx Care came into existence on 01 April 2021, it made a commitment to reduce waiting lists across a number of clinical specialities. It’s doing this by working with a number of individual companies who are supporting the organisation by providing a combination of both virtual consultations and treatment for a broad range of our patients. 

It’s important to make it clear that this approach is not replacing surgery being delivered at Noble’s Hospital and at Ramsey District Cottage Hospital; instead, it’s supplementing the activity that’s being delivered at both locations in order to ensure that those people who have been waiting for treatment for a lengthy period of time receive the consultation and treatment they need faster, whilst also allowing us to transform the way that our services are delivered so that we can build a sustainable infrastructure that will future-proof the health and social care needs of the Island’s population. 

It’s also important to understand that this isn’t an approach that’s being implemented solely by Manx Care. Using external companies and Consultants to tackle waiting list backlogs is the approach that’s being used by NHS Trusts across the UK too. 

Please feel reassured that the clinical teams managing your care at either of our hospitals on the Island will be kept fully informed of the outcome of your appointment, alongside any subsequent diagnostic tests and treatment prescribed by your Medefer NHS Specialist. A record of this will be stored on your Manx Care patient files so that we can refer to it if needed. 

Please be aware that your details will not be passed to Medefer in order for them to progress your appointment until we have received your explicit consent for us to do this, and that you’re happy for your care to be undertaken by Medefer on behalf of Manx Care. 

Yes – Medefer will send the outcome of your appointment and any proposed tests/treatment to the team at Noble's. This will be uploaded onto Manx Care's IT systems and stored for our records. Essentially it will be the same process as per if you were attending a face-to-face appointment with a Specialist – only that your appointment with the Specialist will be conducted on the telephone.

All appointments are conducted by telephone call as Medefer has found this to be the most effective and accessible way to work with patients.

Your Medefer NHS Specialist will arrange for any diagnostic tests you need to be carried out on the Isle of Man (unless any of the tests cannot be performed on the Isle of Man, in which case arrangements will be made for you to have these performed elsewhere). Once the results are available, your Medefer NHS Specialist will arrange a follow-up virtual appointment to discuss these with you and either prescribe a course of treatment or next steps for you, or discharge you back into the care of your GP if appropriate. It may also be the case that your GP can prescribe any medication and ongoing treatment recommended by the Medefer NHS Specialist.

No. No-one from either Manx Care or Medefer will ask you for any form of payment, or for your bank details or any other financial details, either on the phone, in a letter or via email. Your treatment will be free at the point of care. 

In the event that you are contacted by anyone claiming to be from Manx Care or Medefer requesting payment for your virtual consultation, please do not make any form of payment or provide any financial details. Instead, please report this initially to the Patient Information Centre at Noble’s Hospital (call 01624 650103 or email pic@manxcare.im). The team will then report this to the relevant authorities if this is deemed to be an attempted fraud or scam. Alternatively, you can report fraud and scam attempts to www.ocsia.im or read further advice and guidance. You should let your bank know immediately if you’ve given away your account details or sent money to a third party and are concerned about that.  

Initially, we will send a letter to you at the address we hold on our files for you. If you’ve recently moved house or changed address then please make us aware of this as soon as possible. 

The letter will outline some basic facts about what we’re proposing, information about Medefer and next steps, and will seek your official consent to be seen by a Medefer NHS Specialist. The consent form will be on a separate sheet of paper, and a stamped addressed envelope will also be included for ease of return. Please complete the form and post it back to the Patient Information Centre at Noble’s Hospital as soon as possible. We may phone some patients to follow up with them if we don’t receive a response to our initial letter. It’s important that we receive written consent from you so that we can attach a record of this to your patient file. 

Please be aware that in any correspondence – written, email or verbal – we will never ask you for any form of payment, or for you to share your bank or financial details with us. These details are not requested on the consent form either. In the event you receive any such requests from a company purporting to be either Manx Care or Medefer, please do not respond to these and report them to the Patient Information Centre at Noble’s Hospital (call 01624 650103 or email pic@manxcare.im). The team will then report this to the relevant authorities if this is deemed to be an attempted fraud or scam. 

Please be reassured that Manx Care has worked extensively with the Isle of Man Information Commissioner in terms of ensuring that we obtain the appropriate consent from patients, and in terms of our approach to seeking this. View a copy of the Privacy Notice. 

Medefer’s outpatient service has been designed by Clinicians to enable patients to be reviewed, investigated, and managed without the need for a physical attendance at a hospital outpatient appointment. This has been achieved through developing a virtual outpatient pathway supported by the company’s remote access platform.

The virtual outpatient hospital works with both Primary and Secondary care pathways, and most importantly helps patients to get better, faster. Its unique Virtual Hospital model is used by multiple NHS trusts, CCGs and GP practices across the UK.

The company was co-founded in 2015, led by CEO Bahman Nedjat-Shokouhi, a practising NHS Gastroenterologist Consultant. After witnessing (pre-Covid-19 pandemic) the often-multiple months patients were waiting to attend an outpatient clinic, Bahman realised most hospital outpatient appointments could have been managed more quickly and efficiently in a virtual environment – reducing the anxiety caused by waiting times, reducing the pressure on the NHS by ensuring a Clinician’s time is geared towards patients that need urgent care, and helping to address increasing patient waiting list backlogs. 

Medefer’s aim is to provide a sustainable NHS outpatient service solution given the growing population and longer waiting lists for NHS outpatient clinic appointments – which has been further compounded by the ongoing Covid-19 pandemic.

Medefer believes that every NHS patient deserves the best possible healthcare and access to NHS care as quickly as possible. Medefer’s cutting-edge technologies deliver a unique ‘Virtual Hospital’, where patients receive specialist input to their care within a couple of days of a referral.

Many of the senior management team at Medefer continue to work as NHS Clinicians and are passionate about working with the NHS to complement its current services, not to replace them. All Medefer Specialists are practising NHS Consultants.

In short, Medefer is from the NHS and is for the NHS. 

The Medefer service works as an alternative to the standard outpatient referral pathway. Patients have different needs, but traditional outpatient pathways allocate the same resource (specialist time in clinic) to every patient regardless of urgency or need. 

Medefer delivers personalised patient care by allocating NHS resources to match patient need. Patient need is determined by the review of GP or clinic/hospital notes and is rated Red, Amber or Green – according to urgency. By doing so, patients requiring urgent or priority treatment can be seen and have their care managed quickly. 

In this instance, Medefer is working with Manx Care to help the organisation with its waiting list backlog. Patients who have been referred by their GP into the secondary care setting (for example to see a Specialist at Noble’s Hospital) will be seen by a Medefer Specialist if they are considered to be clinically suitable for this option and they subsequently provide their consent for this to happen. Medefer will then review the patient’s notes and refer accordingly. 

Upon review, the Medefer Consultant will either:

• Refer the patient into the hospital Outpatient Unit directly
• Request additional information, diagnostic tests or investigations

Refer the patient back to the care of their GP as they can be cared for and have their treatment or condition managed in the community/a Primary Care setting               

All of Medefer's Specialists are practising NHS Consultants. As such, they have the same qualifications as you would expect from any practising NHS Clinician or Consultant. Medefer only employs the very best Consultants – and not all Consultants are suited to its way of working.

Medefer is regulated by the Care Quality Commission and is currently rated as 'Good'. Read the latest inspection report.

Medefer has considerable experience in working with remote, Island communities. Since July 2020, it has been working alongside the Isle of Wight to help deliver its virtual outpatient services as part of a proactive COVID recovery programme. Medefer worked with the hospital there to pool clinical resources in the most beneficial and efficient way for patients. In doing so, the Trust on the Isle of Wight is ensuring the local community and its care needs can be managed closer to home and remain on the Island. 

It is delivering significant patient benefit and has been shortlisted for an industry award in recognition of the positive impact it is having. 

Evidence gathered by Medefer from across multiple Trusts and other customer sites shows that the majority of patients – upwards of 60% – do not need a physical outpatient appointment. By seeing patients initially in a virtual setting, Medefer is quickly able to determine which patients will benefit from going into hospital for a face-to-face appointment with a Specialist and which patients can be discharged back into the Community/to the care of their GP. For those patients who are referred on for a physical appointment, that session with the specialist Consultant will be far more valuable and focused on care management plans and things like next steps as opposed to Clinicians learning about the patient and their condition. 

All patient reviews and referrals follow a RAG rating (Red, Amber, Green). This means that outpatient appointments conducted in hospital are geared towards those patients who need the most urgent care. It means Specialists can focus on delivering high value, urgent care to the patients who need it most.

Even before the start of the Covid-19 pandemic in March 2020, healthcare waiting lists on the Isle of Man were lengthy, and with no clear plan in place to focus on reducing these. This was only exacerbated further by the pandemic. When Manx Care came into existence on 01 April 2021, it made a commitment to reduce waiting lists across a number of clinical specialities. It’s doing this by working with a number of individual companies who are supporting the organisation by providing a combination of both virtual consultations and treatment for a broad range of our patients. 

It’s important to make it clear that this approach is not replacing surgery being delivered at Noble’s Hospital and at Ramsey District Cottage Hospital; instead, it’s supplementing the activity that’s being delivered at both locations in order to ensure that those people who have been waiting for treatment for a lengthy period of time receive the consultation and treatment they need faster, whilst also allowing us to transform the way that our services are delivered so that we can build a sustainable infrastructure that will future-proof the health and social care needs of the Island’s population. 

It’s also important to understand that this isn’t an approach that’s being implemented solely by Manx Care. Using external companies and Consultants to tackle waiting list backlogs is the approach that’s being used by NHS Trusts across the UK too. 

Please feel reassured that the clinical teams managing your care at either of our hospitals on the Island will be kept fully informed of the outcome of your appointment, alongside any subsequent diagnostic tests and treatment prescribed by your Medefer Specialist. A record of this will be stored on your Manx Care patient files so that we can refer to it if needed. 

Please be aware that your details will not be passed to Medefer in order for them to progress your appointment until we have received your explicit consent for us to do this, and that you’re happy for your care to be undertaken by Medefer on behalf of Manx Care. 

No, it's not. This is simply how Manx Care is choosing to approach how it reduces its waiting lists and ensures that those who have been waiting the longest for diagnosis and treatment receive this as quickly as possible. The use of external companies to tackle hospital waiting lists is an approach that's being employed by NHS Trusts across the UK too, and so this isn't something that's being done solely by Manx Care. Medefer does not seek to take clinical capacity out of the NHS; its technology enables it to pool existing NHS consultant capacity and deliver it back into the NHS.

In the majority of cases, yes. Appointments will be conducted initially via telephone. However, some patients may be asked to attend a Manx Care facility where they will be seen by a Nurse from the organisation who’ll be in the same room as them, whilst the appointment is conducted via video-link to the Medefer Specialist. This depends on the type of condition they have. 

In the event you need diagnostic tests, you will be asked to attend a Manx Care facility for these to be carried out. If you need any treatment, this may be in person too, or prescribed by your Specialist or your GP. It purely depends on your individual diagnosis. 

The Patient Information Centre at Noble’s Hospital can support you with many of your queries (call 01624 650103 or email pic@manxcare.im). The team is available as follows: 

• Monday to Thursday, 8:30am – 5pm
• Friday, 8:30am – 4:30pm
• Closed during weekends and Isle of Man Public Holidays  

The team operates a voicemail system during out of hours periods. They aim to respond to queries within 48 working hours of receiving these. 

Alternatively, the Manx Care Advice and Liaison Service (MCALS) may be able to support you as well (call 01624 642642 or email MCALS@gov.im). The MCALS team is available as follows: 

• Weekdays, 10am – 3pm
• Closed during weekends and on Isle of Man Public Holidays 

If a message is left on the answer-machine, a member of the team will aim to return the call during the next working day.

We cannot answer this specifically. If you have been included within a list of patients who are being referred to one of our partner healthcare providers, you will be contacted by a member of your clinical team from Manx Care and advised of a date for an initial appointment with your Consultant, either virtually or in person depending on the specialism. From that point on, we cannot comment on how long it may take for any diagnostic tests, follow-up appointments or planned surgery – that can only be determined once we have guidance from your Consultant. They will keep in touch with you on this – it's anticipated that things will move relatively quickly for you once you've had your initial appointment with your Specialist.

This is a difficult question to answer and depends on the clinical specialism and your condition. For some specialities, this will be in order of clinical priority (for example those who are deemed to be most seriously ill or in need of treatment), and for others, patients will be prioritised according to how long they have been awaiting treatment (if appropriate).

The Patient Information Centre at Noble’s Hospital can support you with many of your queries (call 01624 650103 or email pic@manxcare.im). The team is available as follows: 

• Monday to Thursday, 8:30am – 5pm
• Friday, 8:30am – 4:30pm
• Closed during weekends and Isle of Man Public Holidays  

The team operates a voicemail system during out of hours periods. They aim to respond to queries within 48 working hours of receiving these. 

Alternatively, the Manx Care Advice and Liaison Service (MCALS) may be able to support you as well (call 01624 642642 or email MCALS@gov.im). The MCALS team is available as follows: 

• Weekdays, 10am – 3pm
• Closed during weekends and on Isle of Man Public Holidays 

If a message is left on the answer-machine, a member of the team will aim to return the call during the next working day.