Midwives generally see pregnant women early in their pregnancy, and some offer consultations for couples for preconception advice, although not on a regular basis, and also not (yet) reimbursed.
Inter-rater agreement within pairs of ED panel members was most often fair (0.2 < κ ≤ 0.4) (20) and for some consultations poor (κ < 0.2) Agreement across all five panel members was poor for Q1 (κ = 0.178) and fair for Q2 (κ = 0.223).
Making parts of the NHS "virtual" rather than using physical buildings for some consultations, and selling off some buildings that would become surplus to requirements as a result.
With regard to communication with the patient, half of survey respondents indicated that they often or always planned some time during consultations for the patient to express his/her fears or anxieties.
Training in communication skills has been used to address the problem of over prescription of antibiotics, with some success in consultations for adults [ 17- 19] and encouraging results in consultations for children [ 20].
We know of just 8 cohorts who have a mechanism for consulting with parents and 3 a mechanism for consulting with young people themselves, although these were 'one off' consultations for some groups.
Some would schedule extra consultations for this, despite being unsure how useful it was.
The frequency of general practitioner consultations for some diseases, such as osteoarthritis, are even less than once a year.
Patients in the low probability group may need further observation, imaging, or consultations for some other reasons than suspected appendicitis.
Some GPs believed that consultations for future illnesses may also be reduced: "If you don't treat a patient with antibiotics [after CRP testing] and the complaints resolve spontaneously, I think that patients will tend to wait and see and not consult the doctor again for the next similar illness episode.
This has important implications for patients isolated by either their physical location (e.g., rural communities) or their function (e.g., disabled older people in aged care facilities) and paves the way for at least some specialist consultation for people living in rural or remote areas to avoid the expense and inconvenience of long distance travel.
