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Summary for secondary care

Ten Top Tips for Secondary Care: Telephone Consultations

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This specialist Guidelines summary covers 10 top tips from Macmillan Cancer Support to help secondary care professionals support patients at every stage of the cancer pathway. These tips are designed to showcase best practice and offer practical advice for your role.

This summary is intended for use by secondary care oncologists.

Ten Top Tips

1. Prepare Your Work Environment

Ensure you are in a quiet workspace with minimal background noise. Ensure you have access to the patient's notes and/or computer systems. Invest in a headset—this leaves your hands free to update notes and the sound will be better for your caller than using standard handsfree.

2. Consider Using a Checklist or Template

Don’t assume that telephone consults will be shorter, and prepare enough time for the conversation. Consider using a checklist or template.

3. Check Whether a Preferred Number has Been Given to Call

If there is an answering machine, remember to respect confidentiality with any messages left.

4. Introductions Are Important

Introduce yourself with full name and clearly explain your role. Clarify who you are talking to, and who else is involved in the conversation. Check the identity of the patient preferably with three identifiers (name, address, date of birth).

5. Check Where the Patient Is

Check where the patient is and that they are comfortable prior to beginning the consultation. Ask if there is anyone else not already present that they would like to include.

6. Telephone Consultations Can Increase Health Inequalities

It may be more difficult for patients with English as a second language, patients with a learning disability, or those with hearing or speech impairments. Be prepared to facilitate face-to-face consultation if necessary for these groups.

7. Communication Without Non-verbal Cues Can Be Challenging

Open questions allow patients time and space to express their thoughts and feelings, but closed questions may be required to bring the consultation into focus. Listen carefully and allow silences in order to pick up subtle audible clues (sighing, crying, breathing pattern).

8. Be Prepared to Ask Direct Questions

Research shows that there is less problem disclosure from patients in telephone consultations than in face-to-face consultations. This is more pronounced in male patients. Be prepared to ask far more direct questions than you might usually in a face-to-face consultation.

9. Do Not Allow the Format to Compromise Essential Aspects of Care

Continually reflect on whether the patient requires a physical review. Audit your conversion rate from telephone to physical attendance, as this will help service planning.

10. Look After Yourself and Be Active

A sedentary clinic spent sitting entirely at a monitor and telephone is unhealthy. Take short breaks or stand during some consultations.