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    Using widely-used software also made it more acceptable to patients and avoided the technology becoming redundant or the process becoming technology-focused.

    Our project coincided with the publication of NHS guidance on the use of Skype and other remote technology.

    Uptake of online appointments by patients Overall uptake was 62% of those approached (Table 2).

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    It was widely accepted that the diabetes service locally would be both unaffordable and undeliverable, given workforce and financial restrictions, unless new ways of delivering care could be found.

    By using readily available video conferencing software (Skype), our service model can be easily replicable across the majority of outpatient care.

    Further work is now being done to explore the impact of online consultations on improving patient self-management, particularly for those patients labelled “hard to reach”.

    Patients were also actively encouraged to initiate online contact with the clinical staff if help or advice was required with clinical management.

    They were, however, advised that staff may not be able to respond immediately at all times, and the service was not to be used for emergency or out-of-hours management.

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