All involved in the nurse-led telemedicine service viewed it favourably and patients said that they would use it again. Part two, to be published in next week's Nursing Standard, will discuss the findings of the evaluation in relation to the wider picture of nursing involvement in teleconsultation.

No abstract

The article summarises key aspects of government intervention in the British film industry since the election of a Labour government in 1997. The process of amalgamating a variety of existing institutions (including British Screen, the British Film Commission and the Arts Council's Lottery Film Department) into the new UK Film Council is described and the implications for developments in the English regions is considered. The issue of the continuing American dominance of the industry is explored and this is related to the contentious concept of an economically 'sustainable' domestic industry. In conclusion it is proposed that more careful attention be given to the cultural and educational implications of current policy.

A pilot trial of telemedicine in primary care began in the village of Letham in 1998. The service provided conventional consultations with the district nurse, plus teleconsultations with a general practitioner (GP) at the health centre in Forfar, a few km away. In the first year, the videoconferencing link was used by 14 patients, all aged over 65 years. The telemedicine service was judged to be successful and subsequently expanded to patients of any age. It was used for a wide range of health matters, including postnatal care, mental health problems, physical ailments, receiving test results and discussions with the doctor. During the 11-year study period, a total of 646 teleconsultations were conducted, a median rate of 65 per year. A qualitative evaluation of the service was conducted in 1999. Although the GPs involved expressed some reservations about the limited video quality, all three user groups were positive about the service. Nonetheless, the telemedicine service was not adopted as a routine method of health-care delivery by the NHS. To enable any telemedicine application to move from the pilot trial stage to routine service requires several things to happen at an organisational and contractual level. Ultimately an organizational decision about adoption is required, followed by appropriate mechanisms to enable diffusion.

Opportunities now exist for nurses to use teleconsultation for the benefit of their patients. A systematic development of this type of nursing role through integration with broader service development would be valuable.