When we were told that the entire clinical patient facing service will come to a halt, I was initially relieved as we were taking the right steps to be safe. I also thought that this would be a great opportunity to complete a lot of my written academic and portfolio work as the practical aspect had come to a stop.

However, after a few days of sitting at my desk and typing away, my mental well-being started to dip. I started to feel tired and felt that my days were repetitive, to the point where my drive for creating one file content started to feel like a chore! I felt as though this would be the case for the next few months and there’s no way to overcome this.

After weeks of thinking about how to make use of this time without our patients, I realised that there are ways to head towards competence without seeing our patients face to face.

Where some services are back to full capacity, others still have high DNA (‘did not attend’) rates or fewer patients to see. So whilst we make our way out of the locked down past, here are some ideas that helped me achieve competence without seeing patients face to face.


Remote telephone or video appointments have become a norm for some and are unknown for others. These appointments are a great opportunity for assessments and building competence for obtaining consent, patient communication, history taking and confirming identification.

Where the service is not in place, conduct some research, an audit, present the idea to your colleagues and pilot it!

Case Based Discussions

If you have come across a case that was of interest to you, or come across a new condition through your reading, gather information and create a presentation surrounding the case to present to your colleagues.

This is a great way to have a look at complex pathologies and genetic associations within your specialism, and a great way of sharing knowledge with others, plus gaining their insight on the case too!

Language improvement

If you find it difficult to address challenging conversations, whether that be with patients or colleagues, speak to senior members of staff to see what they would say in certain situations and how they would handle challenging situations. With patients returning from lockdown, there have been tragic life events and a rise in anxiety. So prepare yourself with the language of what’s best to say in situations you may have never been in. Some trusts offer courses on how to address challenging conversations which may further aid your confidence with this.

Service development

If there’s a gap in your service or room for improvement, gather the information you need to address this and conduct a project to aid improvement within the service. The QSIR (Quality, Service Improvement and Redesign) training offered by the NHS is a great way of providing you with the correct tools and project initiation ideas to aid projects for service improvement.


If there’s a piece of medical equipment, a test or a procedure that you’re not yet competent with completing, find a quiet space to work in and familiarise yourself with the kit. Practice a test procedure either with another colleague (using PPE!) or run through the test without a second person. This will help you prepare better for when the patients are to arrive, building you towards competence and confidence.


One of the best things I can recommend is to not be dismissive of your well-being. Take time out to focus on yourself, whether that’s doing something you like or doing nothing at all! If you put too much strain and pressure on yourself, the outcome on your health will only stop you from moving forward. Enjoy your training programme! Don’t let it feel like a chore.