As the NHS, wider organisations and local communities have pulled together over the last few months, we’ve been doing all we can to support our health and social care colleagues respond to COVID-19.
Part One covers a whole host of innovations and re-deployment support efforts, from the truly national Capacity Tracker to the ground breaking work of our GP ICT Programmes and Projects team.
Enabling care homes to share capacity and issues
At the forefront of our efforts has been the Capacity Tracker; our award winning web-based application originally sponsored by the North East and Yorkshire Region of NHS England, and further developed in partnership with NHSE Community Services and Analytics, local authorities and care home providers themselves. The Capacity Tracker has been able to provide up-to-date, real-time central view on capacity and current issues facing the care home sector. In March, the government issued guidance requiring all care homes, hospices and providers of inpatient community rehabilitation to start the using the Capacity Tracker.
The functionality of the Capacity Tracker has expanded significantly, now recording coronavirus infectoions, workforce status, PPE requirements as well as bed vacancies. Having played a vital role in helping NHS Trusts to accelerate safe patient discharge, freeing up capacity in the acute sector ahead of the anticipated surge in patients with coronavirus, it went on to help social care response teams, including councils and local resilience forums, to target their support based on the needs of care home providers. More than 16,000 care homes in England are now registered on the system – more than 99% of all care homes.!
Sharing knowledge on non-Covid morbidity and mortality
Working collaboratively with Public Health England and NHS England, we’ve helped launch C-WorKS — a knowledge hub set up to share information about the impacts of COVID-19 on non-Covid morbidity and mortality.
The hub gathers intelligence at regional level within a structured framework. Users can upload or describe information about work in progress in their area, share contact details, view information, pose questions and start discussions.
Supporting the deployment of people into essential roles
During the pandemic, we were commissioned to develop and implement an automated ‘Deployment Hub’ to facilitate the placement of staff from a range of NHS organisations, including NECS, CCGs and General Practices, across the system into essential covid-19 support roles.
More than one hundred deployment requests have been made to the hub which has seen more than 400 staff deployments. Almost a quarter of these have been from NECS’ clinical teams who have undertaken a wide variety of crucial nursing and pharmacy assignments in Foundation Trusts and Care Homes across the North East and North Cumbria.
A NECS employee who was a former neonatal intensive care unit manager, was one of those who volunteered to be redeployed. She said: “I’ve always been passionate about nursing, ever since I qualified in 1988, and when the pandemic hit I knew I needed to help.”
After a half day training webinar covering adult parameters had brought her up to speed, she was straight onto the ward.
“The team has appreciated my help which has been lovely. When I first started a nurse asked me where I worked, and I explained I worked at NECS supporting CCGs. I was bemused because her reaction was ‘wow and you want to come and help us?’. These front line staff don’t realise how significant a role they play every day and I found the nurses attitudes really humbling.
“As I start 14 days of isolation, just to ensure I’m not putting anyone at risk, I have started reflecting on the experience and I think we take a lot of things for granted. Seeing it in the news is one thing but seeing the reality has been something else. It’s made me appreciate all the little things and I’m confident there will be some learning for the future.”
Clinical System Migrations in lockdown
The outbreak of COVID-19 has necessitated a major change in how our ICT Projects Team deliver GP practice clinical system migrations.
The risk of infection and the need to protect our people, the practice staff and patients forced the team to innovate and adapt, particularly when tasked to project manage two GP clinical system mergers with one migration across Derbyshire as well as two GP merges and the continuation of two GP clinical system migrations in the North East.
With smart card access and the deployment of Microsoft Teams and greater utilisation of Cisco WebEx, NECS colleagues managed to develop a complete remote support package, creating new processes to provide minimal impact on the customers and to maintain clinical safety.
The communication platform with screen share functionality and the support of all parties involved, limited the impact of COVID-19 to ensure the successful completion of the migration and mergers.
Using video consultation as an effective alternative
As a result of COVID-19, it has been essential to make significant changes to the way primary care services are delivered in order to reduce the spread of infection and comply with social distancing and isolation regulations.
The option for clinicians to holdvideo consultations, as an alternative to face-to-face contact, has been crucial . Consequently, there has been an urgent demand for video consultation capability to be rolled out across primary care. Our ICT Programmes and Projects Team implemented a digital-first approach in primary care, with General Practitioners able to protect the safety of paients and their staff whilst maintaining quality of care.
Digital First – Offering remote consultations instead of face to face (In response to a request from the Secretary of State for Health and Care, Matt Hancock, to adopt a digital-first approach in primary care to improve the experience of both patients and clinicians by using digital technology, GP practices across the North East & Cumbria were required to implement full video consultation availability status by 17th April 2020)
Within an ambitious timeframe of five days, every GP practice in the North East & Cumbria region (371 practices) were fully enabled to deliver video consultations. Software was installed via a link and existing devices used where possible, some additional cameras and software drivers were required in some instances. To achieve the April 17th deadline, most work was completed over a five day period.
Providing timely access to a patient’s electronic medical records
A priority has been sustaining primary care services and continuing to provide the best possible care to patients during the pandemic. This has required new ways of delivering services to those who needed it most for example enabling patients to access a network of GPs and other healthcare professionals, irrespective of their registered GP practice.
To make to make this as safe as possible we have had to fined a way for the clinician to have timely access to the patient’s electronic medical record, regardless of the registered practice’s native clinical system; something which traditionally has not been possible.
The ICT Programmes and Projects Team worked with Primary Care Network (PCN) Leads to discuss options available to them, and further engagement identified additional support requirements to cover all scenarios. Solutions for System Integration were discussed, agreed and implemented within a 1 week timeframe to 206 GP Practices within 5 CCGs.
A high volume of calls were made to PCN Leads during which discussions were had around the solutions that could be deployed quickly, and with minimal impact to GP practice staff. Solutions offered were: Use of EMIS Switcher, Cross System working with installation of EMIS Web on 40 PCs across a number of SystmOne practices.
To supplement solutions, 60 online training sessions were made available to practices across the North East, the subject of which were inclusive of: EMIS to EMIS FAQs, TPP SystmOne to TPP SystmOne FAQs, EMIS Introduction – Clinical Users, EMIS Introduction – Administrators, TPP SystmOne Introduction – Clinical Users, TPP SystmOne – Administrators. Following each online session supporting guidance was sent to PCN Lead for dissemination to practice staff. In order to ensure staff could gain access to clinical systems quickly NECS Project Team proactively requested CCG Leads to identify RA Sponsors who could then ensure PBAC access was given within a quick turnaround.
As a result of additional solutions and new ways of working across PCNs, GP practice have an increased resilience and responsiveness to COVID 19, ensuring patients can be seen at any practice within each PCN, irrespective of clinical system.
Enabling patients to receive their prescribed medication
During COVID-19 restrictions, a solution was required to enable patients to receive their prescribed medication without the need to visit a GP practice or a specified pharmacy.
As a result, our ICT Programme and Projects Team supported practices with the introduction of an Electronic Prescription Service (EPS) Phase 4. Under Phase 4 of EPS, prescriptions would be sent via EPS by default, whether a patient has an EPS nominated pharmacy in place or not. This meant that either patients or their carers could visit the pharmacy of their choice to collect medication.
A series of tailored communications were created and signposting to the latest information and updates were disseminated to GP practices along with 18 online awareness sessions which helped engage staff in the change. Effective system-wide stakeholder engagement led to all practices going live with Phase 4, and a knowledge and information resource is now available to all organisations at a regional and national level.
Supporting the set-up and configuration of specialist Covid-19 ‘Hot Hubs’
The ICT Programmes and Projects Team supported the set-up and configuration of specialist Covid-19 ‘Hot Hubs’ for 10 local CCGs. People exhibiting symptoms could be assessed in a separate location, reducing avoidable footfall into GP practices, protecting patients and staff from risk of infection throughout the pandemic.
Due to the crucially short timescales demanded in establishing the hot hubs, NECS quickly established a COVID response team. The Project Manager oversaw the project ensuring the implementation was delivered safely and efficiently, monitoring activities and highlighting potential delays early. A new, shared email inbox was established for all sites to provide a single point of communication and reduce delay in response times.
NECS supported these sites with additional network upgrades or provided additional IT equipment ensuring the hubs were fully operational as quickly as possible, the process took 6 weeks and encompassed 47 sites. A total of 40 Hot Hubs were created across the 10 CCGs, with an additional 7 sites identified in the North Cumbria area.
To find out about our full range of support and how we can support your health or social care organisation at this difficult time, take a look at our service offering.