Our Digital Journey

St Fillan’s Medical Centre is a small GP practice located in Penwortham, Preston, Lancashire, supporting a practice population of around 9,000 patients. The practice workforce includes GP partners and salaried GPs, alongside a team including: Advanced Nurse Practitioners, Practice Nurses and Health Care Assistants, alongside the usual ancillary staff, secretaries, administrative staff and a Practice Manager.

Corie Lewellyn is an Advanced Nurse Practitioner at the centre and is a Digital Champion for the practice.

“When I arrived, we were very remote in the way that we worked. We offered a more traditional service, and we couldn’t reach the patients outside of traditional consultations.”

Why did you engage with the Digital Exemplar Programme?

St Fillan’s Medical Centre wanted to explore the possibilities for using digital technologies to reach out and communicate with patients in a different way. Initially they were looking to set up and use Facebook to communicate practice information to patients on a 24-hour basis, recognising the challenges of communicating with patients using traditional methods.

Looking forward, the practice was aware that practice nurses across the network would be looking to scale back their hours due to parental commitments or considering retirement. The practice was keen to explore digital opportunities to retain these nurses at some level. It’s important to the practice that they do not lose the current ‘skill mix’ and that moving to a more digital facing service would also help with nurse retention and recruitment going forward.

“I’m future planning basically, I’ve got a really brilliant, experienced practice nurse and across the network we’ve probably got quite a few that are coming up to that retirement age. It might be that they retire but still having some input into practices because of digital.”

The practice wanted to explore the possibilities of utilising digital for remote clinics for patients with long term conditions and, alongside this, Covid-19 restrictions meant that the practice needed to quickly adapt to enable video consultations with patients.

Implementing Digital Solutions

Developing the use of Digital Technologies within the practice has been led over the past 18 months by Corrie Lewellyn, Advanced Nurse Practitioner. Corrie is supported with digital by the assistant practice manager.

At the outset Corrie received training as part of the Exemplar programme and additionally did two days of training on a Digital Nurse Upskilling programme. With further support from NHS England, all the nurses in the practice received additional training in digital and the administrative staff were trained in the use of Visconn Clinic, supported by a series of training webinars. This will have future benefits in their work with care homes going forward.

Initially the practice started with the development of a practice Facebook page to promote public health campaigns and communicate practice messages to patients on a daily basis, via a platform that patients were already familiar with.

Following successful implementation of the Facebook page, the practice started to offer virtual clinics and annual reviews. These include diabetes, asthma, hypertension, COPD and all other chronic diseases. They are working to get their social prescriber linked into the virtual clinics.

Initially the practice recognised that the IT infrastructure in the practice was limited. This was addressed by the introduction of Tablet devices for nurses which enabled them to carry out consultations. The move to digital was further supported through the integration of a Remote Visconn Clinic Unit into the practice, a unit they share with other practices in their network on a timetabled basis.

The practice has focused on increasing the number of patients signed up to the iPlato myGP digital consultation platform and are now able to offer one-one video consultations between GPs, nurses and the patients.

“I think the benefit of Covid is they’ve had to be thrown into it. So, from a GP point of view, the GPs have had to work from home for some instances, and without actually having the digital stuff there, they wouldn’t have been able to do it.”

Why Digital?

“It’s the NHS, so the computer systems weren’t fantastic. We had no videos or audio on most of our office computers.”

“One nurse, who’s been a practice nurse for over twenty-five years, is really good with women’s health and contraception. When we lose her, we’ll lose that skill. If we manage to retain her, even if she works digitally, doing a few clinics or training from home.”

“As new nurses come in, we’ve got to keep them keen and interested. If we haven’t got the digital tech, primary care could be left behind.”

Digital Solutions

Hardware

  • Remote Video Consultation Unit
  • Samsung Tablet Devices

Software

  • EMIS
  • Visconn
  • Accurx
  • Facebook
  • Clarity Team Net
  • Microsoft Teams

Support

  • Digital Exemplar Programme
  • Lancashire and Cumbria Training Hub
  • NHS England
  • Redmoor Health
  • Local Primary Care Network
  • Integrated Care System

Impact of Digital Solutions

Initially it took some time to get the practice staff to buy into the use of digital. However, when the Covid-19 pandemic hit in March 2020, the practice needed to move to more remote working, with GPs having to work from home in some instances. The groundwork that had been laid through involvement in the Digital Exemplar meant the practice could easily adapt to this new way of working.

This has been clearly evident through the patient’s annual reviews. The use of the Samsung tablets has enabled the nurses to continue with the reviews and reach a greater number of patients than through the traditional face to face consultations.

Through the utilization of the text reminder system on the myGP app, the practice has reduced the number of patients who ‘do not attend’ their appointment and have been able to offer a service to patients who struggle to get into the surgery. Video conference calls are also now part of regular Practice.

GPs and practice nurses’ comment on the improvements in their work-life balance. They acknowledge that, without the remote working, they wouldn’t have been able to put the same amount of sessions on for the patients.

With support from the Exemplar programme and Redmoor Health, Corrie is running training session for other nurses using the Visconn unit. This has included training in mental health, empowering nurses to help patients with related long-term conditions.

Implementations

“Because I was part of the first digital programme, I completed a two-day digital course with Redmoor Health. The nurses each got a Samsung tablet, they’ve been invaluable, they really have.”

“We thought we would have a problem with the elderly because they’re not used to tech, but a lot of them have really embraced it”

Impact Of Digital

“During Covid, we’ve been able to carry on providing services to the patients. We wouldn’t have been able to without this. We shut the doors because of Covid, so for that reason alone we’ve still been able to carry on with everything.”

  • Engaging in the programme ensured the practice were ahead of the game in managing Covid-19 restrictions.

“One of our practices is a singlehanded GP practice, and he’s had to shield due to his age, He’s had to work digitally from home. This has kept his sessions open.”

  • Staff morale has been enhanced and patient satisfaction increased
  • More patients are being seen more quickly
  • Increase in patient usage of MYGP App
  • Positive changes to routine and scheduling for bookable appointments.

“We’ve got GPs that have got young families. Delivering remote clinics has meant so much to their work-life balance.”

“Patients who are working a distance from the surgery have found it extremely beneficial that they’ve been able to get the service wherever they are. And that’s had a massive impact for patients.”

  • Introduction of practice Facebook has empowered staff and patients.
  • The use of apps has supported selfcare amongst patients with Long Term Conditions
  • 4 nurses are allocated 1 session (3hrs) a week offering video consultations to support patients in their long-term conditions

“We’re putting new Facebook feeds on daily, informing the patients about GP practice news, public health campaigns such as Flu Vacs and smears. This has helped us reach people that don’t normally come into surgery”

  • The RCVU has enabled remote staff training across practices, saving time, money and resources
  • The start of a standardisation of care, using technology across Primary Care Nurses

“I can deliver staff training through the Visconn Unit. Usually we would have to pay for premises, book somebody in to deliver the training. It’s been a cost saving exercise for the network”

“There’s been a lot of input from the Digital Team to make sure that the practices are up and running with IT. There’s been several training webinars that we’ve all attended”

Key Messages

Find a Digital Champion in the practice

Someone who embraces digital and has the enthusiasm and knowledge to engage other staff members. The champion should provide or facilitate training, explore new digital channels and disseminate and support more hesitant staff.

Just do it

You build confidence and knowledge in digital by just having a go and persevere and demonstrate to practice managers and GPs that this really can be beneficial to them.

Access the training individually and across practices

Utilise the opportunities available, through NHS England and Redmoor, and cascade the learning through your networks.

“At first there was a reluctance to change ... so proving its benefits had to be demonstrated... The practice would not have managed Covid-19 as well had it not been for the support and training from Redmoor Health. Nurses were confident to pick up quickly with what had to be done and adapted to more digital services … so much so it has given me more sway to encourage GP’s to get more Digital Champions for the Practice/Group.’’

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