Developing Effective Remote Consultations in Outpatients webinar
•Download as PPTX, PDF•
0 likes•70 views
1) The document discusses strategic plans to increase the use of virtual appointments through video to help restore NHS services and reduce backlogs as directed nationally. 2) Data is presented on the percentage of virtual vs face-to-face appointments by specialty for different regions, showing variation between specialties and trusts in uptake of virtual appointments. 3) Interviews were conducted with NHS staff across roles and specialties to understand the reasons for the differences in uptake of virtual appointments and identify barriers to wider adoption. A separate report from patient interviews also provided feedback.
Recommended
Recommended
More Related Content
What's hot
What's hot (20)
Similar to Developing Effective Remote Consultations in Outpatients webinar
Similar to Developing Effective Remote Consultations in Outpatients webinar (20)
More from Innovation Agency
More from Innovation Agency (20)
Recently uploaded
Recently uploaded (20)
Developing Effective Remote Consultations in Outpatients webinar
- 2. Peter Jenkinson Chief of Digital Operations NHSEI
- 3. Strategic national direction is to increase use of video appointments An enabler to supporting restoring services, reducing backlogs Planning guidance; exploit the potential of digital technologies to transform the delivery of care LTP priority that patients will be able to access virtual outpatient services Support productive use of clinician time – clinics finishing late, reduce travel Alignment with wider digital pathway transformation
- 4. North West – virtual by specialty Was there an underlying reason for the drop off in virtual activity?
- 5. North West – % virtual & % recovery by specialty Top % Virtual Ratio Specialty: 50% % Activity Face to Face Virtual Activity Face to Face Virtual Recovery Ophthalmology 597,936 99% 1% 334,328 88% 12% 56% Trauma & Orthopaedics 490,723 99% 1% 317,906 64% 36% 65% Clinical Oncology (previously Radiotherapy) 257,094 98% 2% 215,471 71% 29% 84% Gynaecology 269,559 97% 3% 189,188 70% 30% 70% Dermatology 260,579 100% 0% 182,341 63% 37% 70% Cardiology 257,338 98% 2% 184,052 59% 41% 72% Ear, Nose & Throat (ENT) 250,453 100% 0% 158,863 51% 49% 63% Medical Oncology 202,870 97% 3% 190,946 64% 36% 94% Urology 201,682 100% 0% 154,650 50% 50% 77% Clinical Haematology 156,894 96% 4% 120,576 51% 49% 77% Grand Total 2,945,128 99% 1% 2,048,321 66% 34% 70% Urology All Trusts Yes 2020 Yes 2019 North West - Top 10 Specialties (by Total Activity excl. Other) Why was there a spread of usage across specialties?
- 6. Trust Top % Virtual Ratio Specialty: 63% % Activity Face to Face Virtual Activity Face to Face Virtual Recovery 49,378 98% 2% 32,964 73% 27% 67% 38,212 100% 0% 25,408 88% 12% 66% 22,346 100% 0% 15,228 73% 27% 68% 20,994 100% 0% 16,543 77% 23% 79% 15,979 81% 19% 10,075 62% 38% 63% 13,517 88% 12% 8,250 60% 40% 61% 12,594 100% 0% 8,114 62% 38% 64% 11,274 92% 8% 8,254 79% 21% 73% 8,430 99% 1% 9,120 51% 49% 108% 10,336 100% 0% 6,377 37% 63% 62% Grand Total 203,060 97% 3% 140,333 71% 29% 69% xxx North West Baselines - Top 10 Trusts (by Total Activity) Specialty: Gynaecology Apr-Oct 2019 Apr-Oct 2020 Why was the virtual activity here so different from here?
- 7. On-going review of virtual outpatient activity that captured appointments delivered by Telephone Video What we saw was variation in uptake Across specialties Across Trusts Whilst generic lessons were available from a national survey identifying good practice and blockers, this didn’t help us understand the differences in the North West What we hoped for was to begin to understand some of the underlying reasons for this variation and gain recommendations in taking virtual appointments forward sustainably
- 8. Ed Millensted – Head of Programmes Charlotte Hall – Programme Manager
- 9. To surface the key characteristics of successful adoption To understand the barriers to wider adoption and why variation exists To act as a reference source to inform system strategy development and trust planning To stimulate strategic thinking around remote consultation as one part of large-scale pathway redesign To stimulate thinking around the development of remote consultation within personalised care
- 10. 40 x facilitated conversations held – 90 mins each 15 x different Trusts across mainly C&M, L&SC but also GM Range of professions and specialties consulted CNIOs, CCIOs, CIOs, specialist nurses, consultants, clinical directors, outpatient dept mgrs, operational managers Oncology, psychology, acute medicine, breast, orthopaedics, dermatology, therapies, MSK, genetics, mental health
- 15. The Innovation Agency commissioned Healthwatch Together to hear first-hand experiences from patients and these are reflected throughout the report. Conversations with over 50 people Diverse range of groups spoken with e.g. learning disabilities Headlines Digital poverty and accessibility (hearing/visual impaired) Not feeling suitable for certain conditions If always remote care patients feel less cared for Healthwatch Report can be accessed clicking here
- 18. Develop national guidance to enhance clinical confidence Exec & Clinical leadership is essential to implementation strategies Opportunity to address digital exclusion Opportunity for large scale change programme Opportunity to do things differently and be innovative Share and learn from others Leverage existing and future funding to drive and sustain change End to end pathway view of patient journey Patient choice
Editor's Notes
- Say who the AHSN network are
- Since the start of the pandemic we have seen a rapid uptake of remote consultations in outpatient services 60% follow up and 25% new New ways of working have been adopted at pace and teams have managed substantial change. A genuine shift in outpatient care delivery has begun – but we need to kick start this again due to declining figures understand why variation in remote consultation adoption exists
- 36% of activity data coded to “other” – removed for this analysis
- Since the start of the pandemic we have seen a rapid uptake of remote consultations in outpatient services 60% follow up and 25% new New ways of working have been adopted at pace and teams have managed substantial change. A genuine shift in outpatient care delivery has begun – but we need to kick start this again due to declining figures understand why variation in remote consultation adoption exists
- Say who the AHSN network are
- The enquiry is a blend of operational and strategic insights Learn from what is working well; recognise the reasons that underpin good adoption Determine how remote consultations could be delivered within pathways, supporting broader digital care pathways
- Cover intro to why we have undertaken this work and what we have done Resourced by the Innovation Agency; 2 x FTE working on this Very large scale and scope of the report – brings credibility
- Patient related barriers
- Workforce Under huge pressure and haven’t had the time or headspace for innovation Clinical Seen increased amount of diagnostic investigations due to clinician not being physically present with patient; reducing the decision making threshold. Coincides with reduced amount of discharges (not confident enough as not seen in person) Lack of clinical evidence around working in this way creating nervousness Operational Massive operational challenge, the amount of change required should not be under-estimated due to; new processes, template changes, increased admin, new procedures for booking teams, identifying appropriate patients Needs dedicated Change Team to implement effectively Leadership Lack of strategic roll out plan hampers spread, lack of plan doesn’t include the cultural changes required in large scale change Digital Lack of interoperability and insufficient hardware
- Operational Process mapping the whole pathway to address all touch points, starting with patient profiling the appropriate cohorts and considering patient comms at each stage Leadership Multi-professional approach between clinicians and managers – including protected clinical time Use of dashboards to track uptake with tailored targets Digital Invest in quality and sufficient hardware
- Understanding the touch points with other programmes, connect in with other work programmes, don’t think about it on it’s own – where can RC compliment and align with existing change programmes e.g. primary care, digital, workforce, remote monitoring, personalised care 2. Don’t think about this in isolation, take an end-end pathway view; how can it dovetail with PIFU/digital comms/A&G for instance. GP referral is the start and OP appointment is not the end. 3. Opportunity to really enhance and deliver personalised care – offer choice and involve patients in the decision, not what we think they need 4. Development of Trust plans – exec and clinical leadership is essential to building and delivering effective strategies 5. Real opt here to do things differently, number of innovations that can be considered and the workforce are key to this 6. Oppt to leverage sig reset and recovery funding 7. Take full opt to address digital exclusion and we don’t want to drive inequalities, build in design principles that address digital exclusion. 8. Share learning 9. Support clinicians who have only learnt how to deliver care F2F and not in a remote manner. Bigger picture, what should we consider next Not Trusts operating as silo’s but consider adoption together.