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Agile Working

This is an ongoing project that we have started with our group of practices and PCN prior to the outbreak, with the Covid-19 outbreak accelerating its implementation. 

 

What we have formulated is a new model of access to primary care including FCP services and also a way of promoting remote consultations. 


There are four main models we have developed and utilise, to different extends, pre and post Covid-19 

 

Work From Home (WFH), Clinic to Clinic (C2C), Clinic in Clinic (CIC), and Hot Hub Clinic (HHC)  
  1. Work From Home allows our clinicians to support the practice and patients remotely from their own home through video. This is particularly useful if clinicians are self-isolating, need to be shielded or as part of a return to work scheme under the current emergency.

  2. Clinic to Clinic remote hubs allow clinics to support branch sites or other practices within a locality who are struggling to meet demand. This offers flexibility to the physiotherapists to be present across all sites as we operate amongst multiple clinics.

  3. Clinic in Clinic remote hubs allow clinicians to work within practices conducting video consultations routinely. Examples of this include direct patient consultations and virtual ward rounds with care homes, or physiotherapists providing services between PCNs. This can also support clinical supervision and training.

  4. Hot Hub remote clinics, allow multiple clinicians and other community specialists within a locality to work together to provide a service. This can also reduce pressure on hospitals because patients presenting with potential COVID-19 can be reviewed and managed effectively in the community where appropriate. 

In order to deliver these services effectively we have provided additional routes of access to FCP services in addition to the traditional routes e.g. online bookings or calling our reception. Patients have the option to self access a virtual waiting area and join virtual queues to be seen by the FCP, but also other practitioners. There is no need to call to book a set appointment slot or log in to set an online appointment. This offers a flexibility to patients to access services bypassing waiting lists on the phone or being tied to a specific time slot.


 

We have also completed an ergonomic analysis to provide an efficacious set up for clinicians to work remotely including webcams, dual monitors etc. This an example of a non MSK clinic, but the principles that we utilise.

 

What is needed to sustain the change?

Commitment from all stakeholders, support via wider regulation and investment for infrastructure.

What is your region?

Midlands

edited on Jul 10, 2020 by Kyle Beacham
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chris mercer May 26, 2020

Sounds really interesting- how has the model been received by clinicians involved and patients?

Reply 0

Georgios Christopoulos May 29, 2020

Clinicians really enjoyed the adaptability and reflexivity it offered. In some regards helped members of the team to support others under more pressure. Also when MSK presentations were unclear joined consultations were possible.

From a patient perspective the feedback was extremely positive. Currently we are at a stage that we provide more video calls than phone reviews.

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JSmith24 May 29, 2020

How did you market this?

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Georgios Christopoulos May 29, 2020

Two methods really, peer to peer diffusion and also informing patients at end of each contact. Interestingly we also have set a virtual reception were patients can access services independently to reduce pressures on the call centres. This has had a very positive uptake

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shishir malgwa May 31, 2020

Looks promising. Will be useful for clinicians, patients and also for conducting MDT meetings.

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Indeed, we hope that this work will promote in future a better relationship between primary and secondary care.

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Judith Dawson Jun 2, 2020

I am impressed with the idea of being able to provide a quality fully supported service over a wider demographic without moving people around. The virtual waiting room is a brilliant idea- what software are you using for this- and how do patients find you?

Reply 1

The virtual reception is provided via attendanywhere. Access to users is open via our website. Patients have been provided direction for this via text message as well. The phone call centre notifies our users of this service too.

Reply 0

If you wish we can arrange a demo to see how it works. Our team has found this extremely useful especially in MSK examination over phone consults.

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Greta McLachlan Jun 11, 2020

Status labels added: Collaboration, Community Care, Effective Team Working, Home Working / Remote Working, Information Sharing, Investment In Technology, Pathway Redesign, Prim/Sec/Com Integration, Reduced Bureaucracy, Regional Collaboration, Remote Monitoring, Telephone Advice, Telephone Consulting, Triage, Virtual Consulting, Virtual MDT, Horizon 2

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Greta McLachlan Jun 12, 2020

The idea has been progressed to the next milestone.

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Kyle Beacham Jul 10, 2020

Status labels removed: Collaboration, Community Care, Effective Team Working, Home Working / Remote Working, Information Sharing, Investment In Technology, Pathway Redesign, Prim/Sec/Com Integration, Reduced Bureaucracy, Regional Collaboration, Remote Monitoring, Telephone Advice, Telephone Consulting, Triage, Virtual Consulting, Virtual MDT

Reply 0