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Meet the team

Also:

  • Alison Robert, Manager, Tower Hamlets Council for Voluntary Services
  • Barts Health:
  • Helen Wensley, Outpatients Programme Director,
  • Ellen Sykes, Lead Patient Engagement and Advocacy Services,
  • Malika Atoussi, Head Bilingual Health Advocacy,
  • Abbas Mirza, Community engagement Lead,
  • Janice Roper, QI Advisor,
  • Conor Byrne, Consultant (equity subgroup)
  • Sarah Wallace, Specialty Registrar Public Health.

What is the positive change that has emerged through new collaborations or partnerships during Covid-19 that your project is going to embed?

The rapid sale up of remote outpatient consultations, in particular video, has been key to maintaining services throughout the crisis; however video consultations also bring other well documented benefits to patients and staff and meet with key aspirations of the NHS plan to deliver more digitally enabled care.

Our recent post-video consultation survey revealed 82% of 1,927 patients would like to continue video consultations post-pandemic. Patient comment; “I experienced less anxiety from not having to travel to my appointment and in turn,  felt more calm and able to remember questions I wanted to ask”.  21 of 25 patients who don’t speak English, considered their experience of a video consultation to be ‘significantly better’ than face to face.

This work will be supported by key new collaborations between the video consultations implementation team at Barts Health, Bilingual Health Advocacy, BH ‘CoVOG equity improvement workstream’ and the Community Sector; including Tower Hamlets Council for Voluntary Services.

What does your project aim to achieve?

Digital exclusion and other barriers, such as language, have the potential to exacerbate inequalities in access to remote consultations. Approximately 7.5% Newham residents report they cannot speak English well (2017)

AIM

To support and inform the scale up of video consultations in non-English speaking communities:

1) Measure and understand the uptake within non-English speaking communities locally, specifically;

– proportion of non-English speaking patients offered, and accepting, video consultations

– proportion who do not attend

– the use of bilingual health advocates (BHAs) and family members

2) Explore the experience of video consultations from perspectives of non-English speaking patients, local communities and staff

3) Work with patients, community groups and other stakeholders to co-design and test the most promising change ideas with a cross-sector approach to addressing barriers and enhancing access; aiming to double the number of non-English speaking patients accessing successful video consultations during project. One promising idea is bilingual NHS volunteers conducting video ‘test calls’ with patients.

How will the project be delivered?

Through close working of a carefully chosen project team, working closely with members of the community and local charities to co-design and explore a combined community/ health approach, using QI methodology.

The day to day process owner will be Joanne Morris, an experienced project manager and QI coach, with extensive experience leading video consultations roll out. The core team will meet fortnightly, including;

–       Bilingual Health Advocacy Manager

–       Advocacy and outpatients staff delivering day to day operations

–       Community members

–       Clinician/s

–       Key members of BH ‘CoVOG equity improvement workstream’

Wider team will include; local charities, BH community engagement lead, BH head of volunteering, business intelligence unit. The project Sponsor and Lead of Advocacy Services will address project barriers at a senior level.

A small patient and public involvement group will be established.

We will report to the ‘CoVOG equity improvement workstream’ at BH and Tower Hamlets Together ‘Digital Access and Inclusion’ workstream.

How is your project going to share learning?

The work will be embedded in existing workstreams and teams within the Trust and shared with the Tower Hamlets Together ‘Digital Access and Inclusion’ workstream and other charities / community forums (working with Abbas Mirza). Ongoing progress and learning will be shared with these groups and acted on as the project progresses. A shared purpose with these groups will aid future sustainability.

Communication (including project results) will be co-designed with the community representatives, PPI group and bilingual health advocates; and translated into key local languages.

We will disseminate further with other Trusts through external networks such as on the Future NHS platform, through the Health Foundation and with contacts leading the roll out of video consultations in NHSE/I and Academic Health Science networks.

Project information and findings will be hosted on the Barts Health website (patient and clinician pages) and we plan to publish / present our findings for wider dissemination.

How you can contribute

  • We would like to draw on the expertise, experience and connections in the community to inform ideas and progress
  • To link us with what is going on elsewhere, signposting to other work
  • To share feedback and help disseminate findings
  • We would like to hear from anyone tackling similar challenges and work within the community; and anyone who would like to work with us in this project or future collaborations
  • We would particularly like to report to, and receive feedback from (as we progress), the already established special interest groups; 'Video consultations; how to set them up well and fast' and 'Understanding alternatives to traditional models of out patient care'

Plan timeline

16 Apr 2021 SET UP: Stakeholder mapping, recruit additional team memembers& community representatives
26 Apr 2021 SET UP: Agree project charter, SMART aims, define measures,data collection
26 Apr 2021 SET UP: Clarifying team roles, responsibilities; meetings diarised
26 Apr 2021 SET UP: Process flow mapping with team, developing shared purpose
3 May 2021 LAUNCH; presenting plans to ‘CoVOG equity improvement workstream’ at BH
6 May 2021 PPI co-design group meeting
17 May 2021 Baseline data; audit uptake, patient survey, BIU data, qualitative data
27 May 2021 Cross-sector consultation to identify initial change ideas, specific, actionable.
27 May 2021 PDSA cycle plans e.g improve awareness of advocacy booking process
31 May 2021 ONGOING - MONTHLY updates to equity improvement workstream at BH
31 May 2021 ONGOING - THT 'Digital access and inclusion' presentation and feedback
7 Jun 2021 Initial PDSA cycles start followed by ongoing measurement, improvement& consultation
23 Jun 2021 PDSA cycle planning e.g recruit and training volunteers, consent patients
23 Jun 2021 PPI meeting to discuss and co-design
28 Jun 2021 ONGOING PDSA cycles; co-designed - ensuring ongoing patient and staff engagement
29 Nov 2021 End of official PDSAs and focus on write up
31 Dec 2021 Submission of final report to Health Foundation, and wide dissemination

Comments

  1. Hello Joanne,

    I think it's a brilliant project. I'm not sure if you are only including BAME community or non-English speaking overall but I can certainly say that it would benefit to have video consultation for non-English speaking patients. There is nothing more terrifying than not understanding fully what is being said about your health. It can cause a lot of anxiety in patients and possibly delay treatment.

    English is not first language for my husband.He would definitely benefit form having video consultation where he could freely describe the problem and understand if there was somebody for him to translate (apart from me).

    If you need any help with your project please feel free to contact me and I'd more than happy to help.

     

     

    1. Hi Barbara,

      Thanks for you post and good to hear from you - apologies for my very slow reply, I have had a lot of leave last couple of weeks..

      Great to hear about your interest in this; the remit is any non-English speaking patients. We know we have a big problem here but we are not even quite sure how big, so understanding the problem will be the starting point! I'm also aware there is lot going on already around digital inclusion so hoping to link up with other good initiatives. Do you know if there is anything going on in your area?

      Very best wishes,

      Jo

  2. Guest

    Anna Burhouse 6 months ago

    What a great idea this is. I couldn't agree more that unless we think about how to take an inclusive approach to virtual consultation we may inadvertantly miss opportunities to  decrease health inequalities/digital exlusion. Reading your proposal made me wonder what underlying co-production processes might work best for you? It will be important to understand what the current barriers to access are and if they are just about language, or whether there are other important factors for certain communities? It would be good to hear how you plan to include people and if there is an opportunity to work closely with community and/or voluntary sector groups to test out some approaches in the field?

    Great work :)

     

    1. Dear Anna,

      Thanks so much for your valuable response. I have made some changes to try and be clearer about the community engagement aspects of the proposal and included a more formal PPI group to consult / work with. So thanks for the helpful feedback. I agree that it is so important to properly understand the problems (plural) as part of trying to improve and we need to include real ongoing co-design with the community and staff to do this, involving them in solutions too!

      We have already been in touch with a number of charities who are interested to work with us, including Tower Hamlets Council for Voluntary Services. So, we plan to co-design changes with cross sector input (involving NHS staff too), tapping into work already going on if appropriate e.g  ‘language tutor’ volunteers (through Social Action for Health) or NHS volunteers. But we will remain open minded to the most promising change ideas.

      Thanks again.

      Bw, Jo

  3. This sounds interesting. My project idea is also around digital consultations too - teletherapy and we work in a diverse borough. I'm keen to make sure we stop and reflect before moving full steam ahead to more and more digital appointments. In Hackney where we work there is huge digital inequalities and we have experienced issues such as parents not having enough data on their phone for a consultation, not being able to access all of the features that others can because they are using a phone (rather than a desktop), or simply not acessing digital learning and teletherapy. There's also the cultural norms around digital use and access to consider.  BUT access to advocacy and interpreting has worked well in some cases.

    I'd be interested to see if there are better ways to communicate about digital appointments, better ways to manage the interaction and/or additional technology that could be used to support consultations - the use of visuals or shared screens could really support consultations?

    It would be good to connect as we are neighbours!

     

    1. Hi Annabelle,

      Good to hear from you, thanks for getting in touch. Your project sounds great and very worthwhile.

      Yes digital inequalities are becoming a big issue; often with the people who stand to benefit the most unable to access digital services. My idea is currently focused on Non-English speaking patients as we have such an ethnically diverse community within BH (as I'm sure you do!) and I believe the team we have can make a huge difference there.

      We are also aware the issues of digital exclusion are complex with often confounding factors and require creative and potentially collaborative solutions. We will be interested to stay in touch and see how your project also develops.

      Very best wishes, Jo

  4. Hi Joanne,

    Myself and my colleague Emma Adams (Health Transformation Partnership) are supporting the Health Foundation this year by fostering conversations between Q members and encouraging collaboration. We were Exchange applicants last year, so we’re hoping that our experience will help us to help others, as their ideas take shape.

    I wondered if you'd yet had chance to read the idea: "Addressing health inequalities in BAME communities through advocacy." Within this, they are using third sector support to help non-English speaking patients engage with the health system. Which got me wondering whether you are engaged with people already using consultations, or whether you'd be trying to improve access to those potentially harder-to reach members of the community. Either way, I thought I'd highlight their project incase you felt it was helpful to make a connection.

    Best of luck with your idea.

    1. Dear Peter,

      Thank so much for your comment and the useful connection. So far we had focussed on patients already known to us within Barts Health. Obviously there has been a massive shift to remote consultations, with video arguably having added benefits over phone. We believe very few of our non-English speaking patients are accessing video consultations (and we are not sure about phone) and it is about understanding why and looking at promising interventions to address barriers and improve access.

      I am aware there is some great work going on in the community and I should have emphasised our engagement with that; linking with promising interventions already going ahead or planned - so thanks for the prompt. I had put up another idea title which was going to explore our joint work with the community more fully but maybe I'm best bringing both idea together - would appreciate your thoughts on that!

      The other ideas was - 'Understanding and addressing digital exclusion and inequalities in access to video consultations through collaborative working between patients, the NHS, local government and community organisations'

      Many thanks again,

      Bw, Jo

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