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

Our use of digital tools, such as AccuRx, in primary care has increased due to covid-19. Primary care have expanded the offer of remote consultations, which include video calls. This has helped safeguard patients and staff in the context of the pandemic and this has been positive. It has also allowed contact with some of our most vulnerable patients for whom social interaction is otherwise limited.

We are now aiming to capture the positives of use of digital tools and enable access via this route for patients that may need additional support to kick start use. There has been much debate about widening inequalities as a result of digital exclusion and this project aims to reduce this by working to enable better use of digital in groups with added risk factors for exclusion eg. over 65s and non-English speaking groups.

What does your project aim to achieve?

Aim: To improve the confidence in use of digital tools in at risk groups for digital exclusion and to improve access to primary care.

Objectives:

1. Produce a toolkit to enable residents to access digital primary care.

2. Train 30 voluntary sector staff working with clients where digital exclusion is a problem. Training will include a) how to have video consultations with your doctor  (enables safer and fuller assessment remotely where required & enables a patient advocate to aid translation) b) use of NHS app to request repeat medications for your condition (improve safety with medication requests) c) booking GP appointments online

2. The staff and volunteers will be digital champions for primary care – they will hold workshops and face to face drop-ins with clients to improve confidence

By supporting vulnerable clients, including those with long-term conditions who cannot speak English and over 65s, we hope to tackle inequalities.

Recruiting champions from communities supports sustainability.

How will the project be delivered?

The Team:

The Quality Improvement Support Team, Islington GP Federation (IGPF) will work with partners including Healthwatch Islington (HI) and Holloway Neighbourhood Group (HNG) to produce a toolkit to support residents to access primary care using digital means.

IGPF has a primary care team which can provide the clinical oversight and technical information for the toolkit. IGPF hosts the training hub and has infrastructure for virtual workshops and space for in-person training.

HI will connect with existing staff and volunteers who will use our toolkit. HNG runs out of a multipurpose community centre and is connected to those at risk of digital exclusion which will allow rapid deployment of training. All organisations are motivated to support clients with digital exclusion.

Measurement of impact:

– Feedback from staff, volunteers and residents trained (questionnaire measuring change in confidence)

– Number of staff/volunteers and residents trained (sustainability – count digital champions)

– Number of organisations using toolkit

How is your project going to share learning?

The increased use of digital and its implication for patient access and possible widening of inequalities is of immediate concern for patients, providers and policy makers. We will share learning both locally and nationally:

– We will write about our QI journey as this collaboration develops and share with Q members. We aim to share resources with other areas interested in a similar approach.

– Our celebration event will share learning with all organisations involved in the project.

– We are active on social media and would tweet our learning for further reach. Our team members contribute to academic discussion, including via the BMJ.

– Islington GP Federation works closely with Public health and CCG teams and will share findings in our locality, using this platform to disseminate impact in London as well as with Primary Care Network development teams nationally.

– Conference presentations and publications.