Q Exchange
Revolutionising remote Multiple Sclerosis care by rethinking Digital healthcare support
- Shortlisted idea
- 2022
Meet the team
Also:
- Jo Watts - UHS Digital Lead
- Jake Wilkins - Associate Director, Always Improving UHS
What is the challenge your project is going to address and how does it connect to the theme?
· Multiple Sclerosis (MS) is a debilitating long-term condition with significant mobility issues making travel to hospital appointments exhausting. A virtual care model is thus attractive.
· Our digital platform, My Medical Record (MyMR) has already >1,200 MS patients registered who would benefit from virtual outpatient care.
· Clinical nurse specialists are committed to this model but lack time to support virtual care alongside existing work. This requires a specific Virtual care role to help drive change and support these additional responsibilities
· We will pilot a new type of Health Care Assistant (HCA) role, embedded in the clinical team and enabling the virtual patient support. We are thinking differently about the HCA role to attract a different type of candidate by blending digital engagement skills with patient care.
· Evidencing benefit from virtual care for long-term conditions paves the way for further investment, creating a repeatable model for the NHS
What does your project aim to achieve?
The project will achieve
· Over 1,000 patients benefiting from virtual care and avoiding hospital visits increasing patient satisfaction whilst not compromising care
· Identify barriers to use of digital platform and potential interventions to reduce health inequalities particularly around digital inclusion and disability. This will be done in partnership with our local council and voluntary sector.
· Releasing of clinical time – validated data from prostate cancer pathways showed undertaking virtual reviews on the MyMR platform of diagnostics, patient questionnaires and other information provided enabled 3x as many patients to be seen per hour.
· Development of an apprenticeship model for digital HCAs – a novel role to entice a wider spectrum of employees into the NHS
· Creation of a blueprint approach that can be repeated in other services & organisations
· Identification of KPIs to assess the benefit of the role
· A qualitative assessment of impact on staff and patients
· Business case for wider scaling
How will the project be delivered?
An integrated team across Quality, Transformation, People, and Digital will work with members of MS clinical team and patient representatives to co-design and test this role. Roles and responsibilities will be assigned to measure impact, deliver value and benefits realisation. Working together will allow us to capture benefits jointly and bring the communities, skills and perspectives together to maximise success.
Our Trust has a strategic aim to build the capability of people through projects and bring those skills to the wider workforce, driving improvement and digital change themselves.
This project will be an innovative way to attract individuals with digital interest into the HCA workforce, buiding on exisiting organisational work on HCA recruitment and retention.
The Digital team will develop and enhance the MyMR platform to support virtual care in MS and provide IT equipment for the HCA, MS nurses and a pilot group of patients (funding already secured).
How is your project going to share learning?
This project is relevant for health providers looking to extend the use of virtual care to large cohorts of patients. We will establish a monthly group to share learning. It will be open to any interested stakeholders locally or from the wider Q community. Topics might include attracting potential employees to these new roles, sharing job descriptions, identifying core competencies for these roles, assessing & governing patient’s suitability for virtual care, the consenting process for signing patients up to virtual care platforms and the duty of care when providing virtual care/supported self-management.
Learning will be generated through:
· Patient feedback, outcomes and testimonies
· Staff feedback
· Artefacts from the project (Job descriptions etc)
· Benefits realisation study
· Creation of a blueprint implementation approach that other services can replicate
· Case study covering the implementation including lessons from role attraction/recruitment process.
We would anticipate sharing through Q forums and events, presentations, publications, and social media.
How you can contribute
- Feedback from anyone providing virtual care for large co-horts of patients
- Input from Q service users on virtual care – what works, what doesn’t
- Advise on creating new digital and virtual healthcare assistant roles
- Thoughts on how this will address our NHS workforce challenges
Plan timeline
| 30 Nov 2022 | Co-design and recruitment period |
|---|---|
| 1 Jun 2023 | Pilot the HCA role over a period of 12 months |
| 1 Jun 2023 | Review / study – concurrent with HCA role – 12 months |
Comments
Gillian Janes 20 May 2022
This is a really interesting project - outside of Q I'm working on a project looking at service design for Long Covid patients going forward so I'll be interested to know you this progresses as I think it may have transferability - plus our Q project is focusing on digital transformation and staff wellbeing so you got one of my votes and good luck! Gillian
Kate Pryde 20 May 2022
Thanks so much for your support Gillian. I think there is loads of transferability for many areas and sharing this is one of the important aspects of our bid.
Joe Croombs 17 May 2022
Hi Kate and team
This looks like a fantastic resource, great to see access to info with support and with the patient front and centre. Love the outline of the new role and know Solent & other community providers will be keen to support.
Have you considered how the MS community may wish to support itself - existing support groups who may need some tech input? volunteers?
Will be great to see how patients, their loved ones/carers etc. will input into this
Best of Luck Joe :-)
Kate Pryde 20 May 2022
Thanks Joe - yes we will be working with our existing patient groups in MS as well I hope as new ones. Partnering with patients and their families is core to this project.
Appreciate the support
Rachel Chappell 13 May 2022
Really exciting to see how Neuro-MyMR has gone from strength to strength. This work will be a useful addition in our arsenal as we work to understand how best to embed digital technology in our models of care.
Kate Pryde 20 May 2022
Thanks Rachel - it's certainly exciting for us in terms of how we work with patients and carers to embed and embrace the technological advances to benefit their care
Clare Smith 6 May 2022
I am really interested to read about your project Kate, as you are a little further downstream with your My Medical Record app than we are with our Family Assist app that has been developed for children and families (and we would develop as part of our One Big Front Door project). It will be really interesting to learn from your project. I particularly like your proposal to appoint a HCA to support digital engagement and virtual working, particularly to support engagement issues around health inequalities. A governance structure to support the HCA and other clinicians with determining when a patient needs to attend the hospital (when they may prefer the virtual approach) is helpful. We have been offering virtual appointments for children and families for the past couple of years and, whilst mostly beneficial and hugely flexible for families, there have been occasions where for clinical reasons children have needed to attend in person.
Good luck with this stage of the project, and I would be really interested in being updated on the progress.
Kate Pryde 9 May 2022
Thanks Clare for you support and comment. We agree there is lots of leanring to share and others like yourselves who are also on the journery.
We are adapting our proposal to be explicit in terms of setting up an open group to share mutual learning - be that Q community members or anyone intereseted/involved in virtual care. Working together we will go further . . . . .
Natalie Steel 14 Mar 2022
I’m excited to see how the idea of having a digital HCA works out in the MS team. We know from Claire Marsh’s work that the support workers in the cancer teams play an important part in the adoption of My Medical Record (MyMR) amongst the clinical team and the patients.
The digital HCA role would be very beneficial to other clinical teams who are already using MyMR or are looking to start using it. For example, if we had a digital HCA working with the IBD patients then we could immediately free up CNS time to focus on other areas of clinical care. I can think of at least 3 other clinical teams who I am currently working with at UHS who would immediately benefit from having someone in this role.
Kate Pryde 16 Mar 2022
Thanks Natalie for your support - we certainly woudl hope this model would be applicable to other clincial teams and taht woudl be one of the outputs to share a 'blueprint'
Anita Esser 11 Mar 2022
Our HCAs are at the forefront of delivering care to our patients and are therefore ideally placed to support patients to use digital services available to them. Having this role will recognise the importance of the HCA role as a digital champion as we roll out digital services. This is a really exciting initiative and as the lead for support worker training and development at UHS I think this provides another great opportunity to enhance the HCA role and deliver even better patient care.
Kate Pryde 16 Mar 2022
Thanks Anita - great to have your support as you say HCA vital role within NHS and by diversifying roles we can hopefully recruit and retain from a wider population
Carl Adams 11 Mar 2022
I really like this idea, as I was involved in the initial structure and set up of the MyMedicalRecord for people with neurological conditions, where we say the uptake from patients with MS. I recognise the need for HCA or digital support behind the MyMedicalRecord to utilise the platform.
The pathway for patients with MS involves many health and social care providers, so please consider how you are going to work alongside and involve community providers (positive Solent NHS will support) and also volunteer/ peer advocates groups, who may also co deliver with the HCA. It might be a combination of people and organisations to form a team to provide the service.
This work has so much potential!
Kate Pryde 16 Mar 2022
Thanks Carl so much for your enthusiam and support for this project. Really good point about involving community and 3rd sector - thank you.
Collaborating with Solent on this would be brilliant.
Jane Hayward 10 Mar 2022
I think this sounds like a great project for patients but this also creates a really interesting new role for members of staff. We need to bring digital natives into the NHS into interesting new roles. I think this will make such a difference
Kate Pryde 16 Mar 2022
THanks Jayne for hihglighting one of the elements we feel is really exciting - the enticing of a new cohort of indivdiuals into a role within the NHS that might well not preivously have considered it but have loads to give.
Peter Cowburn 10 Mar 2022
I think this is an excellent project. We are developing MMR for heart failure patients but it is clear to maximise this resource patient support is required. I'm sure a health care assistant working with patients and the clinical team has the opportunity to maximise use of the system and improve outcome whilst saving on clinician time. A win for all. I will be interested to hear of the undoubted success of the project and would be keen to look at a similar post for heart failure patients.
Kate Pryde 16 Mar 2022
Peter - thanks for your support. Spreidng wider than MS would be our intention. Will keep in touch and share our learning with you
Jayne Masters 10 Mar 2022
I think this would be a great innovation for MS patients. I am familiar with My Medical Record for another condition, but I have a friend with MS who I know spends a lot of time sourcing support and advice for symptoms and other things. I think this platform could help her enormously.
Judy O'Sullivan 10 Mar 2022
This sounds like a great project that could have read across to other conditions.
Dr Christopher Halfpenny 9 Mar 2022
MyMedicalRecords is an innovative platform that is already helping people with MS to manage their condition better, and improving access to care. We believe this has the potential for even more: This is an exciting project that offers a tremendous opportunity for an HCA with both healthcare and IT skills and attributes to develop the service further. This is likely to lead to significant short- and long-term benefits to patients, both directly and indirectly through freeing-up of nursing and administrative staff.
Kate Pryde 16 Mar 2022
Thank you for your support Christopher - any specifc outcome measures you think we should be including? Particualry with how to quantify time freed up - our time gets filled easily with something esle we might forget what we woudl have been doing!
Gail Doran 9 Mar 2022
Covid accelerated the embracing of digitally supported healthcare by both clinicians and patients so there is a real opportunity to embed and sustain this to secure better healthcare in the future.
An innovative role such as a digital HCA has the potential to realise multiple benefits; the enhancement of the HCA role and its appeal to a wider demographic of applicants, the release of clinical time to enable everyone in the patient pathway to work 'at the top of their license' and the huge benefit to patients of bringing their care closer to their home and with a greater degree of appropriate self-led care.
We know our MS population has changed dramatically over the last ~15 years with earlier diagnosis, better quality of life and improved prognosis but the model of care is largely unchanged. This role would be an essential part of the review of the overall patient pathway and enable all parties to feel confident in developing sustainable change.
Kate Pryde 16 Mar 2022
Thanks so much Gail for your support. Really appreacite it.
Carly Walton 9 Mar 2022
My Medical Record has changed the way patients can review their own information, which has been empowering.
But it has so much potential to keep growing, and improving the communication between patients and clinicians, having additional support for this service is going to be game changing.
Claire Marsh 9 Mar 2022
This is a great opportunity to support patients in the use of digital healthcare. The Support worker is a pivotal part of the team supporting both the CNS and Patients. Using a digital platform for patient initiated follow up works very well in cancer care and this role is key to this success. It allows patients to know there is a physical person to talk to as well as being encouraged to self manage using a digital platform. With a Support worker in post it releases CNS time to focus on the more complex patients using the skills they have trained in. The support worker is provided with an educational/competency plan ensuring they are supported and have development opportunities. I fully support this being rolled out to other long term conditions.
Sarah Williams 8 Mar 2022
Hi Kate and team
Looks like an excellent resource to develop to me.... anything that gives access to information with support, and can be patient led has to be a winner. Love the development of the new support role
One other approach might be to include peer support workers (buddies) who are going through something similar. Or use support groups to help with the digital access etc etc. It's worked well in many of our community rehab programmes, and often helps with QOL for those are the buddies.
Something to consider with the patients inputting into the project
Good luck!
Sarah
Kate Pryde 16 Mar 2022
Thanks Sarah for your support. Idea of digital 'buddies' is great. Someone else also mentioend the volunteer sector and something we will explore.
Reading through some of the other apllciations on improving digital access I have thought we could join up with one of them though populations for them look specific and perhaps only a small number in smae part of the venn diagram . . .
Alvaro Morales Reyes 8 Mar 2022
This app has a huge potential for being set up across the NHS as an interactive tool for patients to get in touch to different teams and specialities for non-urgent advise and support.
It will be interested how the role of the Digital HCA is developed, being a pioneer role in the digital field.
Looking forward to see how this keep developing.
Matthew Williams 8 Mar 2022
Really excited to see the potential for such an exciting role and support this piece of work 100%. HCA are vital to so many aspects of the work being done within the health sector but don't often get opportunities to specialise and develop themselves digitally.
This project has tremendous scope to both improve the care for patients, but also to establish a development opportunity for HCA with a digital interest further developing the workforce whilst at the same time freeing up clinical staff that would previously have spent time working on activity that would now sit within the scope of the 'Digital HCA' role. So it would be a major plus for patients as well as workforce, potentially setting up a model that could be lifted and implemented elsewhere.
The fact that this bid is supported by so many different departments within the hospital gives credibility to how it's likelihood of achieving success. Good ideas are all too often done in isolation by one department and don't end up realising the full scope of the potential benefits. Having the support of Quality, Transformation, People, and Digital as well as the clinical team and patient representatives will enable this piece of work to achieve results but in a manner that keeps the patient at the heart of the decision making.
Kate Pryde 16 Mar 2022
Matt - really good to have your clear support for this and recognisiton of the potential value. Ensurig all the relevant stakeholders engaged was crucial before we evne submitted the bid.
Any thoughts on measuring the time freed up gratefully received.
Will keep you updated and of course be in touch should we be succesful.
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