About the organisation:
Bexley Health Neighbourhood Care (BHNC) is a not-for-profit Community Interest Company and GP Federation supporting 22 GP practices in four PCNs with a patient population of around 446k within South East London. BHNC in its current structure has been in place for just over 12 months and continues to grow and innovate in six areas:
- primary care and PCN support
- community care
- workforce development
- infrastructure and IT
- governance and quality
- business development
- training and education.
The BHNC Board is comprised of four elected voting directors who are all GPs. All 22 GP practices are members of the GP Federation, which supports practices to secure quality services for patients through the delivery of the following objectives:
- Support Bexley GP practices to help secure the best services for patients and meet the challenges of a changing NHS while improving patient outcomes through PCNs.
- Improve the morale of general practice in Bexley by sharing expertise, services and resources to support staff.
- Make a positive impact on the improvement of medical services and the quality of care in Bexley by working closely with the CCG, local NHS trusts, local providers and patient groups to improve the delivery of healthcare based on the needs of the population.
- Lead and improve the education of staff and patients in Bexley by working with the Bexley Training Hub for staff and the GP Federation’s own Training Faculty for patients and staff
- Look at local, national and global innovation to transform PCNs and introduce bespoke digital solutions to create efficiencies with the system.
The two main challenges for BHNC during COVID-19 were and continue to be:
1. How do we track and look after our patients / care home residents?
2. How do we track and look after our staff and the operation of GP practice sites?
This was an immediate COVID-19 challenge, but crucially while we define an ever changing ‘new normal,’ this is very much also a longer term challenge as the NHS will never go back to pre-COVID ways of working. There is also the challenge of coordinating the wider multidisciplinary team caring for our patients / residents in a very agile way. Staff are increasingly working remotely and this will be the ‘new normal’, thanks to the use of digital technology.
What the organisation did:
BHNC responded to COVID-19 by rapidly developing a digital solution to the two challenges above, with its digital partners Appian and Convedo UK, as well as wider social and community care partners. This app was designed to track information about patients and care home residents, including workflows for care assessment, planning and delivery. It has the potential to support PCN service delivery in the long-term, including the enhanced health in care homes service specification which was brought forward following the impact of COVID-19 in care homes. BHCN focussed on building the key areas of the enhanced health in care homes service specification into the patient flow process. The app is built according to specific ‘personas’ who have different levels of access to patient information e.g. discharge staff, social care, rapid response, community care GPs etc. The PCN has a ‘helicopter view’ of all patients in the system, so it knows what pathway each patient is on and where further support is required. This can all be tracked live.
Results and outcomes:
The digital solution has the potential to enable the multidisciplinary team to be very co-ordinated in the way it tracks the care of patients and care home residents. The initial feedback on the digital solution and targeted deployment is very positive. BHCN has been able to collaborate with local partners in the live testing and development of the solution across different boroughs in South East London and across England. These new collaborative partnerships led to a common set of objectives: to beat COVID-19 and digitally innovate to sustain the highest quality of care for patients. The live pilot results will be evaluated in June / July 2020. The new live pilots phase, as part of the PCN service specifications, is with one practice in three care homes in Bexley and a large care home in Lambeth. There is obviously much work still to do. The timetable set out by NHS England and Improvement in the NHS long term plan expects rapid progress on building multidisciplinary teams and digital enablers. By March next year all PCNs and multidisciplinary teams are required to have fully deployed new ways of working, including the digital solutions to meet the challenges. The development and leverage of BHCN’s digital solution is still to be proved at scale but the early signs are positive for staff and patients.
The development of the app was the easiest part. Taking a risk as a small organisation was the biggest challenge. Delivering a large-scale digital change management solution during a pandemic was also a huge challenge as it took time to convince everyone of the longer term benefits of embedding a new system. Successful culture change must be earned, and new digital solutions proven to work for staff and patients. BHCN overcame this by working with individuals who wanted to trial something completely new and continuously improve without being put off by setbacks.
BHNC and their partners continue to learn how best to engage with key stakeholder groups. This is essential to the success of the digital support offer, as staff and patients need to benefit from its use.