One of England's integrated care systems proved the benefit of modern, cloud-telephony during the COVID-19 pandemic, and is now working with X-on on new ideas to support GPs and patients, following a roll-out to practices. Associate director of digital & technology Alicia Dunsby explains.
GPs in Herefordshire and Worcestershire are benefiting from modern, cloud-based telephony, following the roll-out of Surgery Connect to almost all practices in the area.
More than 70 practices within the ICS have adopted the X-on system over the past three years, with the support of NHS Herefordshire and Worcestershire and utilising central funding. Just eight practices have chosen not to buy themselves out of long contracts or have chosen other suppliers.
Alicia Dunsby, associate director of digital & technology at the Integrated Care Board (ICB), explains: "Telephony is incredibly important to general practice. It remains one of the most important channels for patients to contact their GP and access primary care services.
"We identified that some of our practices were struggling with telephony. They were using old analogue systems, constantly looking for more lines to handle an increasing volume of calls, and still seeing calls go unanswered. We decided to help all of our practices move to modern telephony and worked with X-on to achieve that."
COVID-19 shows the value of telephony that works anywhere
NHS Herefordshire and Worcestershire serves a population of more than 800,000 people, who live in a mix of rural areas and small towns and cities. A relatively high and growing proportion of these people are aged over 65, and there are pockets of deprivation in some areas, including parts of Bromsgrove, Kidderminster and Redditch. Although the area has a relatively good road infrastructure, it is 30 miles between its two main acute hospitals in Hereford and Worcester, and there are public transport challenges. There is, for example, no direct bus or train line from Redditch to either city. Therefore, the area’s population profile and geography make primary care the first point of access to the NHS for most patients so, it is essential for some form of GP practice to be open and accessible at all times.Alicia says this became very apparent during COVID-19. Initially, a large number of GPs had to work from home while, later in the pandemic, sickness could force smaller or single-handed practices to temporarily close. When that happened, it was telephone access that enabled patients to continue to access the care they required.
Meanwhile, for GPs, the softphone features of Surgery Connect came to the fore. The softphone is embedded in the user console and enables the user to indicate whether they are available to take calls, to make calls, and use video conferencing from any PC, tablet or smartphone with an internet connection.
"During the pandemic, GPs really came to understand the benefit of the softphone, because it enabled them to work from home," she says. "Twenty practices came on board during the final phase of the roll-out, because they had seen the benefits of remote working."
Tip: a standard build drives additional benefits
GPs also like Surgery Connect's integration with the EMIS patient record system, which means they can use the ‘patient list’ to call or send a message to individuals.Administrators appreciate its reporting capabilities, because they can assess how many calls are coming in and being answered when demand is greatest. Also - depending on how menus are set-up - what services patients are trying to access, from ordering a prescription to checking a test result or booking an appointment.
With the effects of COVID-19 mitigated by vaccination, and the roll-out of cloud-telephony complete, NHS Herefordshire and Worcestershire is starting to work with practices on how its features could help primary care services to support each other, in the face of growing demand and scarce resources.
For example, groups of practices are looking to work together out of hours, when there aren’t enough GPs to staff every surgery, but the area's travel challenges mean patients can't just visit the nearest practice site.
Alicia says this would be much easier if every practice had Surgery Connect set up in the same way; and her top-tip for ICSs and primary care networks that want to get the most out of a cloud-telephony deployment is to make sure that they do.
"If I had my time again, I would ask X-on to do a standard configuration, so the patient experience is the same, whichever practice they call," she says. "We let practices do things their own way, and there were good reasons for that, but you would see additional benefits if you standardised.
"We have groups of practices working to support each other both in and out of hours, and it has been a challenge to make sure that patients get a consistent experience, because we cannot say it will be 'press 1' for this service and 'press 2' for that one across the board."
A new era of rapid innovation
Despite these challenges, NHS Herefordshire and Worcestershire is starting to innovate with its new technology. For example, it is looking to implement a system that will enable other clinicians to get straight through to a GP, if they need information about a patient.At the moment, A&E and hospital doctors, community nurses and care home staff can spend hours trying to find out basic patient details, so being able to get straight through to check a medical history or pick-up medication information is not only more efficient but could generate significant time savings.
The ICS is starting to interrogate the new source of data that Surgery Connect has created. As an example, Alicia says: "We had a lot of nine to 14-year-olds turning up at A&E after school. We asked their GPs for their phone statistics, to see if we could work out why, and whether improved access to another service would stop it happening. Having reviewed the statistics, we found out it was a one-time issue with concerns over Strep A rather than a capacity issue."
Overall, she adds, what is great about moving to modern telephony is the speed at which it makes change possible. "During COVID, we were responsible for co-ordinating the vaccination effort for the local NHS and core public services," she says. "Naturally, there were a lot of questions to be answered.
"So, we established a line with X-on and we staffed it with people who could answer them. Because it was cloud-based, we were able to call X-on on a Wednesday and have it set up and tested on the Thursday and ready to go-live on the Friday. The fact that we could be so responsive was just amazing."