Highlights of an NHS Week - 8th August

So Jerry’s away, what can we do with his blog?!?!  Sharons Matson and Williams have been entrusted with this precious item!

We have been left with a clear set of instructions – clear that is, if you understand blog terminology and Twitter.  Jerry’s parting message was “Enjoy, and babysit well!”  In other words, don’t mess it up!!! 

We have seen a few photos of JC and the family; they seem to be having a good time.  Holiday reading material however seems of questionable quality and taste.  Hilariously we have also seen some photos of the Clough’s dog being “looked after” by neighbours and a promise to only return him if Ouzo is brought back!

So when looking after a blog, one finds oneself really reflecting on what’s gone on in the week.  What is worthy of publishing?  What is worthy of tweeting?  At some point, panic sets in that there will be nothing worth sharing.  However, the panic eventually subsides and some moments of brilliant experience emerge.  Here are this week’s.

Highlights of the Week 1 – Co-ordinating a response for national funding

The Western Locality are co-ordinating the CCG’s contribution to schemes to be funded by a national challenge fund.  As is often the case, the rules are prescriptive, the time-scales terribly short and clashing with summer holidays when many people that need to contribute are themselves, on holiday.  Trying to co-ordinate a series of proposals across 124 practices, ensuring that the schemes they put forward demonstrate value for money and will deliver the programme’s ambitions and objectives is a challenge but this week, we have the real sense that we will extend patient access to primary care and genuinely test some new models of care over the next six months.

Highlights of the Week 2 – The complexity of the urgent care system

Our Urgent Care Partnership met this week.  The agenda was full – Better Care Fund, performance and service demands, delayed transfers of care, learning from Operation Springback and a discussion about our Strategic Resilience Planning were just some of the key items for discussion by senior personnel from a range of organisations.  We had some fantastic challenge and input from our secondary and primary care clinicians and wider members of our community.  We have committed to really “test” our resilience plan so that we can demonstrate a real sense of confidence in the plan that will underpin the “winter” period and we agreed to really focus on ensuring that patients receive high quality services in care in the right setting, at the right time, rather than experiencing preventable delays.  The meeting overran slightly but it was worth it for the thought-provoking debate.

Highlights of the Week 3 – Facebook – some elements of brilliance

Anyone who has a Facebook account will be used to seeing photos, jokes, news feeds and random adverts popping up on their timeline.  This week, this appeared on mine:

This made me pause and think; think how often people genuinely stop, listen and think.  In the Western locality, we have been using Nancy Klein’s wonderful “Thinking Environment” for over a year now.  Personally, I find that using some of the techniques, active listening, rounds and incisive questions, hugely calming and they generate a sense of peacefulness for me.  On a number of occasions, in a large meeting with a complex agenda, where there is a risk of some people not being heard or certain people dominating the conversation, I request that we use the thinking environment to steady the level of noise, the risk of conversations crashing into each other and ensuring that everyone gets a chance to speak and that we get the most out of our expensive and increasingly precious time.  

We’ve been using the Thinking Environment with our wider Locality teams and stakeholders at our Big Events; the third of which was held a few weeks ago.  This week, I wrote up the product of the Big Listen from a few weeks ago where people tell the Senior Leadership Team what’s important to them and the SLT really, really listen to what is said (without hesitation, repetition or duplication!).  There are some real strengths in what’s happening in both the Locality and the wider CCG.  Some of the feedback is set out below:

Highlights of the Week 4 –   Simon Stevens visits Devon

Simon Stevens NHS England's CEO made his inaugural visit to Devon this week.  He was visiting Dartmouth Hospital to listen to local voluntary organisations and to see local community services in action.

In a county that already subscribes to the value of using community services, resources and assets recently set out at the NHS confederation conference, it was great for local leaders of health and social care organisations to have the opportunity  to talk about the wider health needs of the local population and the challenges at hand. 

Dr Tim Burke, NEW Devon's Chair was delighted to meet with Simon Stevens and glad to see local voluntary sector organisations receiving the recognition they deserve.  They provide such a significant part in supporting local communities across Devon and we have high expectations that this will only increase as the joint strategy signed up to across the health economy moves from plan to implementation.

Highlights of the Week 5 –  Strong partnerships in action

Since March, the demand for emergency care services has risen by about 10%.  We are not alone, the rest of the country is also reporting increases in demand but what makes us slightly different in Devon is that we introduced NHS 111 in March.  The natural assumption is, not unreasonably, that the cause must be 111.  It isn't - if only life were that simple!

All organisations in Devon have worked really hard to get to the root cause of the demand increase - none more so than the service provider themselves.  Their performance is amongst, if not, the best in the country; 95% of patients surveyed would use the service again; the evidence reviewed today at a summit chaired by the CCG shows that the cause is not 111 but is a combination of many facets in our health and care system.  

The debate in the room was hugely positive and constructive.  A robust action plan will be put in place with some small tests of change run ASAP to test their efficacy before 'winter' begins.  It was great that the emphasis was on finding the best solutions for patients and the wider system and not on blame.  Some fantastic collaborative work which can only bode well for the Futures programme in our system.

 

And as promised a bonus Summer blog from DRSS…

It’s a very busy time at DRSS.  Not only are we changing all of our processes so that we have a single way of working across both of our sites in Newton Abbot and Plymouth, and getting a new patient (PAS) system; we are also developing a new database system to feed all the reporting and monitoring requirements of the service.  On top of this we also have all 3 of our major national IT systems being replaced: NHSnet – the NHS Spine, NHSmail and Choose and Book (to be known as e-Referrals), in addition to a new CCG wide IT system, DELT, and a new outsourcing contract for all patient letters – all in the next 5 months!

Whilst all this is going on we will still support approximately 6,000 people per week with their physical and mental health referrals. These come from a range of sources including GPs, opticians, dentists and extended scope practitioners (physiotherapists and podiatrists).

We will also be working hard to support the CCG with their plans for financial recovery as part of the NHS Futures programme, particularly focusing on the demand management.

Never heard of us?  Who we are and why we exist…

Devon Referral Support Services (DRSS) is a referrals contact centre which supports individuals in getting the right advice, care or treatment in a timely manner, and we are very passionate about this!  We can’t do this work alone though and work closely with a wide range of people, groups and organisations within our local communities, and further afield, to build collaborative, sustainable systems and solutions within the context of local CCG priorities.

We also provide a range of services that complement and support the contact centre:

• facilitation of service and commissioning redesign across Devon to address financial recovery (such as demand management). 
• managing localised pages of the National Directory of Services (DoS) to ensure the database reflects current service provision in Devon, Cornwall and Isle of Scilly.
• managing 18 community clinics, and booking the physiotherapy service in  South Devon.

DRSS are part of the Collaborative Business Service arm of NEW Devon CCG and provide services for a number of organisations including the 3 local CCGs, NHS England and Devon Partnership Trust for a population of 1.3 million people. 

DRSS Highlights of the week 1 -  Improving the recruitment process

Nearly 10% of the CCG workforce is either a current or former apprentice and earlier this year the CCG was recognised as being Apprentice Employer of the Year by ETS.  

Since 2010 DRSS have employed nearly 60 apprentices (45% of our workforce). We’re really proud that 44 of these apprentices are still working with us in some capacity and that most of the others still work in the local NHS. Working with ETS to develop an apprenticeship programme tailored to the requirements of a business admin role within a NHS referral contact centre has been a fantastic way to ensure that all their learning is relevant, topical and supportive.  

With so many of our team joining us through apprenticeships it has been important to get the recruitment part right, so we’ve been recently asking candidates, both successful and unsuccessful, for their thoughts on our process and have used this feedback to make some changes.

This is the first interview for some candidates so the ‘traditional’ process of a face to face interview doesn’t really give them the best opportunity to shine and share their potential.  How many times have people stormed the interview process but failed to live up to expectations, or frustrated us by being extremely capable of doing a job but being so nervous that they really don’t interview well at all?

To try and get a rounder picture of candidates (and for candidates to get a rounder picture of DRSS as a potential employer) we have now introduced an icebreaker session which the interviewers join in with, a group exercise, a telephone test, a letter test and a chance to meet current apprentices and chat to them informally.

This may all sound rather daunting, but we’ve now used this in 3 rounds of interviews, the latest last week, and feedback has been great.  The candidates felt they had a good understanding of what the job entailed, and we had more time to spend with everyone to get a better sense of their strengths, values and interpersonal skills, which may not be picked up during the ordinary interview. 

Our current apprentices have also really appreciated the opportunity to give something back and chat to new potential staff members.

DRSS Highlight of the week 2  -  Communication creativity

Communication is always a tricky thing.  No matter what we seem to do people don’t feel that they know what’s going on.  Sometimes we can feel that we repeat ourselves (and bore people) endlessly and yet people still don’t think they know what’s going on.

One area we’ve been thinking a lot about is how we communicate with GP practices. We have a bi-monthly bulletin (monthly if there’s a lot going on) which sometimes feels like it’s full of provider information.  It doesn’t always fulfil its potential to share information about our service and yet we have so much information to share.

This edition feels like we might have turned a creative corner!  In fact, we’re really rather proud of it and are feeling energised by providing something we feel is useful.  It’s available here so have a look and see what you think! (You’ll need access to NHSnet to see it though).

DRSS Highlight of the week 3 -  The impact of health literacy

Dealing with six thousand referrals per week means that we are in contact with a whole range of people, with a whole range of needs.  Equality and Diversity are part and parcel of our work so we were thrilled to meet with the CCG Leads for Learning Disabilities for some really helpful discussions about how 'health literacy' issues can limit access to healthcare due to impaired comprehension, difficulties in communicating, lack of assertiveness and their dependency on carers.

We are really looking forward to working with the team to see how we can better support people with LDs or dementias by reviewing our letters, phone scripts and patient surveys to ensure they are ‘Easy Read’.  

We know it’s going to take a work of art to get our patient letter right for everybody (we’ve already had conversations with our practice manager group on how to do this) but we are up for the challenge!

DRSS Highlight of the week 4 -  Welcoming more primary care practitioners to the team

As a clinically led service we have a team of practicing GPs from across Devon and East Cornwall who, with their clinical knowledge, provide general advice and support to the team.  They are pivotal to supporting the implementation of commissioning policies, clinical referral guidelines (aka pathways) and potential upgrades to urgent or 2ww priorities.

This week we have appointed 6 new GPs to join the team to help ensure we have clinical cover each day, especially over the holiday periods.  

We have found that the GP role is a vital link between practices and providers, building rapport and relationships that inform and shape how the service develops and so we are pleased to welcome some new faces and new energy to the team J.

DRSS Highlight of the week 5 – Take a little time to be kind

Kindness – although we’re all the centre of our own universes not everything is about us as individuals.  Taking minute can have the most profound impact on people and as a contact centre we have dealings with thousands of people each week, all with their own stories.  

This week we booked an appointment for an 84 year old gentleman.  He asked if he could take a further minute to play a song on his cello.  He had been a member of an orchestra and didn’t get to play for people anymore.  The call was put on speakerphone and he played ‘The Swan’ to the team.  Having someone to play to again made him very happy and brightened the team’s day too.

Another, rather distressed, patient called to find out information about his referral for a suspected cancer.  He’d been around the houses a bit, and although his referral hadn’t come through the referral service just the fact that someone investigated for him reassured him that he could carry on his day as normal.  The consultant responded within the hour giving him an appointment and peace of mind that he hadn’t been ‘lost in the system’.

Knowing that taking just a minute of our time, no matter how busy we are, can make such a difference to people is a real bonus to us and can be rewarding for everyone.  In the words of Aesop:

‘No act of kindness, no matter how small, is ever wasted’.