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!
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!
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.
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’.
