Julia Holding: The Dr Will Zoom You Now - Remote Consultations

22 September 2020

Julia Holding: The Dr Will Zoom You Now - Remote Consultations

Download:

  • Click here to download The Doctor Will Zoom You Now Insight Report
  • Click here to download The Doctor Will Zoom You Now Top Tips.
  • Click here to get an easy read copy of our top tips for how to make health appointments on your computer or phone better.
  • We held a webinar to mark the lauch of the report on 24 July 2020 - click here to view the recording of the launch. 
  • Click here to view the Activity Map.
  • Click here to view the Webinar Chat Themes.
  • Click here to view the Q&A.

Julia has had a long career with the NHS. She is a registered nurse and has held a number of national senior leadership positions, most recently as the Head of Experience of Care with NHS England and Improvement. Julia was recently recognised at the Patient Experience Network Awards for her Outstanding Contribution to Patient Experience.

Julia is currently working as an independant Healthcare Consultant, and  is supporting Traverse with the Dr Will Zoom You Now project.


Before the end of March 2020, the NHS was in a world where the concept of a remote consultation was one talked about extensively by politicians, and yet remained for many health systems lodged in a series of pilots and isolated projects.

By the end of March 2020 there had been a seismic shift, with the instruction to stay away from others there was a clear disbenefit to attending hospitals and other healthcare settings, thus the remote consultation became the primary vehicle for healthcare delivery outside inpatient settings.

The headlines have been about how much better this has been for patients and staff, how much time and how much money it has saved, but what has the real effect been on the three factors which truly determine the quality of care:

  • clinical outcomes,
  • patient safety and
  • patient experience?

We know these three are interdependent, therefor just focussing on safety and clinical outcomes will never give us the whole picture.

After the initial response to COVID19, where energy was focussed on delivering to meet operational need, we have entered a period of reflection where it has been acknowledged we need to understand more about impact, in order for us to plan the changes which are to be sustained. It is important we use the time wisely and remember that patients still have a right to be involved in decisions which affect their care and treatment. NHS Constitution

There have been a number of studies and surveys carried out by among others, the Royal Collage of General Practioners RCGP, Nuffield Trust , and The Health Foundation. Work is also being undertaken by a number of academic bodies, broadly under the auspices of the  National Institute for Health Research NIHR much of this review and evaluation work has focussed on the impact on and the views of clinicians, and few have proactively engaged patients.

The exception has been a piece of work delivered through a partnership between National Voices, Healthwatch England and Traverse, called ‘The Dr Will Zoom You Now’ This was not a commissioned piece, instead it was borne of a mutual desire to not see patients left out of this important debate about the future of healthcare. Its purpose was to demonstrate the value in engaging patients in this subject, and to produce a body of evidence to help inform future work.

Like it’s subject, the research utilised a range of non-face to face approaches, experimenting with online deliberative approaches as well as more traditional phone interviews

The key themes which emerged from this research study are clearly relevant to the debate about what patients need and want in a post COVID 19 world where services have been transformed and remote care the new norm.

  • Quality personal communication matters to patients – no matter what form it comes in
  • There needs to be clear boundaries, with appointments that are timed to fit around the needs of patients as well as clinicians
  • It is important to provide information so both patients and clinicians can be prepared, this also helps to set expectations 
  • There should be a choice of phone, video or text/email and face to face, to meet the needs of people, based on what is right for the person and what is right for the situation 
  • There is an appetite for patients to be involved in designing, teasing and evaluating new approaches
  • There is not one single approach which meets the needs of all patients, either because their type of need for clinical care or because they are unable or unwilling to use any type of non-face to face interaction

This project has been in the spotlight since it launched in July 2020, there has been interest from right across the NHS with an online presentation attended by over 300 people. There has been extensive engagement with the Primary Care Networks, with a presentation about the work to over 500 PCN members. In addition, there has been interest from the Royal College of General Practitioners (RCGP), and the Royal College of Physicians (RCP).  A set of  Tips for remote consultations have been produced, including in Easy Read  versions and these are currently being used extensively. 

The research is being considered as part of the NHS England and NHS Improvement Benefits Realisation work. This work has been cited in a number of other documents including the COVID 19 Third Phase Letter  sent by Simon Stevens on the 31st July.

So, what next?

This work has proved the value of using patient feedback to support the future development of services and of methods of delivering future clinical care.

Its hoped that many will learn from the research approach and from its outcomes. Where there is a will to do more, at a CCG, Trust, or STP level but a need for some extra help or advice please contact Jessie Cunnett, Director of Health and Social Care at Traverse Jessie.Cunnett@Traverse.Ltd

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