We thought of ourselves as having made a good start. And we had. One of the cleverest analysts I know had developed a system to help electronically schedule our community team visits. Excel spreadsheets stretching their functionality as far as possible and beyond. Auto-populated from a patient administration system (PAS), every day our teams headed out on their visits with printed copies of their work lists. They wrote their patient notes into yellow folders
But Herefordshire’s community is changing, and digitisation is our watchword.
The community services are hosted by Wye Valley NHS Trust, a combined acute and community Trust. Having set out on our journey to develop and implement an electronic patient record system, it quickly became clear that the needs of the community teams were vastly different from acute hospital teams and would be difficult to accommodate.
In 2018, Wye Valley NHS Trust joined a programme with Malinko to create an auto-scheduling system for community teams. The system was developed in conjunction with the teams, and had the additional benefit of working on a smartphone platform.
For the first time, community nurses and therapists had online connectivity. These brought about additional benefits including a secure camera (no more returning to the office for a camera for wounds), geo-location tracking (lone working safety) and other useful software applications. It’s the little things that have made such a huge difference….
In tandem with this, Herefordshire CCG successfully led a bid for Health System Led Investment funding, in support of a system-wide community electronic patient record. Every GP practice in the county already used EMIS, as did the out-of-house service, but this was the opportunity to also have Wye Valley NHS Trust teams use this as a platform for records, alongside the county-wide hospice service.
In April 2019, the Wye Valley NHS Trust Hospital-at-Home service and community matron teams moved onto the EMIS system. The programme will see the provision of a further 350 mobile devices, which in itself will be a challenge. We have found a wide range of digital literacy skills within our teams, and in learning from this, are now engaging our wider Trust education team to develop some introduction training. Again, it’s the little things…
A full roll-out of community EMIS to all of our teams will happen over the coming year. Further decisions will need to be taken on our approach to scheduling, systems interoperability and even the 18 week wait pathway recording.
Finally, data and information are slowly being developed which will be vital, and we are close (but by no means confirmed) to achieving an acceptable information sharing agreement across the system. In reality, that alone will make the greatest difference.
Throughout, we have been learning from other’s experience, including our trust foundation group, and the opportunity to benefit from wider discussions at Confed19 will be hugely valuable and really exciting.
David Farnsworth is Associate Director Integrated Care at Wye Valley NHS Trust and member of Herefordshire Integrated Care Alliance Primary Care Home. He will be taking part in NAPC’s Primary Care Zone at Confed19 on 20 June in the digital primary care home: moving from extraordinary to ordinary session at 14:45 – 15:30.