Background to learning
Locala is a Social Enterprise, community provider of NHS funded healthcare across Kirklees, Calderdale and Bradford. Locala works closely with GPs, Social Services, other local NHS organisations and Local Authorities to deliver a coordinated approach to care and support. Like other community providers Local has looked to deploy digital solutions continue to provide community services to patients during Covid-19.
This case study focussed on how Locala nurses introduced phone and video appointments at pace to ensure the relevant patients were able to continue to receive care across different service areas.
Learning and advice to be shared
Video consultations have enabled nurses working at Locala to continue to provide support and clinical care to many patients in their own homes whilst simultaneously helping to lower covid-19 transmission risks as patients were not required to come into care facilities. Through this use of technology, Locala’s nurse led services have been able to assess patient needs and continue to provide appropriate care, whilst ensuring that those patients who do need face-to-face interventions continue to receive these. Several service adaptations were implemented:
- A new service based on video consultation triage was established for bank holidays and weekends.
- A service enabled and supported the relevant patients to feel confident to undertake self-care for wound dressings. The use of digital technology where patients could share wound/dressing images was also implemented to enable feedback and advice from nurses when needed.
- SH24, a 2-way messaging sexual health service for younger people, was expanded to cover all areas across Kirklees and Bradford. The use of telephone appointments was also increased, and this supported better access to routine testing and treatment for some STIs.
- Insulin start sessions were able to take place via video links should patients want to choose this option. This enabled more people to learn injection technique from a video and demonstration, and then to practice and receive feedback.
- More signposting to on-line resources was offered and this increased self-management confidence in many patients.
Would it be beneficial to retain these changes?
Feedback from clinicians as well as patients has been positive – and in many areas this has highlighted how progress on provided care in different ways can be accelerated in ways not previously thought possible.
Locala is recognising the positive value of these new developments and has developed a ‘Reformation/ Transformation’ programme to ensure that the positive benefits from using digital solutions become embedded in the longer term. All services are now identifying how they will continue to deliver services in the ‘new way’ – identifying which patient interactions (first appointments, follow up appointments) and patient cohorts are best delivered in the new way.
Importantly, as these new ways of working are being assessed the patient engagement team is working closely with services to continue to gain feedback from patients to inform this work.