Clare Morrison

National Near Me Lead, TEC Programme

@clareupnorth

Near Me: enabling consultations by video

#VideoConsultations

What is Near Me?

#VideoConsultations

March 2020

“Suddenly the relative advantage of virtual consultations has changed dramatically.”

Professor Trisha Greenhalgh

(March 2020)

#VideoConsultations

Covid response: rapid scale up

February300 calls/week

Mid May13,200 calls/week

Technical set up

Service processes

Individual training

0

2000

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Week 0 Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Week 7 Week 8 Week 9 Week 10

Near Me Consultations from 1 March

#VideoConsultations

Accident & Emergency, Addiction Services, Advice Services, Anaesthetics, Art Therapies, Cardiology, Cardiothoracic Surgery, Chemical Pathology, Child & Adolescent Psychiatry, Chiropody/Podiatry, Chronic Pain, Clinical Genetics,

Clinical Neurophysiology, Clinical Oncology, Clinical Psychology, Clinical Radiology, Community Mental Health, Community Nursing & Health Visiting,

Counselling, Dental, Dermatology, Dietetics, Ear, Nose & Throat, Endocrinology & Diabetes, Forensic Psychiatry, Gastroenterology, General Medicine, General Practice, General Psychiatry, General Surgery, Geriatric Medicine, Haematology, Health Visiting, Immunology, Infectious Disease,

Integrated Care, Intensive Care Medicine, Learning Disability, Link Workers, Medical Oncology, Mental Health Nursing, Midwifery, Neurology, Neurosurgery, Obstetrics & Gynaecology, Occupational Medicine,

Occupational Therapy, Ophthalmology, Paediatric Surgery, Paediatrics, Palliative Medicine, Pharmacy, Physiotherapy, Plastic Surgery,

Prosthetics/Orthotics, Psychiatry & Old Age, Psychotherapy, Public Health, Rehabilitation Medicine, Renal Medicine, Respiratory Medicine,

Rheumatology, Sexual & Reproductive Health, Sleep Therapy, Social Work, Speech & Language Therapy, Trauma & Orthopaedic Surgery, Urology

Primary care, Outpatient, Inpatient & Community services

#VideoConsultations

Patient survey:Would you use Near Me video again?

97.8%

2.2%0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Yes No

Per

cen

t

#VideoConsultations

Patient feedback from survey

#VideoConsultations

Back to the beginning

#VideoConsultations

Back to the beginning

1: Co-design2: Systems thinking

#VideoConsultations

Co-design#VideoConsultations

Systems thinking#VideoConsultations

Why the QI approach? examplesArea Issues Changes made

Patient access URL confusion Patient information too complex

No kit or accessLack of confidence

Single point of accessCo-designed patient information website, leaflets, videosRemote patient roomsOpen “try it out” sessions

Virtualreception

Patient wish for “normality” Role of the receptionist Concerns about call waiting

Receptionist greets patientsMultiple tests before final modelInformation added to screen

Appointment booking

Separate systems are problematic

Need for flexibility in clinicsHow to involve third party callers (family, interpreters)

Embed Near Me into existingbooking systemsIntroduced mixed clinicsGuidance produced

Clinician set up

What eHealth kit to use Introduced: second screen, privacy covers, speakersDealt with: digital dictation device clash, settings locked

#VideoConsultations

Scaling up: In response to Covid

#VideoConsultations

Technical set up

Service processes

Individual training

Rapid expansion: 3-step process

#VideoConsultations

Rapid expansion: support

• Core Near Me national team and local NHS board teams

• Attend Anywhere (platform provider)

• National VC team

• Scottish Government – divisions, policy & clinical leads

• NHS Board eHealth and strategic teams

• Healthcare Improvement Scotland

• Scottish Access Collaborative

• Care Inspectorate

• Communications company

• Professional bodies …..and many more

#VideoConsultations

https://tec.scot

Rapid expansion: processes#VideoConsultations

https://tec.scot/

Rapid expansion: patient info

www.nearme.scot

#VideoConsultations

http://www.nearme.scot/

Rapid expansion: training

https://learn.nes.nhs.scot/28943/coronavirus-covid-19/remote-consulting

• Technical skills (how to use Near Me)

• Video consulting skills (for clinicians)

• Practices processes and other resources

#VideoConsultations

https://learn.nes.nhs.scot/28943/coronavirus-covid-19/remote-consulting

Rapid expansion: shared learning

#VideoConsultations

Scaling up: Near Me in the new norm

#VideoConsultations

Clear rationale

For 3 reasons…

All health and care consultations are provided by Near Me whenever it is clinically appropriate

#VideoConsultations

1. Enables continued physical distancing

#VideoConsultations

2. Person-centred care & meets demand

#VideoConsultations

3. Environmental imperatives

#VideoConsultations

Next steps

@clareupnorth @nhsnearme

• Develop our vision into a delivery plan

• Set up Near Me improvement collaborative

• Improve the data system

www.nearme.scot

#VideoConsultations