This year we celebrated our fourth birthday. But it feels like we’re a lot older. Why? A lot has happened in those four years.
Since we started in 2015, we have:
- Grown the number of patients our service covers from zero to over 19 million;
- Set up the National Consultant Network, a team of out-of-area consultants who are able to answer calls or written requests for advice;
- Expanded our service to offer Enhanced Advice and Guidance: Telephone, Photo, National Consultant Network;
- Introduced the UK’s first Information Governance secure clinical photography app which is now the most used photo app in the NHS;
- Launched a Mental Health Advice & Guidance service;
- Been included in 4 of NHS England’s Elective Care Transformation Programme Handbooks & Case Studies;
- Featured in the press with articles in the HSJ, The Times, The Guardian, Primary Health Care, Digital Health, and more;
- Had the impact of e-RS A&G and Consultant Connect measured by an independent report;
- Collected a huge amount of positive case studies;
- Hosted 8 webinars attracting thousands of delegates (NHS senior leaders);
- Got through (at least) 10 coffee machines.
So what have we learned that we think you’ll be interested in?
1. Great stories are as important as great numbers
When we first launched our service in June 2015 we were obsessed with the numbers – we wanted to know how many calls GPs would make to which specialties and how many of those calls would result in a patient avoiding an avoidable referral or admission. This was why people would invest in our service, so it was the right approach to take. Or so we thought.
After a few months something interesting happened. We noticed that potential customers seemed as interested in the stories that we told of how the service worked in practice as they were in the numbers. For example, the elderly lady who was convinced her next trip to hospital would be her last and her delight when a Consultant Connect call spared her the journey. The seemingly fit (and very lucky) man who had something slightly wrong with his ECG and who was sent to hospital as a precaution on the advice of a consultant, only to have a massive heart attack as he entered A&E. The child who had been vomiting for 48 hours and whose GP was advised by an extremely confident paediatrician that the bug would be gone and forgotten by the next day – and it was.
2. Getting stakeholders on board takes time but it’s worth it!
This is going to sound ridiculous but, when we were very young, we didn’t always appreciate how important it is to make sure everyone involved in a project is happy. For example, if the commissioner said that the Trust would “be fine”, we’d take the project on. Only to find out that they weren’t fine and then have a LOT of extra work and conflict that could have been avoided.
It’s not only the commissioner and the Trust that need to be on board, it’s just as important to make sure the clinicians who are expected to use the service for advice use it and those who are expected to respond to advice requests respond! Whether it’s e-RS written advice or Consultant Connect telephone advice or both, there are 2 golden rules for Advice & Guidance success – GPs & Paramedics need to use the service and the responding clinician needs to respond. Read more.
Today we have learned that lesson. For example, we won’t agree to take on a project unless we have sign off from a senior sponsor at every organisation (CCG and Trust) involved in a project. This can take a lot of time to agree. We have had a few projects that have been delayed by 3 – 6 months whilst everyone agreed. But, boy, was it worth waiting – addressing issues before they become problems is key to launching our projects. We send clear communication to engage with the service users (GPs, paramedics, nurses, consultants etc.) and make sure they know how their use of the service not only improves patient care, but also system efficiency.
3. Everyone wants the same thing, just differently
You know that old NHS adage that “no two areas are the same”? Yes, yes – it’s true, but it’s easy to forget that everyone is trying to achieve the same thing. And everyone IS trying to achieve the same thing, often from similar angles. Every area, without exception, is trying to improve patient care, make the most of their budget, make clinicians’ jobs more straightforward.
What this means is that areas are often not as different as they think they may be. There ARE different challenges to be faced, such as different budget constraints, different levels of deprivation and agedness, different availability of clinicians, different histories of organisations working together. But we’ve learned a lot in four years and when somebody says “what’s peculiar about our area is…” they are often quite entertained to hear that the peculiarity isn’t so, well, peculiar!
What this means in practice is that we have a way of dealing with almost all eventualities on a project. Terrible reception in your Trust? Here are three things that we can do to overcome that. GPs fed up with new initiatives? Here are different ways to engage with them to get them on board. In short, if you think a telephone Advice & Guidance project could never work in your area – challenge us to come up with an answer!
4. Using out-of-area consultants to support local capacity does work
One of the biggest challenges for hospitals delivering an Advice & Guidance service is staffing it – particularly during winter. The good news is that there’s now a way you can “switch on / switch off” additional consultant resource during peak periods. Steve Burnett, Assistant General Manager for Specialty Medicine at East Suffolk and North Essex Foundation Trust comments “Obviously I can’t magically give consultants more time to answer their phone, so we looked at other possible solutions. That’s when Consultant Connect talked about their national network – we could outsource some of these calls to other neurology consultants elsewhere.” Read the case study.
The National Consultant Network (NCN) consists of NHS consultants (on the Specialty Register) who are able to answer calls or written requests for advice. For example, they may work part time and be willing to take calls on their days off.
The good news is – it’s very flexible and can be ‘switched on’ (within 48 hours) as a back up whenever your hospital needs it. For example, you may decide to use the NCN during a short peak period e.g November – February.
Many areas across the UK are already using the National Consultant Network – currently 74% of all calls to the NCN result in an admission or referral being avoided.
If you have any questions on the above or would like to find out how we can help your area, please call us on 01865 261467 or email firstname.lastname@example.org.