How Technology can Improve Collaborative Working Across PCN’s

?“One of the biggest challenges to medicine is the incorporation of information technology in our practices.”

Samuel Wilson

?Over the years at Libera we’ve helped many practices and PCNs develop teams, change working practices and become more resilient.

?During this time, we’ve found that issues affecting the efficiency of a practice, often revolve around their use of IT systems.

When implemented properly and fully embraced by a well-trained team, IT systems can save time, improve efficiency and contribute to better health care for patients. Too often, however, there lies a gaping chasm between a system’s capability and user understanding.

?IT Literacy in General Practice:

“Technology will play a central role in realising the Long-Term Plan.”

NHS Long Term Plan, January 2019.

?When we talk about IT in general practice, we’re talking about phones, patient records, document management, online consultation systems, CQRS and all the other ancillary systems which help with the day-to-day running of a facility.

?As active members of the British Computer Society Primary Health Care Specialist Group (BCS PHCSG), we’ve had the good fortune to have worked with many of the country’s preeminent health informaticians. They’re usually GP’s who are interested in technology and data and have developed tools to support their practices in improving efficiency and increasing productivity.

?Unfortunately, they do not represent most of general practice.

?Embracing Technology:

Digital health is supposed to be a key element of the NHS’s long-term plan, and although some progress was made during the pandemic by installing online triage systems, many practices have since reverted to the phone as a method of access.

?“Don’t go backwards – you’ve already been there.”

Ray Charles.

?Of course, issues with IT are not just limited to the use of new technology; sometimes getting teams to embrace new ways of using existing technology can be a struggle.?

?At Libera, we’ve worked with several practices who appear to not understand the importance of appropriate data coding; staff simply treat the EPR as a filing cabinet (and a very untidy one at that).

?“Information is the lifeblood of medicine and health information technology is destined to be the circulatory system for that information.”

David Blumenthal

This prescient quote highlights the importance of practices improving their knowledge of current systems and ensuring that any data they put into the system is of a high quality. Those of you who have had recent CQC inspections will be only too aware of the importance of data quality!

In addition to data entry/storage issues, we’ve worked with practices who thought nothing of sharing smart cards and have encountered many receptionists and administrators who, having only being trained by their predecessors, have preserved old and inefficient ways of working.

If digital health really is to play a ‘central role’ in the NHS’s Long-Term Plan, then why isn’t this reflected in practice?

Our Survey Says…

?To better understand why we see such resistance from practices around the use of technology, we conducted a simple LinkedIn survey:

Our results indicate that remote patient monitoring and back-office systems would benefit most from the improvement of digital health systems, but a lack of IT skills amongst the workforce is standing in the way.

Thankfully, this is nothing a little training can’t fix…

In-House IT Training:

?“Any new technology tends to go through a 25-year adoption cycle.” ?

Marc Andreessen?

?It’s likely that when your computer systems were installed, training was provided as part of the rollout. As NHS systems are often rolled out ‘en-masse’, they normally involve group classroom or online-based training.

?This type of training, however, doesn’t work for everybody; many of us learn best through hands-on experience.

?“Tell me and I forget. Teach me and I may remember. Involve me and I learn.”

Benjamin Franklin.

?Training needs to be grounded in the reality of what you do. If a newly learnt skill isn’t put to work straight away, a person can forget and consequently adopt less efficient workarounds to complete their tasks.

?There’s also the question of system development. The longer a system has been in situ, the greater the chance there have been updates to the platform since training was provided; these changes often include more and better ways of completing tasks in practice.

This is where PCN’s can help themselves!

?Every practice will have different approaches to ‘getting the job done’ and some will inevitably be more efficient than others (some may even be lucky enough to have an interested GP or IT support).

At Libera, we always suggest that PCNs develop the equivalent of an IT ‘action learning set’ (ALS) across their group, so practices can effectively learn from each other.

This cross-practice collaboration will not only improve day to day efficiency but having common practices will allow teams to support one another more easily during times of crisis.

The sharing of ‘system best practice’ between teams within a PCN isn’t the only advantage of creating a cross-practice ALS; innovative new ways of working can also be created because of their collaborative thinking. ?

Having an IT ALS is a fantastic opportunity for practices to learn from each other and leverage skills to save time and reduce stress

Even if a PCN needs to bring in outside assistance to facilitate the initiative, the benefits to both patient experience and the CCG’s bottom line should make the investment a no-brainer.

To illustrate, we recently facilitated a PLT for a PCN and nurses from one practice were astounded to hear how another practice were using the EPR for recall; they realised that if they did the same, it would save them hours and release time to care.

Thankfully, this change to a more efficient way of working wouldn’t require a new system or expensive training; they’d simply have to leverage the systems that already existed and apply them innovatively.

Had their PCN had an IT ALS group in place, this invaluable information would have already been shared throughout the group.

How many other examples like this are out there? ?

It's Time to Challenge the Norm:

?"If you always do what you’ve always done, you’ll always get what you’ve always got.”

Henry Ford

?A good proportion of staff in our practices have been doing their jobs on the same systems for a very long time. Whilst the experience they have gained during their service is invaluable to the NHS, sometimes using the same system for years, can leave a person nervous about change and therefore resistant to it.

?“Since improvement depends on the actions of people, ultimately it comes down to winning hearts and minds.”

NHS England

According to change experts ProSci, there are 5 reasons employees resist change:

1. A lack of awareness about the reason for change.
2. Their job changing.
3. Fear of the unknown (which in this case is further compounded by a fear of technology).
4. Lack of support/trust in their leaders.
5. Exclusion from change-related decisions.

Leaders must challenge the “it’s just the way things are done around here,” mentality, by showing their teams that by switching up the way they do things, they can make their lives easier.

(Our article: Getting the most from your PCN, goes into more detail on managing and embracing change within a PCN.)

Ultimately, a cross-practice ALS is the perfect environment to be inclusive, create awareness, build support, and create advocates for change.

Share and Share Alike:

There are some great things happening in practices and PCNs across the country and Libera feel passionate that this ‘best practice’ needs to be shared.

We were also delighted to see in a recent PCN DES update, investment is being made to improve digital strategy in the form of the Digital Transformation role.

The individual who secures this new and eagerly anticipated role in your PCN can help set the digital strategy, spend time understanding any barriers to overcome and consider how best to work with your team (and patients/services users) to move towards digital health for all. They’d also be in the perfect position to help your PCN implement a cross-practice, IT ALS.

Libera Partners Can Help:

At Libera we can work with your teams to facilitate the ALS, identify the areas that they are most concerned about and source internal or external resources to support.

We can also help to develop the new digital transformation role within your PCN, working hand in hand with the new candidate to ensure due consideration is given to the impact of any new strategies on your people, processes, and technology.

Bottom line, most PCN’s already have the human and technological resources available to improve efficiency across the board.

Why not give us call and let us help get you and your team started on that road to collaboration? ?

Tel:???????????07803736911

Email: ??????[email protected]

?“Unity is strength…when there is teamwork and collaboration, wonderful things can be achieved.”

Mattie Stepanek