Just getting started.

This week’s Covid-19 related blog is by Gillian Ferguson, Digital Health AHP Clinical Lead in NHS Greater Glasgow & Clyde

Where we have been…

I was just 6 weeks into my very new role within NHSGGC ehealth team – 3 days a week digital health and 2 days team lead paeds physio –  when coronavirus swept through the world and stopped normal work and home life as we know it. I have currently chosen to be deployed to elderly care and have put my projects and plans on hold but feel it is important to keep digital health at the forefront and I know my colleagues in the ehealth team are working flat out to enable and upgrade IT systems to help staff adapt to very new ways of working due to COVID-19.

You may ask what led me to securing such a position or even for putting myself forward for a clinical lead role in digital health in the first place. I completed the NES dNMAHP Leadership course in 2017 – an excellent leadership course in digital health and one I thoroughly recommend . 

My project was based around using a video conferencing tool (Zoom) and working with library services to develop a journal club for our small but widely spread paediatric physiotherapy team. This may not sound a big deal but I had no idea about the various programmes and apps available at the time to help facilitate the work. The course allowed us to use lots of these different tools as a means to communicate in ways other than face to face or email. Jump forward 3 years and now we are using it with our patients but more of this in a bit. I was able to establish the club and we are now into our second year – our journal club is part of our in-service training programme and therefore its business as usual (BAU) with Zoom sessions being set up most times we meet.

I think it’s fair to say my small team was an early adopter of VC for work use and I believe it has allowed us to embrace Attend Anywhere/NearMe more quickly when the time came. I became part of the GGC network for those that had completed the digital leadership programme and attended several clinical links workshops run by the digital health clinical team. I took a position on the national dNMAHP leadership group at start of the year. Scotland’s national strategy can be read here 

 Where we are currently…

I started my new role in February and my first few weeks with the  digital health team were a complete step out of my comfort zone to say the least as well as being one of the biggest and fastest  learning journeys I’ve ever been on in my 30 year career.  My new colleagues were mostly business analysts with a very different set of skills to mine who were involved with numerous ongoing projects. The list seemed endless and bewildering when I first read through them! Most of them were so pleased to have me on the team but at this point I couldn’t quite see why! So what is the point of digital health?

‘To enable and enhance delivery of quality health and care services, using digital to deliver positive health outcomes and experiences for the people of Greater Glasgow & Clyde’. Greater Glasgow and Clyde Digital Strategy 2018-2022

In my first 2-3 weeks I spent some time with specific analysts who were working on improving Trackcare and clinical portal –  two of the ‘cornerstone’ programmes used for electronic patient health records (EPHR). As an EMISweb user I understood the vital role EPHR plays in our clinical work – sharing information improves outcomes in a nutshell.

At this point I was able to formulate a work plan and also began to see why I was necessary! This job does not come with a manual or a competency training packages. In some ways hugely liberating but in others extremely daunting. Having read the national and local policies I wanted to base my first few months on re- establishing the digital health AHP network within NHSGGC, promoting the use of EPHR and also promoting the use of Attend Anywhere/NearMe – the videoconferencing tool for patient use. I did succeed in speaking to most of the AHPs that have completed or are in the middle of the NES dNMAHP course. The completed projects can be viewed on community of practice (see previous link ) but what I wanted to know was how are the projects doing now.

It was hugely encouraging to see that much of the work is now established into routine clinical practice or is currently on going and being further developed –a testament to the NES leadership course. I met with some key AHPs helping to develop EPHR and I started to get a feel for where my role lies – an interface between IT and clinician, a leader who can promote digital, a spreader of information and news. I felt I was on a roll but then things changed– a deadly virus swept across the world interrupting all our lives. Up until this point the use of Attend Anywhere /Near Me  was patchy across NHSGGC, much more established in NHS Highland with Professor Tricia Greenhalgh carrying out an evaluation. Several pilot sites had started and I was to lead on one for my own service in specialist childrens service looking at the entire service using it – CAMHs, OT, nursing, PT, dietetics, paediatricians with a start date of 30th March.  Coronavirus made us speed up rapidly! 

The NHSGGC ehealth team responded in an astonishing way and has now delivered kits to all GP practices and most of the acute sites. They are now focusing on the community sites that require it. I was pleased to be able to assist and set up the CAMHs service based at Royal Hospital for Children. Everyone wants to have access and at time of writing a systems update is being deployed to help support the demand. iPads have now been delivered to all the in patient wards  to allow patients to facetime their relatives using Zoom, Skype or Facetime.  A much needed resource as families cannot visit their loved ones just now.

On a more personal note technology has helped ease the unsettling worry of not being able to see my elderly relatives. I now FaceTIme my mum each evening – she is very adept at it and always manages to look great on camera. We even set up a 3 way with my techno phobic brother in Ireland and it has allowed her to see her grandkids. And my in-laws both in their 80s but fit and able have successfully set up internet banking to allow them to transfer cash for their shopping.

Where are we going to…

Will this continue after we return to normal? Have a read of Paul Gray’s inspiring blog and his rallying call that..

‘…We can’t go back to the way we were’ .

  1. I hope Attend Anywhere/Near Me becomes business as usual not just a tool used in times of dire emergency. Our patients and families need this and will thank us for it. Anything that reduces the stress of attending the hospital, clinic or GP surgery where possible can only be good. And cutting down clinicians’ travel time and cost will surely benefit the workforce in lots of different ways.
  2. I hope my mum continues to video call my brother as there will come a time where traveling to see him will become too difficult for her. 
  3.  I hope my in-laws see the benefits of not having to drive miles to one of the few banks left on our high streets to carry out their banking so they can remain independent as time tramps on.

Having been deployed to the acute adult services to assist and release staff to critical care or cover sickness absence the NES module found in TURAS is helping me up skill and feel more ready for what may lie ahead. I am back to using paper notes! But I have at least started the discussion about using EHPR with my new colleagues. They are willing to try a test of change using clinical portal and I hope to assist the MSK physio team this week with speeding up the installation of their Attend Anywhere/Near Me kits and sharing some of the excellent work done by the NHSGGC dieticians to help staff make best use it. 

It’s difficult to say when things will return to ‘normal’ but in the meantime I will fly the digital flag hopefully from not too far and I can share my trials and tribulations in a few months. Please get in touch with me to share your ideas and work or share your frustrations with systems that seem to hinder rather than help.

Good luck and stay safe and well.

Contact me on Gillian.Ferguson3@ggc.scot.nhs.uk

Via Twitter @GillieAHP

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