Community Hubs: Bringing Near Me to all

Due to the pandemic the need to reduce people coming into buildings paused the Community Hub model for Near Me video appointments. Here @marcbeswickahp explains what the Community Hub model is and why it is very much back on the agenda.

People who are digitally disadvantaged or lack a safe private space can find accessing services remotely difficult. If we want to promote remote access as a fair option, and we do, we must co-design solutions to overcome such barriers.

Loaning of devices, supporting volunteers, providing training through digital champions, and local Community Hubs are all possible solutions.  These are being co-designed and tested in communities to enable people to access services more easily from their home or closer to home.

Some background

Notably when Near Me was first set up in NHS Highland in 2017 (under the banner of NHS Near Me), it used a Community Hub model.  Video clinic rooms were set up in local hospitals and other settings. This guaranteed that people did not have to worry about connectivity, privacy, having a device or digital skills.  Plus, if support was necessary, or tests or monitoring required, then this could also be done. Early use of such Hubs was mostly for hospital outpatient appointments but as the model continued to be co-produced it was the public who said: “If we could have our appointments at home then we would not have travel at all.” 

Webinars to share learning

At a Webinar held on 10th June 2021 with over 200 participants, solutions being piloted in two areas within @NHSHighland were described. The speakers updated on how new ways of thinking and working are bringing healthcare and other services closer to their communities.

Cairndow Hub

As part of a series of community initiatives a Near Me Hub is being pioneered in Cairndow village hall in Argyll. Sharon Hepburn and Debbie Donald from “Friends of Cairndow Hall” explained that the service is run by trained volunteers and is in a newly refurbished clinic room within the hall, commenting: “to set up and run the Hub is a partnership model between the community and the Health and Social Care Partnership.”  If successful it will reduce the need to travel including to acute services where journeys can often be long and arduous.

Health and well-being

Their vision is to promote health and well-being and includes a popular book exchange, community green house and garden. It is a great example of co-production to deliver local solutions to things that matter most to local people. I hope it goes from strength to strength and others develop their own local versions.

The initiative in Cairndow village hall is being funded by the National Lottery while the equipment was funded by Argyll and Bute Health and Social Care Partnership.

North Skye Hub and Help

Meanwhile on Skye the local community in Staffin in the North of the Island are also keen on using technology, to help connect people and improve access to services. Indeed, the name Near Me was born in Skye and it was great to hear the enthusiasm and cooperation being developed to overcome some of their local challenges.

A member of the local community Mairi MacDonald from the “Staffin Helpers” who has been pivotal in driving the work forward during Covid-19, told the webinar:

“We have been working with NHS Highland to reduce travel times for health appointments. Near Me is a great service it cuts out a six-hour round trip for what can be a five-minute-long appointment”.

Staffin Helpers was set up in March 2020 and you can find out more here Staffin Helpers – Home | Facebook

Staff Helpers links in with the newly developed SkyeLab 

SkyeLab officially launched in May 2021 by the Finance Secretary @KateForbes and includes use of Near Me

“Magical Benefits of Near Me”

The unfairness of long travel times was something that another Highland MSP was passionate about improving.  @MareeTodd MSP for Caithness, Sutherland and Ross, and Minister for Public Health, Women’s Health and Sport highlighted the benefits of Near Me at the recent NHS Scotland National Event. She told the virtual audience of some 2,000 participants:

“We have long distances sometimes people from the islands taking several days, with time out of their lives to attend a hospital appointment where actually nobody was laying any hands on them. Despite the need it was hard to get Near Me adopted.”

And added: “So even when the need is great it is difficult to change the way we do things because it is the way we have always done them. I would like to think that the experience with Near Me, which is now not only used all over Scotland but also used across the UK and Republic of Ireland, shows what can be done when we work together, and we are seeing some real benefits.”

The importance of co-production and offering informed choice continues to gather momentum.  It is something that strikes at the heart of Realistic Medicine’s aim for people to feel empowered to discuss their care including accessing care.

One of the strongest advocates of @RealisticMed is @DrGregorSmith, Chief Medical Officer for Scotland, who in conversation with Maree Todd described how Near Me offered “fantastic advantage” over the course of the pandemic allowing people to access care in a safe way and with the option to have an appointment in their own home.

Maree Todd again: “There is something about the empowerment of individual patients being in their own home that emboldens you and shifts that power relationship between individuals and their health professional. So, I think there are real magical benefits coming through and I would like to hope that for every one of us, we will be able to look at all the systems changes and not go back to the way we did things before.

To this end there is much work both nationally through the likes of Connecting Scotland and local initiatives such as Staffin Helpers to loan devices and/or support someone how to use a device.  All of this together offers the potential for many more people to access care in their own home or at least have the option to do so.

Summing up and to reflect on

The above issues are not unique to remote and rural parts of Scotland, people also experience isolation, digital disadvantage, travel challenges, inconvenience in urban and inner-city communities too. What seems to be universally acceptable is we should be promoting options to access care and helping citizens to make informed choices. In tandem with this of course we need to also support professionals to be comfortable with offering choice and understanding the benefits in doing so.

So, I would ask you to consider the following:

  • Do you offer Near Me appointments for people to choose as part of planned options?
  • Are you part of a centralised regional/specialist service making appointments for people across Scotland?  If so, do you offer Near Me appointments?
  • Do you know if your patients have access to a local Near Me hub?
  • What are your thoughts on how we can routinely offer Near Me as choice or be requested by patients?

Whether accessing from home or in a Community Hub, as Maree Todd eloquently described there are ‘real magical benefits’ of Near Me.

Thank you for reading this and please get in touch @marcbeswickahp or email nss.nearme@nhs.scot

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