Convening health and care leaders to share COVID-19 innovation

Driven by the necessity of responding to the pandemic at speed, those working in health and care across the region have introduced new working practices in a matter of weeks that would generally have taken months or years.

With some services nearing pre-COVID levels of activity, providers are beginning to assess which changes should be kept, which are no longer needed, and which can be scaled and spread.

Health Innovation East, on behalf of NHS England and NHS Improvement, convened leaders and decision makers from across the East of England healthcare system to showcase some of the best practice innovations from across ICSs and STPs in our region which we believe could be spread more widely as we move into future planning. These inspiring stories told how health and care professionals have come together during COVID-19 with innovative ways to deliver care.

The session focused on out-of-hospital innovations with a particular emphasis on supporting the vulnerable and reducing health inequalities.

Piers Ricketts reflects on the event

A regional view of the impact on social care

Peter Fairley, Director of Strategy, Policy and Integration at Essex County Council described how services across the region moved to a system-wide view of capacity, working across social care, public health, NHS and the Care Quality Commission (CQC) to improve discharge outcomes. He detailed how the Essex Wellbeing Services was launched and recruited 5,200 volunteers to the service.

Digital transformation at speed

Kate Walker, Head of Digital Strategy & Transformation at Suffolk and North East Essex ICS presented on the impact delivered by East Accord’s COVID-19 Digital Cell. The Digital Cell included staff and expertise from Health Innovation East, NHS England, NHS Improvement, NHS Digital, NHSX, AstraZeneca, providers and commissioners across the East of England. Multidisciplinary teams worked together to enable home working and video consultations across primary, secondary and community care, mental health services and the region’s ambulance trust. Due to the work of the Digital Cell, 99.1% of general practices were able to offer video consultations within a few months.

National social care challenges and opportunities

Simon Bottery, Senior Fellow for Social Care at The Kings Fund, provided background on the issues facing social care amidst the coronavirus pandemic, including funding challenges and increased demands on services. He highlighted better integration, use of technology and workforce management as progress made during the pandemic upon which we have the opportunity to build.

NHS Reset: an new direction for health and care

Fiona Claridge, the NHS Confederation Regional Director for the East of England, gave an overview of the report NHS Reset: a new direction for health and care. The report outlined five factors that will fund fundamentally reset the way health and care is planned, commissioned and delivered: honesty and realism; extra funding; a lighter leaner culture; integrating health and care and tackling health inequalities, including the establishment of the NHS Race and Health Observatory.

Fiona praised the huge amount of innovation and progress made in the region in digital solutions and culture change to enable rapid uptake.

The local showcases

Using data to improve the social care response in Norfolk

Geoff Connell, Head of Information Management and Technology & Sarah Rank, Head of Business and Technology, Adult Social Services, Norfolk County Council.

Geoff explained the steps taken by Norfolk County Council as part of their Smarter Working Technology programme which underpinned their digital service delivery. They also launched the Norfolk Vulnerability Hub and Local Resilience Forum to ensure continued social care support for vulnerable and shielding residents in the county, while moving to an online delivery model for their services.

The vulnerability hub enabled all social care and voluntary services across the county to access a single secure data base of resident information which enabled a single point of contact and the coordination of thousands of food parcel and prescription deliveries.

Sarah explained how the council was able to manage the application process for assistive technology and online and on the phone to distribute much needed tools to vulnerable residents.

Mid and South Essex Primary Care Inclusion Programme

Jennifer Speller, Associate Director for Primary Care at Southend CCG

Jennifer outlined how the Mid and South Essex Health and Care Partnership’s COVID-19 response and recovery programme built on existing work to improve inclusion of staff and communities through a number of initiatives. The programme has broadened the conversation, improved representation and provided varied insights which will inform how services are designed to ensure they are effective as possible for their population.

COVID-19 caused an accelration of an existing five-year plan to bring together all of health and care’s organisations together to support healthier communities in the area, with a focus on engaging diverse communities and individuals, involving their own workforce and building insights into service planning.

How to support those most at risk in the community in Norfolk – COVID Protect

Dr Julian Brown – GP Partner at Litchum Health Centre and Founder of Health Amplifier

COVID Protect was a programme which identified those most at risk during the start of the pandemic and proactively engaged these groups with an integrated care and support service to ensure the support they needed was delivered safely. This included all shielding and high-risk patients, combining healthcare data in a safe environment accessible to the ambulance service, clinical commissioning groups, council and approved charities via a portal. Over 250,000 patients answered questionnaires which led to 12,000 calls to action for local services to process and support. Read more on the Norfolk and Waveney CCG website.

How to provide virtual exercise consultations and classes for acute pain – Musculoskeletal, the digital journey

Sarah Saul, Operational Manager and Alex Theobald, Digital Lead at Cambridgeshire Community Services NHS Trust

Cambridgeshire Community Services NHS Trust rolled out virtual exercise and chronic pain classes, interpretation services and virtual clinics. This enabled patients to continue their treatment and rehabilitation from their homes. The service has supported over 3,500 video consultations by 80 clinicians during the pandemic so far whilst reducing costs and travel and improving patient satisfaction.

Transforming social prescribing in the east during COVID-19

Sian Brand, NHS England Regional Social Prescribing Facilitator and Learning Coordinator

Sian explained how the introduction of social prescribing link workers has been used to co-design primary care services with the voluntary sector and patients to keep them safe whilst delivering personalised care. Within the programme link workers received training to support digital inclusion and COVID psychological support.

Teledermatology – delivering dermatology services online

Dr Peter Holloway, Ipswich and East Suffolk CCG

Patients with suspect skin lesions in Ipswich and East Suffolk on were given remote access to care during COVID-19 due to the rollout of a teledermatology platform to manage and conduct appointments and referrals. The platform enables GPs to request and receive patient images via an integrated mobile app or to upload images from other virtual consultation platforms before sharing securely with a dermatologist.

The system has reduced anxiety, waiting times, travel time, cost and inconvenience for patients and feeds back results to GPs to help them learn. It has also reduced unnecessary secondary care appointments and shortened the time taken for patients to receive their results.

Remote monitoring in care homes

Caroline Angel, Director of Patient Safety at Health Innovation East

Caroline explained how Health Innovation East used funding from Innovate UK for remote monitoring tools in care homes, connecting primary care, care homes, commissioners and acute providers.

The remote monitoring was used in conjunction with soft signs training, National Early Warning Score (NEWS) and SBAR communication tools for patient deterioration to ensure consistency across organisations. Used together, the remote monitoring programme facilitates earlier treatment for deteriorating patients and avoids unnecessary transfers to hospital.