It’s been a while since the last blog, but you know by now that I am a sharer by nature, and I can’t help but want to improve things (which is not always welcome at home). Yet there are many times when, even though the opportunity presents itself, we are just not in a place to see what needs to be done. Primary Care has many of these opportunities but, overwhelmed staff perhaps can’t always navigate the complexity and volume of policy aspirations, contract changes and digital solutions intended to help. So, offering suggestions to do things differently needs a considered and sensitive approach and finding the right time is crucial.
There are many competing priorities in digital health. Some people have policy to implement, others have money to allocate and need to demonstrate value for that money. Some people have services to deliver and want to give patients the best consistent experience. Some people have teams to manage, and all our digital development needs are different. Confidence and competence levels vary from person to person and practice to practice. I realise that there is an awful lot of variation in the elements of this paragraph, so I’m going to share with you, the journey of the Digital Journey Planner and how it is intended to address some of the above. Because it feels to me, like this baby has had a long gestation, and now its ready for delivery, across General Practice in England – and I’m more than a little bit chuffed about this.
When did it all start?
One Saturday morning in July 2020, I posted a question into (one of the many) WhatsApp forums that sprang up at the start of the pandemic. I wanted to ask if there was such as thing as a ‘digital maturity matrix’. I was looking for something that was available to General Practice, to help assess digital progress, with a ‘checklist’ approach, of things that practices should be doing or offering and something that would help embed ‘digital’ as a way of working.
Thankfully, this generated a thread of enthusiasm from people in a variety of roles, some senior leaders, others commissioning or providing, and some were trusted (geeky) colleagues and people like me, who want to improve things. Game on!
What was I looking for?
I wanted to develop something that was easy to follow, that would curate the myriad of resources available to us into one place and was linked to improving service provision for patients. I felt that we needed a modular approach, to address the various components or ‘building blocks’ but also to allow people to work at a pace that felt comfortable. The modules would need to address service delivery such as GP Access, and it would need to help practices to optimise clinical systems and improve communications with patients. All of this needs to be in place before we can successfully move on to do the more complex or ‘at scale’ stuff of Primary Care Networks (PCNs). To encourage teams to invest in this process, we would need to help to understand ‘the Why’ or the benefits of digital General Practice. I wanted this ‘thing’ to be a safe place for practice teams to be honest with each other about what they do and don’t do. We had to find a way to motivate people to find the precious time to answer some questions, then to unlock their team’s potential through new knowledge and to improve their digital service provision. I’m extremely fortunate that Redmoor Health indulged this desire and that Marc Schmid, CEO and the team agreed that we should try and build this thing. It was after all, the framework that the Redmoor Team use to coach and support improvement, so why not make it a self assessment, available to all. We wanted to do this with the NHS, so thank you also to Dr Minal Bakhai and the Digital First team in NHSE&I for finding a way to support this effort.
What should we call it?
The name ‘Digital Maturity Matrix’ wasn’t really describing what we wanted though. Commissioners need assurance and to understand the variation of their providers, so we’ve built a separate system to help with that issue.
Practices have different needs to commissioners; they need to know just what is ‘best practice’ and What Good Looks Like (sorry) doesn’t really do that for practices. They also need to know what learning information is available, where to find it, how to access support and then teach their teams and work with patients to get the best bits for all. Then they can share, so that others don’t reinvent the wheel. Just like good old Strictly (apologies again, I feel like I am doing my own buzzword bingo today, but I’m going to use the ‘J’ word), a wise colleague suggested that ‘we are all on a journey with implementation of digital services’. It’s not a static thing, so we need to baseline the start, see what’s to do and have a plan for sharing knowledge and best practice. Perfect – the Digital Journey Planner was emerging.
What it does and more importantly what it does not do
Many great minds were keen to tell us what they didn’t want and here are some of the requirements from that initial WhatsApp enquiry. It must not be ‘yet another bureaucratic paper filing exercise that burdens practices’. So that burned any ideas of spreadsheets that needed submission to someone, never to be seen again. It mustn’t be used to ‘performance manage practices’ or people might fib (really?) when answering the questions. I loved that one – it meant we didn’t have to build in any Red, Amber, Green or star ratings that could be both subjective and misinterpreted. It needed to ‘feel supportive and show practices how to get that support’. It needed to be a ‘local roadmap (practice and PCN)’ and it also needed to ‘improve digital literacy….to maximise our GP IT systems and streamline processes’.
We were keen to make it accessible, so we followed the NHS digital service manual principles and we needed to keep it concise, so we have limited each assessment to approximately 20 questions taking no more than 10 minutes to complete. If it was to address national priorities of making the right access easier for patients, we needed to share hints and tips based on our experience of working in and with practices and spread the best practice from those who are adopting digital healthcare well.
Why we need it now
General practice has had so much pandemic pressure, dealing with the disease, the vaccination programme and staff shortages and isolation, we held back delivery in Dec 2020 and again Dec 2021. Many Practices have had staff turnover during that period, and in many cases, IT solutions and products were thrown in with little time for real preparation, or consideration of changing process and engaging with people. The technology adoption life cycle has literally been condensed into 18months. Practices had to rapidly change how they deliver services. Patients had to get used to alternative methods of access and communication. All of this, however, presents us with the biggest window of opportunity to take the best, and run with it.
Who is it intended to help?
This version of the DJP is aimed at helping General Practice to improve. It can also support PCNs to prioritise their digital agenda and develop together, to deliver consistency and to level up (I’m there again). However already, we can see this process being developed with other sectors and themes.
To address the different needs of practice, commissioner and PCNs, we have two levels of access. Foundation access will be available to all practices, this includes access to the self-assessments and bespoke implementation plans. Enhanced access is also available on subscription and in addition to the assessments and implementation plans, contains better reporting of usage and activity (not the assessment detail, which remains in the practice) along with additional help from the Redmoor Support centre to help embed the change required to improve. More details can be found on the Redmoor DJP webpage. We have been working closely to develop the DJP with a few areas and have already observed an increase in confidence and competence of staff, an increase in the digital maturity of practices and seen improvements to GP websites and GP online access to improve the experience for patients.
The best bit for me – making life easier for Practice Managers and teams
As an ex-practice manager, I know first hand the complexity of the role and the volume of things you need to know about. They are often the conduit for all communications from Primary Care teams, Digital First teams, within Primary Care Networks and practices and with patients. This DJP is to help you and your team navigate the digital landscape. So, here’s my advice, let your team loose with this – they cant get anything wrong – other than to learn from each other and come up with a simple plan to improve. Oh, and don’t ask your Partners permission to do this either, just show them the implementation plan once the team have finished the assessments. Then perhaps discuss within your PCN and do the work together and for each other.
Thank you to everyone who’s contributed to this project
– I’ve got a good feeling about it….
PS, receiving these testimonials made me a happy person.
Once I had completed the modules, I found the Implementation plan very useful and a clear guide to the area’s where we were doing well and where we could improve. I felt reassured to read about the things we were getting right, the area’s we were doing well with and pleased to find help and support to hand for the area’s where we needed to improve. I found it so helpful to be able to talk to someone and go through and be advised on a 1-1 basis of the area’s I was unsure about. The help and support I received enabled me to gain an understanding of something I was previously unfamiliar with and once demonstrated and explained, meant I could make a couple of quick changes to improve patient communication
I found it really easy to work through, I like the fact it is split into sections making it very user-friendly and enabling us to focus on one area at a time. The assessments that are produced when you have completed each module also give you a good structure to where we could be focussing our efforts.
Things we are doing well – good section as recognising what we have got right
Things we can improve – I made this my to do list which I am working through for each category.
General Feedback – Additional resources were good. I picked up a few things that I hadn’t thought about before:
- Google my business – and using this to its full capacity, the link to the video was very good and gave me a good understanding of what we can do.
2. Patient Feedback – Utilising this to our advantage
3. The links you gave to case studies and Youtube videos were very helpful and a resource I can use again