26 Nov 2020
Dr Tracey Vell – Clinical leadership and engagement during COVID-19
Healthcare services across Greater Manchester have been radically disrupted by COVID-19 with clinicians often being asked to change how they do things on a day-to-day basis to care for patients.
Part of this disruption has been caused by the rapid roll-out of new innovations including virtual consultations, access to patient data and digital COVID-19 trackers in care homes.
In this blog, Dr Tracey Vell, Health Innovation Manchester’s Clinical Director, Medical Executive Lead for Primary Care for Greater Manchester Health and Social Care Partnership and a practicing GP, explains the importance of engaging with clinicians throughout the innovation process to support the embedding of new practices and technology.
Throughout COVID-19 we’ve probably been working at greater speed than we are used to across the system. We’ve had to work quicker and make decisions as a system to innovate, ensure we’re addressing the needs of our system and doing the best for our patients and residents. But we’ve also had to ensure that we are still engaging thoroughly with our clinicians who are working hard on the frontline of the pandemic to make sure that our decisions will support them.
The “people” part and the engagement work of any transformation is valuable time spent because we have to change culture, not just pathways and the ways of doing things. So an essential part of our innovation work has been getting to the frontline clinicians, the carers, the patients and citizens themselves to make sure that it is a person-centred transformation.
And this is a difficult to do, not least during a pandemic when services are stretched, staff are under pressure, virtual meetings are the norm and innovation needs to happen at pace and scale. But in Greater Manchester we’ve been aided in this journey by the variety of our health boards, networks and patient and citizen groups. More importantly, it also gives us a chance to have them feed in the problems they are facing and connect innovation to their needs and priorities. A lot of the best innovations come from problem statements on the frontline.
Using this engagement ensures that the system is prioritising what is actually needed. I’m a clinician myself and see any number of innovations that could be helpful, but it’s not about doing everything at once, it’s about working as a system to set out what we should prioritise now to have the biggest impact. Some things might be useful to certain sector or might be better to look at in six months but the only way to make sure what we’re prioritising now is right is to engage.
Clinical leadership and engagement have been an important part of some of the key COVID-19 programmes undertaken across Greater Manchester. In the work to digitise primary care, enabling GP practices to consult in a remote and virtual way with patients, we’ve worked to ensure it is beneficial to both the practice staff and patients. We’ve engaged with the system to create a standardised framework to support practices to make the most of the technology but also ensure that patients benefit without widening health inequalities at the same time.
We’ve also supported care homes and carers through the pandemic, empowering them through a new digital COVID-19 tracker tool to spot and report symptoms among their residents. The information then maps through to the clinicians who can spot deterioration and provide support. Early in the pandemic care homes had been in the spotlight and were overwhelmed with offers of support. But by engaging carefully with carers and care homes about the benefits of the tracker within Tameside and Glossop, we are seeing the tool in regular use with more than 100,000 assessments completed so far.
Clinical leadership and engagement are also an ongoing part of the GM Care Record acceleration. Rolling out the GM Care Record and enabling clinicians across Greater Manchester to be able to digitally access patient information no matter where the patient’s data is kept is an amazing achievement. If you need a medical intervention the best place to treat you might not be in your local hospital and so clinicians need to be able to access your record to give the best care. And in COVID-19, when people may become suddenly ill or need a test, it is vital clinicians have the compete information.
But the creation of a GM Care Record means there is also a big responsibility to ensure that the information contained within it is relevant and safe. The Clinical Reference Group was created to pull together representatives from across the system, including primary and secondary care and social care, to ensure that it is fit for purpose and will support clinicians to provide care. For example, we’ve looked to standardise the recording of COVID-19 testing. It is fabulous to see all the system really engaging and working together to ensure we have the right governance, data confidentially and clinical recording in place.
We also need to examine some of the challenges we’ve faced. In Greater Manchester’s distributed leadership model we’ve had a challenge of running around different meeting and taking time getting everyone’s approval for decision. But in the pandemic, we’ve seen how agile our system can be and how we can make changes at pace. This is something we need to look to continue in Greater Manchester. We’ve also seen the impact of health transformation and what can happen if we invest in digital, so I would like to hope this could be reflected in future funding for digital transformation work. Finally, after 6 months of the pandemic and many of us being hooked to computers and remote working, we’re going to see an impact on mental health. Importantly now we need to look after our workforce and ourselves and be kind to each other.