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How Liverpool primary care networks are using tech-enabled collaboration to manage Covid-19

1 June 2020

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Dr Simon Bowers is a GP partner at Fulwood Green Medical Centre in Aigburth and Medical Director of Liverpool Networks Alliance

Over the past two years in Liverpool, our GP surgeries have grouped together into 14 primary care networks (PCN) which are driving improvements in patient care and tackling city-wide health inequality. 

PCNs are designed to be a source of resilience for GP practices and to enable the scaled delivery of care – characteristics which have been invaluable to their member practices since the start of the pandemic. 

However, the successful operation of a PCN relies heavily on the success of cooperative efforts from every member.

In South Liverpool, two Networks have been setting the benchmark for tech-driven collaboration in the age of COVID-19 – Speke, Woolton, Allerton, Gateacre, Garston and Aigburth (SWAGGA) PCN, and Childwall Wavertree PCN – who between them represent 24 GP practices. 

Shared ‘hot clinic’

These two Networks made the early decision to pool their resources and protect patients by establishing a joint ‘hot clinic’ for symptomatic COVID-19 patients at South Liverpool NHS Treatment Centre. This clinic accepts referrals from any of the 24 GP practices and will provide outpatient treatment to manage virus symptoms or triage to hospital admission. A discharge with a simple telehealth package (monitoring of Pulse Oximetry, pulse and blood pressure for 7-14 days) will go live in the coming weeks.

Setting up and operating this clinic jointly was a first-time project for all involved, and inevitably there were a number of obstacles to overcome. The question of how to appropriately manage the staffing of the hub was certainly a sticking point in the first weeks of operation. 

Staffing challenges

With hundreds of GPs from the 24 partner practices who could potentially be called upon, and no centralised system to acknowledge differing schedules and commitments, the initial method of scheduling via Excel spreadsheet was laborious and inefficient. Without an overarching employer to supply admin support, sudden surges in demand at the clinic were difficult to manage from a staffing perspective. This was compounded by the unpredictability posed by GPs having to self-isolate on account of showing symptoms (or someone they had come into close contact with showing symptoms) of COVID-19.  

The Network leaders understood that the virus, and the unique demands it placed on primary care providers, would not be disappearing in a matter of weeks. They needed to establish a workable staffing solution which was not a major administrative burden and which enabled the reactivity and flexibility that the clinic required.   

Digital staff bank solution

With the help of our long-standing partners Capacity, we reached out to Patchwork Health – a doctor-founded healthtech startup working in partnership with the NHS to digitise staff banks and empower clinicians to safely self-schedule. 

In response to the pandemic, Patchwork Health had begun building digital regional staff banks. These banks brought together staff from across a whole region who could quickly take on shifts as and when they were broadcast. In a matter of days, their tech team were able to use their existing technology to build us a bespoke digital staff bank which would support the staffing needs of the South Liverpool hot clinic. 

Tailored to staffing needs

Face-to-face training was, of course, outside the realm of possibility, but video conferencing software was put to great use in demonstrating how the new system could be operated remotely. 

At the outset of the collaboration, a number of partners expressed concern that the pressures of working in the hot clinic could accelerate burnout amongst their doctors and nurses. By making this known from the start, the Network leaders were able to work with the developers to integrate a shift self-selection feature. 

This meant that rather than relying on an algorithm or an administrator to assign hot hub shifts to doctors, the GPs could log on to a specially created app to view and sign up for the vacant shifts that suited them. 

Benefits for whole practice team

Whilst still in the nascent stages, we’re excited about what this embrace of technology means. We’re able to offer a new level of autonomy to clinicians over shift choice, and the administrative burden of rota creation has been dramatically reduced. 

There is no longer the need to rely on clunky systems to find and onboard doctors to fill vacancies, as the technology has delivered greater visibility over shift patterns, which enables managers to anticipate and prepare for alternative staff provision. 

Members of both PCNs have expressed a keen desire to continue using the platform to manage their own staff deployment and tackle doctor burnout even after the clinic is rolled back or evolved. 

Owing to the enthusiastic cooperation, openness to frank communication and the ability to quickly and evaluate and embrace new technology, the relationship between South Liverpool’s primary care providers has been made to feel natural and productive rather than complicated or mandated. The Networks will emerge from the pandemic as stronger and more efficient bodies. 

Previously published by Pulse Intelligence – a new service to help you run your practice efficiently, maximise income and understand the GP contract.