Cumbria Northumberland Tyne and Wear NHS (CNTW) Foundation Trust
Enabling secure patient appointments with OneConsultation
Cumbria Northumberland Tyne and Wear NHS (CNTW) Foundation Trust was formed in 2019 and works from more than 70 sites across Cumbria, Northumberland, Newcastle, North Tyneside, Gateshead, South Tyneside, and Sunderland. With more than 7,000 employees and a budget of over £380 million, it is one of the largest NHS Trusts in the North of England.
Video-enabling patient consultations have been a requirement across the NHS for a while but the sudden onset of the COVID 19 pandemic beginning in March 2020 brought this into sharp focus. CNTW suddenly found that due to social distancing measures it needed to move as many non-emergency appointments online as quickly as possible and do so in a way that could be used securely and easily by both staff members and service users.
Whilst many organisations turned to ‘off the shelf’ conference services, CNTW (like most in the healthcare sector) decided these were not suitable given its patients are often vulnerable and can struggle with technology. Most consultations are also highly confidential which necessitate different security features and compliance regulations.
Even before the pandemic, CNTW took a long-term view. It wanted to broaden the patient choice and looked to a future of ‘blended appointments’ where virtual consultations would be a permanent option for patient consultations. The objective was therefore to improve clinicians' capacity for service user care overall rather than a short-term fix to an immediate problem. CNTW, therefore, ensured that the success of the programme would be measured from day one and it used Sheffield Hallam University during a pilot stage to apply a data-driven approach to track staff and service user feedback on behalf of CNTW. This ensured these learnings would contribute to long-term success.
CNTW started the process of deploying OneConsultation via a pilot stage just before the start of the pandemic in March 2020. This meant The Trust was in a strong position for a full launch on the 6th of April just three weeks after ‘lockdown’ was announced by the Government.
Take-up was rapid. In the first full month, 400 clinicians had access to the service and over 5,000 video consultations were completed. Service adoption has accelerated rapidly thereafter. In the last 14 months (as measured at the end of June 2021), CNTW has conducted 52,494 online consultations using the OneConsultation platform. Currently, the solution is available to 141 teams across the Trust with 3,151 staff having access to the solution. The Trust now averages 3,768 online consultations per month with CNTW having now resumed some face-to-face consultations.
Feedback from both service users and staff has been high. When asked (if) “I was satisfied with the overall experience of today’s video call” 6,455 service users have responded with either “strongly agree” (by 68%) or “agree” (by 28%) – a combined 96% overall satisfaction rate. These high satisfaction rates are reflected in the fact that 93% of patients using it said they would be willing to receive future mental health care by video. Such high satisfaction rates point favourably to continued high use as CNTW moves to a ‘blended’ model where service users can choose from either virtual or in-person appointments.
Feedback amongst staff too has been positive. When asked ‘thinking about using online video consultations in the future, how likely are you to use online video consultations as part of service users’ treatment if it were available’, 71% said either ‘extremely likely’ or ‘likely’.
Finally, another benefit that the Trust is continuing to measure is a reduction in CO2 emissions. From a sample of service users who responded to the patient survey between April and October 2020, it found that 24935.3 miles were travelled by 1547 service users. CNTW also estimates that almost one million miles of staff travel could be saved annually from video consultations. Tracking the carbon savings from both staff and service users will be a key part of the project moving forward.
CNTW had already invested heavily in Microsoft technology, including Skype for Business, Office 365 and Teams. Its staff had embraced these for internal use and now wanted to customise these to ensure they are highly secure and that patients would find them easy to use. In particular, this meant ensuring bespoke waiting rooms are available for each service CNTW provides.
Nasstar’s* OneConsultation is a fully managed, customisable and scalable virtual consultation service that takes the best Microsoft technology and cloud services and combines it with requirements specific to the healthcare sector. One advantage is that it provides a secure virtual consultation room that a doctor can join using Teams and a patient can join via their web browser on any smartphone, tablet or PC at the click of one button.
It also meets all security and privacy needs for the NHS. Upon joining, patients are dynamically assigned a new, unique meeting space in OneConsultation. OneConsultation will also shortly be also to record sessions for specific services directly into CNTW’s O365 tenant using Azure media services. No personal data is stored by OneConsultation maintaining compliance with GDPR and ‘Health Service (Control of Patient Information) Regulations.’
*Previously Modality Systems
Rollouts of this scale would normally take three months or more, but Nasstar responded immediately and collaborated responsively, enabling us to offer virtual consultations just two weeks after lockdown started. By using Microsoft Azure, we have instantly scaled up the service across our 141 teams and over 3,000 staff. OneConsultation is also a key part of our service offering, enabling patients and staff to use it from anywhere providing expertise where and when it is needed.