HETT Unexpected Innovation Awards 2022 - Best Primary Care Digital Project

The HETT Unexpected Innovation Awards returns in November 2022 to celebrate the very best in experimental design, collaboration, and leadership in digital healthcare. 

The event showcases champions of digital health innovation and highlights some great stories of transformation. The awards bring together the health and care ecosystem and highlights best practice examples to inspire more to do the same. 

The Best Primary Care Digital Project recognises those schemes that have adopted a digital-first model in the provision of primary care. The nominees have taken a person-centred approach to delivering these projects, incorporating the core attributes of general practice: continuity, coordination and community focus.  

The three shortlisted submissions for this category are: 

Scottish Government – Digital Mental Health Programme 

Mental health problems cost Scotland £10.7 billion per year, and, diagnostically, insomnia is the most common expression of mental ill health. With a rise in demand for CBT (cognitive behavioural therapy), the Scottish Government identified cCBT (computerised Cognitive Behaviour Therapy) as a critical component to enabling immediate access to psychological self-help resources at population level.  

Big Health was chosen as the digital therapeutics provider to support this growing requirement, based on results from clinical trials for Sleepio and Daylight. 

Early evaluation of deployment of digital therapeutics in Scotland’s mental health offering demonstrated rapid, consistent implementation across clinical referral demographics and geography - supporting the national strategy to improve service reach and equity of patient access. Daylight and Sleepio were selected for national procurement within Scotland’s cCBT programme in 2021. 

Enabler groups (GPs, referrers, care teams and pharmacy) were supported with easy access resources, consistent messaging, and opportunities to share experiences. By understanding barriers early, the Project Delivery Team collaborated with regional teams to execute delivery of solutions at pace. The expectation was it would take 12 months for all health boards to implement cCBT, but it was achieved in just over two months. 

cCBT provided immediate access to people in rural/isolated areas where services were limited. In addition, by understanding the needs of local teams and providing them with bespoke interventions, they have the confidence to refer more patients to cCBT. Furthermore, self-referral uptake has been so high that it has significantly taken the pressure off Primary Care and the wider system. 

Gillingham South Primary Care Network and NHS South, Central and West (SCW) 

Gillingham South PCN joined a pilot of the ELITE programme, which uses a structured approach to identify opportunities to improve the way primary care activity is delivered, before employing quality improvement tools to deliver and measure improvements. 

The PCN chose to focus on reducing avoidable GP appointments by producing guidance for reception/admin staff in triage decisions, including a process map and guidance on conditions that they then used to train staff.  

Traditionally, receptionist/admin staff have learned how to triage patients through shadowing and coaching, but over time the triage process has become more complicated and the PCN believed this new approach would lead to greater consistency and a reduction in avoidable appointments. This project would also help reception/admin staff in signposting patients to more appropriate services. 

The PCN continued to audit ‘avoidable appointments’ throughout the implementation period so they could measure the impact that it was having and could ‘course correct’ where necessary. The audit revealed they had released 2.6% of GPs’ time. This is eight hours of extra GP time per week that can now be used for patients. 

Typically, smaller practices find it difficult to engage in this sort of improvement work, but by pooling resources, this improvement was able to be scaled across the whole PCN of 40,000 patients without as much work required from individual practices.

Soar Beyond Heart Failure Project Team with North Bristol NHS Trust & NHS Bristol, North Somerset and South Gloucestershire Integrated Care Board

In partnership with Soar Beyond, North Bristol NHS Trust (NBT) and BNSSG Clinical Commissioning Group (CCG) invited GP practices across BNSSG to express their interest in a structured heart failure (HF) training programme. The aim was to upskill and empower the primary care workforce with up to 30 clinicians across BNSSG conducting effective HF reviews in practice. 

The multi-professional programme, comprising of both nurses and pharmacists, was designed to help aspiring clinicians improve their competence and confidence to provide high-quality care to people with HF within primary care. 

Soar Beyond was chosen as the preferred education and training partner. In March 2022, the company’s SMART platform was used to baseline the competence of the 30 clinicians against a standardised multi-professional HF competency framework.  

The process of competency assessment involved onboarding the clinicians onto the SMART platform where they self-assessed their competence against the framework. Three multi-professional mentors were also onboarded onto SMART and were either heart failure specialist nurses or heart failure pharmacists. Each participant self-assessed their ‘Circle of Competence’ on SMART, which highlighted their HF training and development needs and defined targets for the 30 trainees in terms of competencies development by the end of the programme.

The individual competency assessments were analysed and themed using the SMART Platform capability map function and this informed a robust curriculum to reflect the collective training needs and skill gaps. Alongside four blended workshops (two face-to-face and two virtual), each of the 30 clinicians received one-to-one sessions with their mentors on SMART, whereby personalised capability reviews and development plans were generated to meet individual development plans. The SMART platform is scalable and has the capability to be rolled out to every trust. 

Visit the HETT Unexpected Innovation Awards 2022 website for more information about the categories and the upcoming awards ceremony.