Joined-up technology enables COVID care innovation

GPs caring for 200,000 people in Herefordshire are providing innovative services, including running a virtual ward with hospital doctors, through cross-organisational record-sharing.

Taurus Healthcare, an out-of-hours provider and federation for all 19 GP practices in the county, has joined forces with nurses and hospital specialists via EMIS Web for community care and cross-organisational tasks.

The initiative is part of the One Herefordshire Sustainability and Transformation Partnership, with local NHS trusts, CCGs, and Worcestershire County Council working as one.

The ability to view patients’ GP records round the clock means that out-of-hours doctors can deal with the presenting problem in its entirety on the spot

Innovations to improve care during the pandemic include:

• A telephone/video service for patients with COVID-19 where GPs and advanced nurse practitioners offer daily phone calls to provide medical care, advice, and guidance for patients who are symptomatic or at risk of more severe illness – minimising the need for patients to go to their GP or A&E. The clinician can access the patient’s usual GP record
• Face-to-face clinics and home visiting service for people with COVID-19 from all 19 practices and a dedicated clinic for shielded patients, run by nurses who do not work in any other part of the primary care service
• A trial with secondary care clinicians of a ‘virtual’ ward for non-COVID patients where GPs and hospital doctors treat patients together using EMIS Web and avoid a hospital admission where possible

“EMIS has helped us to break down boundaries across the NHS,” said Dr Mike Hearne, managing director of Taurus Healthcare.

“Cross-organisational record-sharing has helped us to improve access to care 24/7, as well as run COVID-19 clinics.

“And we could not have done it without EMIS Web.

“The ability to view patients’ GP records round the clock means that out-of-hours doctors can deal with the presenting problem in its entirety on the spot.

“And, if we need to make a referral on to secondary care or another service, we don’t need to send them back to their own GP first.

“In addition, in a mental health crisis, we can refer patients straight on to the mental health service, heading off an acute phase of illness.”

The virtual ward will mean, for example, that rather than send a patient to A+E for investigations, a GP can speak with an acute medicine consultant and arrange a consultation virtually.

Care is then managed among organisations – dissolving the boundary between primary, secondary and community care and making a truly-integrated team.

And cross-organisational tasks enable safe communication, which is recorded in the patient’s record.

Dr James Bartlett, an acute medicine consultant at Wye Valley NHS Trust, said: “This ability to hold risk clearly and transparently has already built trust among teams, as well as capacity to deliver care to patients in their own homes.

“It is already showing results, and there is huge potential to develop this type of care.

“We can consider remote monitoring, point-of-care testing, workforce development, and specialist virtual wards.”