The community interest company provides NHS community services to more than 40,000 people in Kirklees, West Yorkshire. The not-for-profit social enterprise was formed in 2011 and covers four general practices, as well as dentistries, district nurses and home care health visitors.
Using mobile working, the organisation has been able to improve its healthcare service for patients, as well as changing the way its 1,200 employees work.
Jim Barwick, executive director for transformation at Locala Community Parternships, said being a social enterprise provides the freedom to improve and develop its service.
“We still deliver NHS services, but in a much more co-ordinated, integrated and community-focused way,” he said.
Speaking at the Govtoday Digital Healthcare conference in London, Barwick says the organisation already had people mobile working for the past eight years. This first generation of mobile workers used rugged toughbook laptops and had access to clinical records, but had to go back to the office for anything else.
“It’s not really mobile if you’re reliant on a building,” he says.
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Locala spent time analysing what the organisation needed, including remote access to clinical records; access to important information; and applications including financial, complaints, incidents and appraisal.
The first piece of software Locala redesigned was its invaluable intranet. However, instead of a number of fixed pages people use when necessary, it implemented a Facebook-style intranet called Elsie.
Elsie has personal profiles, photographs and details of employee personal interests. The system encourages people to post blogs and has a search functionality. This means if someone needs answers on a medical condition, they can crowdsource and communicate with others very easily.
“It’s not just about the application of technology,” said Barwick, but understanding how employees work, and understanding their culture and behaviours, while overlapping the clinical model as well.
Additionally, Barwick said many of the patients in Kirklees want to understand more about their condition and health records, as well as managing their condition better by using the same technologies they use in everyday life.
Choosing a procurement partner
Being separate from the NHS, Locala was free to procure infrastructure differently, and it chose Dell to create a hybrid cloud which can be used by employees over 3G or Wi-Fi. It also has a secure line to the NHS applications, including the secured N3 network, NHSmail and Choose and Book.
“This is the platform that allows us to do things differently,” said Barwick.
Locala also extensively uses Microsoft Lync, which Barwick said is a “real game changer” in the organisation.
Locala uses Lync for nearly all phone calls and instant messaging, which has reduced email traffic and video conferencing. It has even managed to encourage the local mental health trust and local authority to use Lync to set up video conferences with Locala.
The next step is to integrate a system for sharing clinical and patient records with other NHS organisations
Lync has also been implemented in a clinical sense. If a patient has a symptom, such as a bunion, Locala can offer the patient a virtual assessment, which is provided via a web version of Microsoft Lync.
Patients can access Lync through an emailed hyperlink and the podiatrist can then assess the symptom via video call, reducing the time taken out of the patient’s day.
“It’s not right for everyone,” said Barwick. “It’s probably not for a 90-year-old lady in a home, but for a 30-year-old chap who’s working, it works.”
According to Barwick, there needs to be a balance between virtual contacts and face-to-face interactions.
“You can involve the patient more in their care and transform how general practices might work through virtual contacts,” he added.
A costly system
However, Barwick said this digital mobile working system wasn’t cheap, estimating the Locala digital system cost around 7% of the organisation’s turnover, compared with NHS organisations which spend between 1% and 2% on technology.
“But 7% falls well short of some experiences in the US, which are much further along than we are,” he added.
Barwick said it was necessary for Locala to spend the money and invest in the future to meet the upcoming challenges of more complex healthcare and an ageing population. He also pointed out that while Locala is still paying for the technology, it is also seeing efficiency savings.
The next step is to integrate a system for sharing clinical and patient records with other NHS organisations.
Locala has different records to mental health trusts and social care, but Barwick said it has started to work on sharing with social care by providing the body with some of its own technologies to create a single point of access.