ICT and Outpatients at St George’s Hospital

In March, our Outpatients’ and ICT teams were faced with the challenge of delivering virtual appointments for the thousands of patients that were no longer able to visit St George’s.

Matt Laundy, Chief Clinical Information Officer, Ian Frost, Head of ICT Engagement & Delivery, Leanne Saddler, General Manager, and Caroline Hing, Clinical Director, and Doreen Mangion, Head of Nursing, spoke to us about the collaboration that made the move to virtual possible.

Can you describe the scale of the challenge you faced? 

Matt: “It was an unprecedented challenge – we had to take what was a very deliberate roll out, that was due to take place over a year, and concertina it into a couple of weeks.

“Our original plan was to go through every service, assess what they needed in terms of documentation, output, etc. but we couldn’t do that so we had a one size fits all deployment. It wasn’t ideal but that’s the way we had to do it.”

Caroline: “There was a realisation about the work that needed to be done in such a short time, and all within the constraints of managing Covid and providing a safe service for patients and staff. I admit there was a bit of excitement as well, seeing the red tape rapidly dissolving in front of our eyes.”

What was the collaboration process like? 

Doreen: “It was the first time we had all worked together. At any other time, we all face lots of competing demands on our time, but in March the focus was all on Covid, so it allowed us some space to concentrate on the project.”

Matt: “We had started the tentative process of working together, but Covid sped up our collaboration.”

Leanne: “What we’ve managed to achieve is testament to our collaboration. It was a pleasure to work so closely together and our teams gelled really well.”

What kind of feedback have you had from staff? 

Caroline: “It’s very positive, once clinicians see the advantages of virtual appointments. It was difficult to ensure we were communicating all of the changes, and we wanted to ensure everyone understood what we were trying to do.

“Now that staff have experience of using it they are very happy and can also work remotely.”

Matt: “For support staff it has made a big difference. Using the new system we can generate reports and book appointments and there is no longer a reliance on using paper notes.”

Ian: “Yes this is a big benefit – getting rid of the paper from the process means staff don’t have to chase bits of paper, they’ll be able to see everything electronically.”

Caroline: “Another benefit is the amount of paper saved and the positive impact on the environment. We see 19,000 patients a week, so even if each patient only requires one piece of paper, that’s saved two trees each week.”

What do you think the future will look like? 

Matt: “We plan to tailor the system as much as we can to each service. Rolling out edocuments and eprescribing to the services that don’t have it yet will make a significant impact on work flow.

“Since I took on the role of CCIO, a big frustration was having four different systems that don’t work together, so once we can ensure iClip is the only system we use, this will make a big difference.”

Ian: “We’re now able to capture data and make this available to NHS providers across south west London through the Health Information Exchange, which will make caring for patients easier and more convenient for staff.

“We’ve always seen this work as a first step in the way we support outpatients, and we will be testing new ways we can support the reduction in unnecessary patient attendance and change the way we support the Outpatient department.”

Caroline: “Clinicians come to us now with suggestions on how we can improve and our conversations are much more productive in finding solutions to their problems.

“We’ll continue to improve on the way we offer virtual appointments, and while there will always be a need to see patients face-to-face, we’ve had lots of positive feedback from patients who haven’t had to spend hours waiting, or take their children out of school. They really appreciate the convenience.”