Leanne Saddler, General Manager, Caroline Hing, Clinical Director, and Doreen Mangion, Head of Nursing

In January, our Outpatients department were preparing to start work delivering their new five year strategy; however Covid-19 meant that the team were forced to find new ways of working in a short space of time.

We spoke to Leanne Saddler, General Manager, Caroline Hing, Clinical Director, and Doreen Mangion, Head of Nursing to learn more about the work of their team.

Tell us about what the Outpatients strategy was hoping to deliver?

Our strategy was to get us in to the digital age, with the aim of rolling out changes over the coming year, but in reaction to Covid-19, we recognised the need for it ASAP. Working with IT, we’ve manage to deliver a huge amount of the strategy in a couple of weeks, with no going back to business as usual.

It’s all been a very dynamic process, and if clinicians come to us with suggestions or requests we’re now able to implement this quickly and make things easier for patients.

The way we meet has also completely changed with a lot of our meetings now virtual – which is easier as we have staff working across multiple sites.

What are some of the things you’ve been able to achieve?

Around 75% of our appointments are now done virtually, and we’re pleased to say that 83% of patients rated these as ‘very good’ or ‘good’ in our recent Friends and Family test scores.

Internally, we’re now working in diverse teams rather than silo working across different areas. We’ve established great relationships with colleagues in IT and lots of other teams across the organisation, which is so useful.

There are around 450 people in our directorate and staff wellbeing has been a big focus – we’ve run lots of team talks across each of our sites, held group sessions with staff support and have regular communication with the teams. We hope we’ve kept people feeling part of the team and reminded them of their huge importance to the department, our patients and the organisation.

For us personally, we are a new triumvirate and haven’t been working together long, but since Covid-19 we have bonded as a team and make sure we look after each other.

What were some of the big challenges you faced?

The pace and scale of the change was huge and we had to manage both clinician expectation and workforce fears at the same time.

How have patients reacted to the changes? And staff?

A lot of patients have been scared to come in to hospital, and we don’t want them to be at home without the care and advice they need – both patients and staff have seen the value in virtual clinics in moving them along the clinical pathway.

Patients also appreciate the convenience of not having to organise transport, childcare and a parking spot to attend their appointments.

Some of our patients still need to attend their physical appointments, and we did see high ‘did not attend’ rates amongst patients, for example in rheumatology, where patients are on immunosuppressant medication.

We’ve now been able to contact them and reassure them that measures are in place to keep them safe when they travel to St George’s. For this we have to thank our staff, along with colleagues in estates, who have helped us re-organise the physical space in the department.

What will the future look like for outpatients?

Virtual clinics are here to stay – it’s what patients want and this was always part of our strategy, we’ve just got there sooner than planned.

Patients will always still be able to come in, and we’ll still see patients face-to-face, but virtual appointments are much more convenient for younger patients, and the elderly who struggle with getting to hospital.

To get to this place, we have to pay tribute to the whole team. They have been fantastic and have impressed us by the way they’ve stepped up and taken on the challenge.

The past few months have brought people together and built the relationships that have helped us to solve problems.