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Communications, collaboration, and changing behaviours: three factors to successfully establishing change

Written by: Victoria Vaines - 8th September 2020

In this second blog in our series on Evaluation and Reset, Programme Manager Victoria Vaines talks about how the AHSN has supported the Integrated Care Systems in our region to explore the changes brought about by COVID-19.

We’ve been working closely with our three Integrated Care Systems (ICSs), with North East and North Cumbria AHSN and their ICS, and the region’s HealthWatches – the public health watchdogs, to understand the impact of the pandemic on staff, patients, and the public.

In the first phase of this programme, staff in the four systems participated in a survey which was used to provide evidence and rapid insights into the impact of COVID-19. We also explored the innovations they used during the pandemic.

The most common themes were:

  • Increased collaboration – there has been a sense of community across the systems which has led to an increase in collaboration between teams/specialities, organisations, and systems to develop solutions to shared issues and provide mutual aid. Key contributors to this collaboration have been the use of technology (such as MS Teams), strong leadership, increased communication and a reduction in bureaucracy.
  • Technology – the adoption of technology (including virtual consultations, remote monitoring devices, communication software and IT infrastructure) during the COVID pandemic has been rapid. Both staff and patient attitudes to this have been positive, however we need to think about people’s ability to use new technology and whether they have the right equipment in order to prevent inequalities.
  • Remote working and virtual consultations – staff and patients generally had positive experiences with virtual meetings and consultations and accepted they will continue as part of the ‘new normal’. The difference in patient demographics across the region needs to be considered in terms of accessibility, capacity and capability when using these technologies. These are also important considerations for adoption within health and care organisations.
  • Patient safety, care and experience – there has been a lot of work from all sectors to continue care for patients as much as possible whilst reducing face to face interactions to protect patients and staff. Patients and public have been receptive to this and some have bought equipment such as pulse oximeters to use at home.

Across West Yorkshire and Harrogate Health and Care Partnership we found a strong sense of community, a willingness to share experiences and data, and collaboration on joint issues. Two main types of change were implemented across the system: digital change (including using the Attend Anywhere software and MS Teams) and process change (such as moving from five-day to  seven-day working and the change in hospital discharge processes to make them more streamlined). Though the public didn’t want to overburden healthcare services during the pandemic, they felt confident that they could get access to services if they needed them.

In South Yorkshire and Bassetlaw Integrated Care System funding, technology and the positive behaviour of staff encouraged collaborative working and improved communication. While some patients experienced increased anxiety from postponed or cancelled services, the overall patient and public experience during the pandemic has been positive. Virtual working required rapid upskilling of staff and the IT infrastructure was challenged in managing demand.

Humber, Coast and Vale Health and Care Partnership expanded on its extensive rapid insights work, to undertake a deeper understanding of how respiratory, maternity and outpatient services have been affected and adapted to the pandemic.

The views of staff in the North East reflected what we saw across Yorkshire and the Humber. Staff would like to continue working from home and have found this helped their wellbeing and work/life balance, with the biggest enabler to this being the adoption of technology. The reduction in bureaucracy led to the reduction of unnecessary paperwork and meetings, and leadership was praised across the region.

To summarise, the factors which led to change included effective communication, collaborative working, embracing technology, agile decision making, removing bureaucracy and changes in behaviour and attitudes.

From these collated findings we have amassed a lot of learning during this process which we will be able to utilise in the next stages of this reset and evaluation work as well as future projects. You’ll be able to find out more about some of these learnings in another blog that we’ll be publishing later in the week.