Interview, Primary Care News

Interview: “Involve everybody”, Clare Gallagher, project manager for social prescribing, Digital First at NHS North West London ICB

We recently had the opportunity to speak to Clare Gallagher, project manager for social prescribing in the Digital First team at NHS North West London ICB. Clare chatted with us about ongoing digital projects and programmes in NW London, as well as sharing insights into successful digital social prescribing and priorities for the future.

Digital projects and programmes

To begin, we asked Clare if she could tell us about some of the digital projects and programmes she has been involved in over the last few years.

Clare explained how she is presently working on three projects, including a “Case Management System (CMS) for social prescribers which allows integration between primary care clinical systems (EMIS and S1) and a CMS.  This means GP practices can refer directly to the social prescriber and other ARRS roles with the click of a button and the social prescriber can push back any relevant information to the patient’s record clinical record.

“My second project is around somatisation, now called Body Dysmorphic Disorder (BDD). Misdiagnosis of BDD can lead to unnecessary investigations and treatments, resulting in significant costs to the NHS. Our project aims to use social prescribers or other ARRS roles to offer patients psychological emotional and social health support as an alternative.”

The third project, Clare said, revolves around the Sensley app. “The app is being piloted in Brent which has a high number of Gujarati-speaking patients,” she said. “It helps patients to better manage their diabetes by sharing health and wellbeing information to support long-term condition management.”

Clare has worked as a social prescriber/care coordinator in a number of GP surgeries in NW London and as a IT Facilitator for the ICB delivering training on S1 to GP practices. She also took part in the Digital Pioneer Fellowship with the Learning HUB platform for primary care staff.

A CMS for North West London

Clare explained that a focus of her work over the past two years has focused on bringing in a CMS for social prescribing and other ARRS roles that would link in with GP clinical systems, so that information would flow without the need to cut and pasta data from spreadsheets where information on the patient’s progress was held in the past. To apply for funding, the ICB looked at where social prescribers sat digitally in NW London and what sort of tools would be useful to help them do their jobs effectively. A CMS, Clare noted, was highlighted by social prescribers “as a must”.

Clare’s team went out to procurement for the CMS two years ago, she explained, and looked at most CMS on the NHS framework.

“I engaged with a lot of social prescribers too, and then we jointly viewed demonstrations from each provider to see if they met our criteria and specifications. In the end a CMS called Joy was chosen and we commenced the rollout. There are four PCNs out of 45 who are not using the system which is a massive change in working practice.  I’m not sure if they will ever get the final four on board as it is not a compulsory system to use but we will give it our best shot. Hopefully word will spread to the final areas via our social prescriber’s network, who are best placed to encourage sign up.”

NW London is the “first ICB in London to implement a CMS on such a large scale,” Clare shared. “I believe other ICBs have started the process with perhaps one borough or council; we have eight boroughs within our footprint, and every one of them is covered by the CMS.”

She added that the NW London Digital First team is happy to share their experience with other areas and have been working with a number of areas discussing the rollout. “We received great guidance from Peterborough and Cambridge – why reinvent the wheel?”

Social prescribing in North West London

We asked Clare about the current digital priorities for social prescribing in North West London.

Clare said: “Although the rollout of the CMS is nearly complete, it is used differently in each PCN/borough due to the variance in PCN management structures and social prescribing service delivery models – some PCNs employ their social prescribers, other commission voluntary or council groups – and so we work to accommodate each individual setup.  There is a lot of good work being done and we want to share this learning across the ICB.

“In order to do this, Digital First, along with our partners NAPC (National Association for Primary Care) and social prescribers, have produced a template SOP (Standard Operating Procedure) and are holding face to face Action Learning Sets (ALS) in each area to gain and share lessons learned. ALSs are usually face-to-face discussions to iron out and share solutions on issues around technology, stakeholder behaviours and patient management.”

Clare emphasised the need for data to ensure that the social prescribing roles are valued and sustained:

“If we can’t evidence benefits then we may lose this essential job role. With Joy CMS, we can report on the number of referrals per practice, PCN, borough or ICB. We can see how the patient was affected by the intervention and what onward referrals were used to improve patient care. We can also see the breakdown in demographics and services used which could aid commissioning intentions in the future.”

“Future plans would be to enhance the Joy Marketplace, a directory of services which allows the user to directly refer or signpost their patients to a local service. This is also public-facing, and can be used by everyone to refer. This is an ongoing piece of work for which there is no funding at the moment, and we are encouraging each area to take on the responsibility for uploading services themselves.”

Digital in the future

What does Clare hope to see from digital in the future?

“I think a lot of funding has gone towards making primary care more digital – we have electronic prescribing, record transfer (GP to GP), online consultations, etc, and now we need to copy this great work with social care, secondary care and hospitals.

“A good example of what good looks like is the NHS App. I fractured my wrist recently and before I had left the fracture clinic, my next appointment was pinged to me via the NHS App. I could also see the letters sent from my consultant without the need for a paper copy and view them all on my primary care record. We need one record held by the patient which we can share when in a clinical environment – no more faxing or paper records.”

What advice would Clare give to someone who might be about to embark on a similar journey with digital social prescribing?

“Involve everybody,” Clare replied. “Don’t put in a digital system that has not had approval by the stakeholders who will use it. It is hard enough to get people to accept change, without it being something they have not asked for. Test the validity with your social prescribers, your PCN managers, GPs, practice managers, and make sure it actually works and is tested out.”

In addition, Clare said: “Pick a provider who is supportive and responsive to your needs, as this is not always the case after the contract has been signed. Finally, have a sense of humour and don’t take offence – not everyone likes change, and you will be making them do something new and different even when they feel things were working just fine.”

We’d like to thank Clare for her time, and for sharing with us her work on digital social prescribing in North West London.