August 2020
Dr Farzana Hussain is a high profile inner city single-handed GP working with three salaried doctors running a 5,000 patient practice - The Project Surgery - in Newham, East London. She is clinical director for one of Newham's ten Primary Care Networks (PCNs), which has responsibility for 67,000 patients and co-chair of the NHS Confederation's National PCN Network.
In 2019, she was named Pulse magazine's GP of the Year and recently she was one of the faces of a special promotional campaign acknowledging the remarkable work of frontline NHS staff during the Covid-19 pandemic, to mark the NHS' 72nd birthday.
Here, Dr Hussain highlights some of the benefits her practice has experienced from using Surgery Connect in the last six years, including how it has recently supported delivery of patient care during the Covid-19 pandemic.
The Challenge
The Project Surgery was looking initially for a flexible phone system to support the management of its practice and delivery of patient care and to help make the practice more efficient. It was particularly looking for additional features such as a recording function and capture of data on call waiting times, which has been a general service issue in Newham.
The Solution
X-on supplied The Project Surgery with Surgery Connect, a cloud phone system tailored to the evolving requirements of the primary healthcare sector and readily adaptable to the continuing shift to digital triage. Not only has Surgery Connect provided The Project Surgery with a system that addresses key functional needs for recording and information on call waiting times, it has also provided an 'omnichannel' approach to patient communication. This supports the practice's developing approach to online triage - telephone first for vulnerable groups, for example those with learning disabilities - and then using video if appropriate, and then face to face.
Dr Farzana Hussain Says
"In my role as a single-handed GP and also my PCN work I am very conscious of the need to continue to develop the ways in which we communicate with patients.
"Surgery Connect offers a great model built around the phone as the key channel supporting delivery of primary care. Three of the seven practices in our PCN have X-on's Surgery Connect, so its product is widely used in the Newham area.
"I was interested originally in Surgery Connect because of its consultation recording, which I thought we were likely to need and also because X-on offered competitive pricing.
"But there are many other added benefits too, such as the level of data that is captured by the system that can help in showing how easy or otherwise it is for patients to get through on the phone and how long they are waiting for.
"There has been a big issue in Newham regarding patient access and satisfaction and one of our local practices had one of the worst scores in the country according to last year's GP Patient Survey.
"I asked one of our practices if they thought they were providing enough patient access and they said they were as they had four doctors all doing emergency appointments. But my response was: "How do you know the demand that you are not seeing?", which was something they said they hadn't thought about. So we don't know what we're not measuring – there are all these patients who could be trying to get our help and if we're not measuring call volumes and access, we're not aware of demand. What I love about Surgery Connect is that it shows you when you have missed calls.
"As triage develops as the model of care, I would never now want to reverse how we deliver care with the focus going back to face to face appointments. For our patients who aren't computer savvy, that's fine as they can ring through on the phone. Our high risk patients can ring in as an emergency, and for most other patients if we can't finish the consultation online then it goes to a telephone call. And then if we can't work it out on the telephone, we'll do a video consultation, and if we can't sort the matter that way then we'll do a face to face, but that has only really happened recently in the case of a patient with acute abdominal pains.
"Other than that, during the Covid-19 pandemic, my colleagues and I didn't have a face-to-face appointment in four weeks. We just hadn't needed to; if a patient looks that sick on the video call then you make an assessment as to whether they need an admission. I'd also challenge those who say that it's not possible to take a view on a patient's mental health from a video consultation.
"The Health Secretary's idea of continuing remote working and digital solutions is fundamentally a good idea but I don't think all consultations can be done in this way, there will always be a need for face to face appointments but I believe this does need to be on clinical need not want.
"Surgery Connect has been crucial in keeping practices open during the pandemic and even when at least 50% of staff were isolating at home, it has enabled practice staff to work remotely, with no impact on care quality. In our area, in theory it could help support a virtual partnership of practices. If for instance a GP friend in Merton, South West London, had got no doctors one day, I could 'jump' partnership if they've got X-on, and do some of their calls, meaning they've still got capacity.
"I would not be defined by sitting in Newham, which is great because we know we've got GP shortages, and this type of benefit will make the world of difference for GPs' wellbeing, for practices and for our patients. With X-on, I could be sitting in East London and helping somebody in Yorkshire. It's just an amazing thing that nobody thinks of really, but it's easy to do.
"X-on is also a strong support for medical legal issues in terms of the back-up from recording and also for helping support general learning and doctors' training. We had a patient complaint where the patient said the doctor had refused to refer them to a neurologist and was threatening to get the doctor struck off. It was a serious complaint but we were able to listen to the recording of the relevant consultation, share it with the patient and prove what was actually said and resolve the matter - it was very supportive for our colleague and a powerful asset in managing the situation."
Dr Farzana Hussain
Co-chair of the NHS Confederation's National PCN Network
nhsconfed.org/networks/pcn-network
For further information on Surgery Connect please call Sales on 0333 332 0000.
