100% Digital Leeds has partnered with Leeds Community Healthcare NHS Trust (LCH) since 2020. The partnership began with 100% Digital Leeds working with individual LCH services to support the implementation of specific digital health tools, or to embed digital inclusion within discrete projects. This includes supporting patient uptake of digital tools to support the self-management of long-term conditions such as COPD and diabetes. The partnership has continued to develop, seeing 100% Digital Leeds supporting LCH to embed digital inclusion into the trust’s soon to be published Digital, Data and Technology Strategy, ensuring digital inclusion is considered across the whole Trust.
Most recently 100% Digital Leeds is working with LCH to ensure the trust’s 3,500 staff are aware of the potential impact of digital exclusion, can easily identify digitally excluded patients, and can sign-post people to the right community support. To support this 100% Digital Leeds has worked with LCH to coproduce Digital Inclusion Awareness training. LCH has also implemented Electronic Patient Record (EPR) screening questions, supporting staff to have conversations with patients and service users around their digital inclusion needs and sign-posting them to support in the community. In this way LCH ensure that patient digital inclusion needs are identified and addressed as standard practice.
Leeds Community Healthcare NHS Trust
Leeds Community Healthcare NHS Trust was formed in 2011 to provide community healthcare services for the people of Leeds. The trust delivers services in or close to people’s homes and works with the whole family. Their 3,500 strong workforce includes nurses, therapists, pharmacists, non-registered and registered clinical staff, supported by their corporate services. LCH works closely with the other trusts that make up the NHS in Leeds, recognising that patients will move between services and trusts depending on their health needs.
Services include:
- Primary Care, offering GP services.
- Leeds Teaching Hospital NHS Trust, the city’s hospitals.
- Leeds and York Partnership NHS Foundation Trust, the main provider of specialist mental health and learning disability services in Leeds.
LCH is keen to support digital inclusion for the benefit of patient’s health and wellbeing in the long term, regardless of the service they currently access.
Working with LCH to embed digital inclusion into specific projects
100% Digital Leeds has partnered with many LCH services to embed digital inclusion into discrete projects. Examples include working with the Cardiac team to support the rollout of Airmid enabling patients to remotely submit blood pressure readings, working with the Weight Management team to support uptake of nutrition and fitness apps, and the rollout of AccuRX to support virtual consultations during the pandemic.
Further examples of project-based partnership work include:
Increasing the uptake of the MyCOPD app
myCOPD is a self-management app with integrated online education, symptom reporting, and pulmonary rehabilitation system, support people living with COPD to manage their condition. The app is issued free of charge through Leeds Community Healthcare NHS Trust, Leeds Chest Clinic and Primary Care, funded by NHS England. 100% Digital Leeds worked with LCH to embed digital inclusion awareness into the app’s rollout. Clinicians and Breathe Easy groups were trained in digital inclusion awareness, addressing digital inclusion needs alongside the issue of the app, supporting increased uptake.
Supporting digital inclusion provision to be embedded within the Enhance Programme
The Enhance Programme is a partnership between Leeds Community Healthcare NHS Trust, Leeds Older Peoples Forum, and 13 third sector delivery partners. The programme supports safe and sustainable discharge from hospital and neighbourhood teams into a secure home environment, providing person-centred holistic support at home for people receiving community-based healthcare. When the programme was launched 100% Digital Leeds facilitated digital inclusion awareness workshops with the third sector partners, supporting them to build digital inclusion provision into programme delivery.
Embedding digital inclusion within Student Nurse Programme
100% Digital Leeds partnered with LCH’s Senior Practice Learning Facilitator to include a digital inclusion strand within the Leeds Primary Care Leadership Placement. 100% Digital Leeds delivered a digital inclusion training package to the student nurses, providing them with greater insight and understanding of digital inclusion, tools they could use to explore barriers and challenges, and resources to support them to signpost service users who identify they would like help to become more digitally included. For the remainder of the placement, the students led on NHS Health Check Clinics in general practice settings and spent time in a community setting, building relationships with a diverse population group, enabling them to have meaningful conversations about digital health.
Baby Bubble Leeds
100% Digital Leeds partnered with LCH’s 0-19 Public Health Integrated Nursing Service to support the development of Baby Bubble Leeds, an initiative to access support and information from health professionals using closed, moderated Facebook groups. 100% Digital Leeds worked with LCH to ensure that the project is as inclusive as possible, recognising that, whilst the women the project is aimed at may find it useful to engage with health services digitally, they are also likely to face some barriers to engaging with digital.
Embedding digital inclusion across the organisation
The success of the partnership between 100% Digital Leeds and LCH in addressing digital exclusion for improved health outcomes was a key factor in LCH continuing to partner with 100% Digital Leeds, going on to embed digital inclusion into their service at a strategic level. 100% Digital Leeds is helping to embed digital inclusion within LCH’s strategy and working with LCH’s business units to determine the best approach for each team in relation to digital inclusion.
The strategy is yet to be published but the key objectives are to:
- Provide the best possible care in every community
- Keep people well at home
- Provide choice to patients and service users
- Support out of hospital care
- Support people to maintain their independence
- Promote self- management
Digital inclusion is integral to enabling the strategy’s objectives:
“As a Trust we have a vision to use digital technologies at the heart of our service delivery model to improve access to care and ensure our services and staff are as efficient as they can be. In order to do this effectively, we need to bring our patients and service users along the journey with us. We want to co-design all future digital solutions with patients and service users to ensure we get this right from the outset. We are very mindful that there will be people who aren’t able to use digital and we want to support them, through partnership working with 100% Digital Leeds, to access the most appropriate support.”
Dawn Greaves, Associate Director of Digital Transformation, Leeds Community Healthcare NHS Trust.
Digital inclusion screening questions
LCH has introduced digital inclusion screening questions, supporting clinicians to have conversations with patients and service users around digital inclusion. Once the support needs have been established clinicians can directly link into 100% Digital Leeds’s Community Support Directory and ensure the right support is offered to each patient.
“We must make sure that our offers are digitally inclusive and accessible to everyone who wishes to access them. To achieve this, we have to ensure we routinely ask our patients and service users about their digital literacy skills and digital inclusion support needs. By starting a positive conversation about digital we can understand the needs of the patient and ensure that the information we direct them to is accessible for them. We may send them links via SystmOne, direct them to Patient Information Hub, or recommend the NHS app, but we need to make sure that they’re able to access and use those resources.”
Amanda Jackson, 0-19 PHINS Clinical Team Manager & Baby Bubble Leeds Lead, Leeds Community Healthcare NHS Trust.
The template will be used across the trust’s business units and services. The patients will be asked the questions both as part of an initial assessment and again at regular intervals, recognising that a patient’s situation and digital inclusion needs can change over time.
Guiding staff to have positive digital conversations with patients
The questions revolve around three topics:
- Which of these can you do via digital methods?
- If you don’t currently use digital options, why not?
- What would help you to use digital options?
The template is designed as a questionnaire with set multiple choice answers, but the questions are intended to be used as conversational prompts, guiding staff to provide the right information and resource for the patient. During this conversation staff are expected to highlight the potential benefits of the patient engaging with digital tools and services relevant to their needs, supporting patient motivation.
Embedded within SystmOne, for ease of staff
Both the ‘Digital Ability and Access to Digital Devices’ template and the links to community sign-posting information are embedded within LCH’s Electronic Patient Record, SystmOne. Once staff have established the patient’s needs, they can click straight through to the 100% Digital Leeds Community Support Directory or the AbilityNet referral form, or a link to the LCH intranet with further information about accessible information and digital inclusion. Embedding both the screening questions and support information within the trust’s key systems makes the process as simple as possible for staff.
Considering digital inclusion alongside wider communication needs
The template is sat within the wider ‘Communication Needs’ screening section on SystmOne, encouraging staff to consider digital inclusion alongside wider accessibility needs. Accessibility needs such as whether the patient is visually impaired, has English as an additional language, or has learning disabilities, are considered when identifying the right community digital inclusion support to signpost to.
Digital inclusion awareness training
LCH aims for all staff to have an understanding of both digital exclusion as issue, and their role in supporting digital inclusion. Since the trust has a workforce of 3500, with different teams and roles requiring different levels of understanding around digital inclusion, LCH and 100% Digital Leeds have worked together to develop a stepped approach. A short training video has been coproduced to give all staff across the organisation a basic understanding of digital inclusion. After watching the video staff are asked to reflect on the impact of digital exclusion in their service area. Where staff feel their team support patient cohorts where digital exclusion is particularly prevalent or complex, or where patient uptake of particular digital tools is essential, such as with long term condition-specific self-management apps, staff are offered a more in-depth digital inclusion workshop.
Digital inclusion awareness training video
100% Digital Leeds and LCH coproduced a 30 minute digital inclusion awareness training video. The training is designed to give all LCH staff a basic understanding of the potential scale and impact of digital exclusion, and their role in supporting patient inclusion. It gives staff the knowledge and tools needed to gain a deeper understand the patient’s needs, enabling them to signpost people to the right support.
The training video introduces staff to:
- The potential scale of digital exclusion across the city.
- The potential impact of digital inclusion on patients, exacerbating existing health inequalities.
- How to have a person-centred, motivational conversation around digital.
- How to identify a potentially digitally excluded patient.
- The range of digital inclusion support available in Leeds.
- How to signpost potentially digitally excluded patients to relevant community support, taking into account the patient’s holistic needs.
- Further support available from 100% Digital Leeds, where teams support patient cohorts where digital exclusion is particularly prevalent or complex.
The training video is introduced by a member of LCH staff, positioning digital inclusion as an enabler to the trust’s Digital, Data and Technology Strategy. The final section of the training sees the member of LCH staff introduce the new digital inclusion screening template, ensuring staff understand how the training will be practically applied going forward.
Whilst the training video has only recently been launched, initial staff feedback has been positive:
“This was an education indeed! I was pleased to see how much support there is available on the Community Support Directory, especially seeing the scale of potential digital exclusion in Leeds.”
Member of Leeds Community Healthcare NHS Trust staff.
Team specific digital inclusion awareness workshops
Where staff feel their team support patient cohorts where digital exclusion is particularly prevalent or complex, or where patient uptake of particular digital tools is essential, such as with long term condition-specific self-management apps, staff are offered a more in-depth digital inclusion workshop.
The workshops are an opportunity for 100% Digital Leeds to work more closely with a particular team, to further understand the barriers to digital inclusion faced by particular patient cohorts, and how the team can offer further digital inclusion support. This may involve LCH teams working more closely with community organisations offering support tailored to meet the needs of a particular community of interest facing existing health inequalities, such as people experiencing homelessness, refugees and asylum seekers, or people from areas of economic deprivation.
The workshop gives staff the understanding and tools needed to play a more active role in supporting patient digital inclusion. This may include having a deeper understanding of how to support patients with low digital motivation, offering more in-depth skills support to support uptake of a particular digital tool such as a condition specific self-management app, or gift patients’ digital equipment and 4G data sims via the National Databank.
Securing organisational buy in at all levels
As a huge service with over 70 service areas and 3500 staff, LCH has taken the time to engage staff at different levels, setting digital inclusion in the context of strategy, and securing buy-in. The strategic approach to digital inclusion was launched at the trust’s Leaders Network, a forum chaired by the trust’s Chief Executive, with attendance from across the leadership team.
They coincided this with an update on the new Digital, Data and Technology Strategy, clearly aligning digital inclusion as essential to the realisation of the strategy’s objectives and priorities. They have rolled digital inclusion messaging into service readiness for current digital projects such as Digital Letters and Patient Information Hub, making the most of existing engagement opportunities with service areas.
The work has been led by a member of staff with experience and expertise in both digital transformation and clinical practice, and shaped by the service’s existing Staff Digital Champions Network.
Led by a member of staff with experience of both digital transformation and clinical practice
The work has been led by Amanda Jackson, a Nurse and Health Visitor by background, working for LCH’s 0-19 Public Health Integrated Nursing Service as a Clinical Team Manager. Amanda has recently completed a Florence Nightingale Fellowship that had an entirely digital focus. As a result, Amanda has been spending time working alongside the LCH Digital Patient Communications Team and shares her clinical nursing knowledge. This breadth of experience makes Amanda, and her colleagues well placed to help shape the organisation’s Patient Engagement and Digital Inclusion agendas, sharing insights from a range of perspectives.
Staff Digital Champions Network
LCH’s Digital Champion Network is a trust-wide network formed in 2021, including over 40 LCH staff ranging from senior strategic roles to frontline clinicians. The network brings staff together to share thoughts around digital transformation and equip each other with new digital skills.
The network is led by the LCH Digital Innovation lead who works across the service to spot any opportunities where digital innovation can help drive improvements in care quality. 100% Digital Leeds delivered a digital inclusion awareness workshop for network members, supporting staff to reflect on where digital exclusion may impact on the success of newly introduced digital solutions.
Attending the network also supported 100% Digital Leeds to have a greater understanding of other potential barriers to successful digital innovation, such as where staff may lack the digital skills and confidence to embrace digital change, or where internal factors such as a lack of capacity or poor digital infrastructure may need to be considered. The insight of the network has been an important factor in ensuring the success of trust-wide digital inclusion interventions.
“We’ve also taken the digital inclusion training and screening questions to the Staff Digital Champions Network so they can feed in their thoughts and encourage their service areas to engage. I’m getting feedback from the Digital Champions and, where teams are now using the digital inclusion screening questions as routine, they say it’s usually a one-minute conversation. It’s not adding to their day, and that’s what I keep saying to the wider LCH staff teams. In other cases, it might be a little bit of a longer conversation, but where it is longer, that conversation is much needed, and saves staff time in the long run.”
Amanda Jackson, 0-19 PHINS Clinical Team Manager & Baby Bubble Leeds Lead, Leeds Community Healthcare NHS Trust.
Next steps
100% Digital Leeds and LCH continue to work together to embed digital inclusion awareness and support within clinical practice and the healthcare system. The roll-out of digital inclusion training is ongoing. 100% Digital Leeds continue to work with individual teams where digital exclusion is particularly prevalent or impactful, to co-design bespoke digital inclusion interventions.