The Physician Response Unit is part of the wider Barts Health NHS Trust which is one of the largest NHS Trusts in England with over 2.5 million people using their service for their healthcare. The Physician Response Unit is a pre-hospital community team, part of London Air Ambulance and specialise in community emergency medicine. Their role is to bring the Emergency Department to patients that need it, in whatever capacity they can.
Within Barts NHS Trust, a new service was being started called ‘The Remote Emergency Access Coordination Hub’. The overall objective of this new service was to create a better interface between primary and secondary care within the trust.
The concept of the new service is that when the ambulance crews determined that a patient needed to come to hospital, as it would be unsafe to leave them at home, they would phone a number and speak to one of the emergency medicine consultants and talk to them about the case. Prior to the introduction of this service, many cases that ended up being brought to hospital did not need to, and this service would provide a way of effectively treating them in the community, without the need to use additional Trust resources. Overall, the new programme was designed to effectively connect community staff with the hospital-based team to help assess a patient’s needs.
To support this new project, Barts NHS Trust needed a new, structured phone system for handling calls. Patients were needed to be booked in by someone from the admin or reception team, then the ambulance crew would speak to the consultant whereupon they would be told to come to the hospital, or they would be referred directly to a Physician Response Unit or, have a virtual consultation arranged with the patient. To make this project a success, the phone system needed to be able to manage the administrative booking tasks and then be able to quickly pass that call onto another queue for a consultant.
The core requirements that were most important were to have a single point of access number and speed of answering. There was no need for consultants to be spending time booking patients in when they could be taking clinical phone calls. Another important feature for the project was access to call recordings from a governance point of view and because it was going to be NHS patient data, high levels of security were crucial, and this was not possible with the in-house system.
As well as those important features, hybrid working was another key consideration. The introduction of this project was before people were primarily in a work from home setup, and the Trust knew that some staff were potentially vulnerable to Covid, and that this might become the norm. So whichever solution was chosen, it needed to be well-suited to remote and hybrid working.
Gradwell were recommended to Barts NHS Trust so they contacted us to work through the requirements for the new phone system. Following a discovery session to scope out all the requirements, 3CX was the chosen solution. Gradwell were selected by the trust due to outperforming other providers in terms of flexibility, cost effectiveness, speed of provision, and through understanding the long-term vision of the project including future requirements. Crucially, for the success of this project, the Gradwell 3CX solution provided the flexibility and functionality to be able to add new users immediately and to easily upscale.
In addition to the solution, Gradwell provided an end-to-end service in terms of managing the implementation and working closely with the in-house team. This included understanding the challenges posed by the security systems in place in large organisations, which the in-house team would not have been able to facilitate. To ensure this project was a success, our knowledgeable and easy to access support teams made a huge difference and were only ever a phone call away to provide support and advice, ensuring that Barts NHS Trust could always access a rapid diagnosis.
Without Gradwell and the 3CX solution, the project would have only had a basic extension number for the ambulance crews which would have been transferred between teams and would have been engaged more often than not, which would have resulted in people being turned off by the service. People would have been frustrated and would not use the new service and the whole project would have ended before it started.
Working from home would also have been impossible for this project without this solution. The alternative would have been the trust handing out personal mobile numbers which would have been unworkable and so without the new telephony system, the plans would not have even got off the ground, such is its integral nature to the project.
The solution enabled the team to set up call queues with agents which meant that not only did the team only have to dial one number, but people could log on and off as they needed to. If the primary contact does not answer then after a certain amount of time, it gets reverted to the backup queue and someone else in the team is likely to pick it up. If there is an emergency, then it can now be dealt with easily.
As a result of the project, which was enabled by the Gradwell 3CX solution the Barts NHS Trust project team won a Health Service Journal Award.