Digital volunteer pilot collaboration helped reduced Do Not Attend rate

31st October 2021

Royal Free charity

Due to Covid response there had been an increasing number of outpatient appointments across the NHS delivered by either telephone or video. The sleep and ventilation therapies team at the Royal Free Hospital, London were one of the early adopters of virtual clinics due to the vulnerability of their patient group, with over 80% of clinics being delivered this way. This clinic was chosen to pilot a digital skills project because their DNA (did not arrive) rate was high - up to 100% in some sessions - resulting in delayed care, poor experience for patients and additional workload for staff. The North Central London area also has a poor level of digital literacy known to affect health outcomes and access to care.

Two clinicians, Stephanie Mansell, Consultant Respiratory Physiotherapist, and Sarah Milne, Lead Nurse Nephrology who is also Population Health Fellow - Health Education England, from the Royal Free London NHS Trust, applied for a grant and received funding from NHSE/I to pilot a digital skills project to be run by the Royal Free Charity volunteers between January 2021 and March 2021. Stephanie and Sarah instigated and led an innovative volunteer programme with a successful collaboration between the Trust and the Charity volunteer team. They empowered and trusted volunteers to co-design the digital pilot project to best help the patients to attend their virtual appointments. They trained and communicated with volunteers and met online with the volunteer team each week. Stephanie and Sarah listened to the volunteer suggestions to improve the pilot e.g. volunteers made important comments for improving the technology of the pilot as well as suggestions on how to enhance how patients and the volunteers could better communicate with the service. Volunteers were asked to contact patients to remind them of their appointment and reschedule them if required. They were asked to advise patients of infection control procedures for face-to-face appointments and to offer training and practice using the video platform “Attend anywhere”.

Volunteers were provided with email addresses so that they could access the clinic appointment details securely. Each volunteer received a tablet so they could access clinic lists on TEAMS and were able to communicate within the NHS and the volunteer team. The core project team met virtually for a weekly one hour catch up to review progress and highlight any concerns and actions for the following week. Two online sessions were held with the volunteers to provide the opportunity to feedback and share their learning and experience.

An experienced volunteer was given the opportunity to train up the newer volunteers and to compile a training manual for the rest of the team which was invaluable. Stephanie and Sarah achieved the pilot goals which were as follows: For volunteers to safely carry out pre-appointment calls with patients; improve patient experience of telephone and video appointments; reduce DNA rates; reduce inequalities in access to care; improve understanding of the digital literacy and support needs of the patient population; use the Royal Free Charity volunteering resource efficiently and ensure a positive experience was had for the volunteers. On analysis it was found that 400 pre-appointment calls were made by volunteers over the pilot period between January 2021-March 2021 and around 20% of patients required some form of support from the volunteer. Patients enjoyed the interaction from volunteers. Remote volunteering was effective to provide direct patient support with hospital administrative and clinical time saved through volunteer contact.

Watch this video of a volunteer from the Trust to learn more how his role played an important part in this project:

This pilot showed that the collaboration between hospital and charity was well received and that it was practical, innovative, and inclusive. It proved to be well received by all and has continued to flourish. The collaboration between NHS leads Stephanie and Sarah with the volunteer team and especially the volunteers was exceptional. Following the success of this pilot programme, Stephanie and Sarah have created an extensive report which will be shared with other services. They presented it to the volunteers and thanked them and acknowledged the volunteers in their report and slides. There are plans to roll this pilot out to many more services across Royal Free services in North Central London to try and reduce the inequities of care and make full use of our exceptional volunteer capability.

Quote from Digital volunteer Vin Taylor “As technology advances, we can harness it into our day-to-day work to eliminate some of the manual tasks and automating them using computer technology. This would speed up the process and leave us with more time to concentrate on more important tasks within the processes.” In some areas of volunteers’ work, digital technology can also be applied to enhance patients' experience and help hospital staff to focus more on their important day to day tasks. This requires an innovative approach. Thanks to Sarah Milnes and Stephanie Mansell, I have been fortunate enough to be involved, as a volunteer, with such an innovative digital project since November 2020. It has been a really enjoyable experience and volunteers have been able to add value to the process of ensuring that the patients were aware of their appointments and if they had any issues with their appointment then discuss it with the volunteers. It started as a pilot project and now there are plans to use the process for other areas of the hospital and to other north London hospitals. The success of the project can be attributed to collaborative work of clinicians, medical secretaries, volunteers, and AI dept. under the leadership of Sarah and Stephanie. I hope that there will be other projects such as this in future where volunteers are able to contribute and enhance patient experience.

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