North East Lincolnshire Clinical Commissioning Group

North East Lincolnshire Clinical Commissioning Group (CCG) is one of multiple CCGs operating across the Humber region, which includes: North East Lincolnshire CCG, North Lincolnshire CCG, East Riding of Yorkshire CCG, and NHS Hull CCG. The region consists of over 160 GP sites in the Hull, Cleethorpes, Grimsby and Immingham areas with practices spread across a wide range of geographical locations from city centre to rural areas. The CCGs are responsible for commissioning health services for over 960,000 people across the Humber Region. The CCG is part of the Humber Coast and Vale ICS and part of the Humber Transforming Care Partnership for Learning Disability. The CCGs have delegated primary care commissioning arrangements with NHS England, and work closely with a number of key care providers across health and social care.

Prior to the migration to the Health and Social Care Network (HSCN), technical delivery and IT support proved to be problematic, with system suppliers having to visit sites rather than be able to perform updates remotely, remote support was almost impossible with the N3 connections being fully utilised all of the time.

NHS Digital supported the CCG in their procurement activities assisting their move on to the Crown Commercial Services framework providing the CCG with commercial support. Also, the NHS Digital Migration Team provided invaluable support to help the CCG reach the position they needed to be when they needed to be. Two procurements were run – one for the north bank of the Humber, which was awarded to Kcom, who already had a large presence in the area. The south bank procurement was awarded to Virgin Media Business.

The change in technology from N3 to HSCN enabled the CCG to multiply their bandwidth tenfold, with an increase from 2MB to 20MB, and in some sites even more. It gave the CCG chance to assess the current real world requirement for bandwidth against their current provision.

During the COVID-19 pandemic the CCG were not only migrating to HSCN but were also changing their IT provider, with all these things happening simultaneously it provided the perfect catalyst to drive through business and technology change at pace.

Following the migration to HSCN clinicians noticed smoother access to clinical systems and other enabling systems.

Prior to the COVID-19 pandemic primary care was very much focused around a physical building and patients visiting that building. However, COVID-19 prevented that from happening. Thanks to the migration to HSCN practices were able to provide remote consultations within a very short space of time. This allowed GPs who were having to self-isolate, but were still well enough to work, to consult with their patients from their own homes. Utilising virtual private network (VPN) technology GPs were able to access all the clinical systems they needed from a home laptop.

The CCG recently finished their migrations and it was apparent that practices who had been among the first to migrate were having a much more positive experience delivering remote primary care than those still on the N3 network.

Remote working and video consultations will be part of the CCG’s long-term plan post COVID-19 and because of the ability to provide care in this way thanks to the extra bandwidth provided by HSCN, primary care is now more accessible than ever before.

Thanks to the technology enablers that HSCN has brought, one GP has described how he was able to consult and treat patients not in the immediate locality and in one case on the other side of the world. This meant patients could be treated by their own GP rather than attending an out-of-hours walk-in centre. Overall patient accessibility to primary care services has improved significantly and new ways of working have allowed the trust and clinicians to respond to pandemic in a more effective manner through HSCN connectivity.

In the future, the technology will also allow some outpatient services such as optometry traditionally delivered in acute trusts to be delivered in primary care settings – this would not have been possible under the old technology. During the pandemic, the CCG also rolled out the use of digital signatures, allowing GPs to sign fit notes without having to be physically in front of the patient.

During the pandemic the CCG deployed tablet devices into care homes to allow video consultations between primary care and care homes. By sending a single short message service (SMS) message to a tablet, a remote consultation could be started by a single button press on the tablet device. This is a significant step forward in the delivery of primary care into care homes. Future plans for care homes include allowing users to access NHSmail and the summary care record.