Primary care is changing. New approaches to care delivery and organisational design are emerging in response to a range of pressures, making the traditional model of general practice increasingly obsolete. Technology is playing a central role in enabling the development of new models. There is potential for organisations to make much greater use of existing technology. There is also scope for further technology innovation. But obstacles still stand in the way of primary care making greater use of existing technologies and developing new innovative solutions.

AT Medics is at the forefront of innovation in Primary Care, and so when Nuffield Trust was commissioned by NHS England in summer 2015 to undertake a review of the primary care landscape and to consider what emerging trends mean for the digital requirements of the sector, it was no surprise that the review would include a case study of AT Medics. The reports set out the findings of that review and the possibilities to transform healthcare offered by digital technologies, with important insight about how to grasp those possibilities and benefits from those furthest on in their digital journey, as well as considering the role that NHS England could play in driving the uptake and development of technology.

View the reports

Candace Imison, Director of Policy, Nuffield Trust said “I am pleased to share with you a major new report from the Nuffield Trust on the opportunities for digital healthcare in the NHS. The report is informed by an extensive review of academic and grey literature as well as interviews with many of the most important organisation and clinical leaders, from across the globe, with experience in this area. It provides numerous examples of technology successes, as well as valuable lessons for healthcare organisations on how to maximise the benefits from digital technology.”

AT Medics is committed to investing in people, and continuously develops its teaching portfolio and resources, to enhance and improve learning experiences. Clinical staff of all grades are able to access and join a number of continued professional development and relevant case based learning programmes led by GP Directors, delivered securely online improving efficiency and reducing costs such as travel and time, whilst administrative staff are up skilled with a combination of face-to-face and web based learning to improve quality and build continuity of service across the organisation.

Excerpt from report – Case Study: AT Medics

Technology enablers: digital and online technologies can facilitate greater knowledge sharing. Webex and video conferencing technology enable GPs to take part in group learning from remote locations. Similarly, social media is facilitating informal knowledge sharing among professionals and the establishment of virtual communities of practice.

AT Medics is a general practice provider company operating 24 practices and a number of urgent care centres across South, East and West London. Run by six directors and serving 130 000 patients, the company was established in 2003 with the aim of delivering high quality general practice. One of its founding principles was a commitment to education and training.

This commitment to training and education was originally delivered via in-person sessions run by directors who travelled between practices. As the company grew and took on more practices, this became increasingly challenging and costly. Since 2012 and the advent of Webex technology, AT medics has adopted a virtual approach to its training programme. The technology is now used to deliver the majority of their education programme and has enabled them to expand and extend the home and scope of training offered. Despite other, sometimes free, technologies being available, AT Medics has chosen to use Webex because of its N3 capabilities. Although the company does not formally measure the impact of its training programmes beyond gathering feedback from participants, the directors feel that it has a positive impact on professional experience, staff retention and, because of its ability to share good practice and standardised protocols, on clinical quality and patient satisfaction.

The main enabler identified by the organisation is their relatively lean management structure which means that they were “just able to do it”. Strong and stable leadership and a genuine commitment to embedding learning in the organisation have also played their part. AT Medics would like to go further and make greater use of technology in its education programme and beyond but it is facing a number of challenges. A lack of interoperability between clinical systems poses a barrier to information sharing.

Developing a telephone triage hub across the organisation has been met with challenges due to CCG reluctance to allow data to be shared across boundaries. Furthermore, the transience of national funding has made embedding technologies problematic. One example given was of text messaging – national funding was provided to local commissioners to get the service started but is now being withdrawn by the CCG, the result being that providers themselves have to absorb the costs or they will have to stop offering the service.

At a glance

Technology employed to improve education and training

  • Webex technology

Enablers

  • Lean management structure
  • Strong and stable leadership
  • Commitment to learning

Barriers

  • Lack of interoperability
  • CCG reluctance to allow data sharing
  • Unstable funding flows

About Nuffield Trust

Nuffield Trust is an independent health charity. We aim to improve the quality of health care in the UK by providing evidence-based research and policy analysis and informing and generating debate. www.nuffieldtrust.org.uk