CASE STUDY
In the heart of Ellesmere Port there are 6 GP surgeries that comprise One Ellesmere Port Primary Care Network (PCN) covering over 70,000 patients. The network has a team of 6 dedicated social prescribers with five of them focusing on adult care and one specialising on the children in the community. In addition to social prescribing, the PCN offers a range of services such as health and wellbeing coaches, dietitians, and a dementia practitioner.
Although the team can make referrals to community services, there were important parts missing. The challenge was capturing and measuring the impact these teams were having on the community. Since their existing product fell short, they actively sought an alternative solution.
The social prescribing team were using an existing solution to make referrals into community services which focussed on making the referral process easier. While you could make referrals, that was it. The software did not save what the team were recording into patient's clinical records or feed back into data captured in the GP system. It also did not give any insights to help understand what these referrals meant for the community or what services the community needed. The software did not allow practice staff to make referrals placing all the burden on GPs and PCN services.
The team had heard positive feedback from a nearby PCN within the area using a product called Joy. The ICB leads came to One Ellesmere Port with the proposition to move to another social prescribing tool. First introductions were successful with three stand out aspects to Joy:
1. Joy can collect data which is presented on a dashboard.
2. It enables coding to be integrated back into the clinical system, along with notes from the social prescribing team being transmitted to the patients' medical records.
3. Patients also have the option to view this information in their medical records if they wish.
The technical ability within the PCN varies, but the more services use Joy the easier it becomes. Initially the referral process was confusing for doctors as it was not clearly defined what each service provided. Joy heard this feedback and acted by adding pictures of each service with a detail section below so the doctor can clearly see who they are referring to. They also added an inclusion and exclusion criteria to be able to quickly determine if it's the correct referral.
"Joy is more than just a social prescribing software; it is a referral solution for the PCN. It is also a dashboard, a calendar, and somewhere where you can look at your clients more clearly.”
The transition wasn't without its ups and downs. The One Ellesmere Port team noticed some gaps in the Joy platform and provided this feedback in their regular meetings with the Joy team. When making feature suggestions Joy wanted to meet all needs but was realistic about what was possible and create clear timelines. Joy responded and rolled out a requested calendar feature, certain task buttons and specific templates. It took the clinicians around 2 months to get a hang of the system and notice positive difference.
After 4 months, the new features were implemented, and data was available to look back over the quarter. The data they received from Joy enabled the PCN to review and demonstrate the value in the investment.
Joy has improved the entire process of social prescribing and referral processes. Joy can categorise the patients, drive best practices for coding, and represent all data in a dashboard. One Ellesmere Port PCN was able to use this data to recognise the high demand on social prescribers specialising in nutrition and children. With this evidence the PCN council have now hired a health and wellbeing coach to support them.
With Joy, One Ellesmere Port PCN clinicians and Social Prescribers can properly code social prescribing referrals into the clinical systems. This has helped to receive additional funding from the Impact and Investment fund, an NHS funding stream. This stream provides indicators which must be met to unlock funding. By using Joy, One Ellesmere Port PCN have exceeded the social prescribing indicator by quadruple. At their quarterly meeting, One Ellesmere Port PCN will be using Joy to show how social prescribing provides more patient access. Joy has helped the PCN to set targets for capacity, manage workflow and understand what the community needs to plan effectively.
“Joy has helped us hit our targets and exceed them by 4x. This gave us even more confidence that Joy is worth the investment”
One Ellesmere Port PCN have added other personalised care roles onto the Joy platform including mental health workers, counsellors, and employment support workers.
The Joy system has multiple use cases. Since Joy is a single hub where clinicians and practice staff can access a list of services there are plans to develop this list so that more community support can be reached. One Ellesmere Port PCN are excited for the road ahead with Joy in partnership.
If you are a local service hoping to find out more information about Joy please contact support@thejoyapp.com