Urgent and Unscheduled ‘Primary Care at Scale’

DocAbode® is an innovative software platform to help the GP practice of the future match capacity to demand by widening the network of a flexible, sustainable and local clinical workforce. This new system supports cross-organisational collaboration, efficiency and workflow integration between primary, community and urgent care providers.

Project Lead

Dr Taz Aldawoud, Doc Abode Ltd

When did project start?

January 2016

Clinical Requirement

Out-of-hours (OOH) GP services in England costs approximately £400m annually and handle around 3.3 million face-to-face consultations, of which 800,000 are resource intensive and costly home visits, leading to consistent failures to meet national quality standards. With a rapidly aging population and increasingly complex co-morbidities, we require the workforce to be able to respond to the population’s specific needs in order to avoid unnecessary hospitalisations. Despite this, practices and urgent care providers are struggling to recruit and retain GPs at a time of unsustainable demand on acute NHS services.

A mechanism is required to access a wider, sustainable and resilient clinical workforce that is able to respond dynamically to the needs of our NHS. The GP practice of the future will be increasingly expected to manage unscheduled and urgent primary care demands, blurring the boundaries between what is traditionally known as ‘in-hours’ verses ‘out of hours’ services.

The Solution

The DocAbode® platform matches capacity to demand by widening the network of a flexible, sustainable and local clinical workforce. It is a well-developed concept, building on the business’s in-depth knowledge of the GP and OOH provider context in West Yorkshire.

At the outset of the project, the D4D team worked with Doc Abode Ltd, assessing the regulatory risks and recommending ways to address all the remaining regulatory requirements. Since then, the major focus of the joint work has been on validating the DocAbode App and development tools to help support its adoption.

This has led to the development of a Project Development Hierarchy, and work on delivering the first 3 steps in this process:

  1. Development of a stochastic model of GP behaviour when offered opportunities to accept OOH ‘jobs’;
  2. Holding a GP Focus Group to validate the initial assumptions in the GP behaviour model, and in the design of the DocAbode App;
  3. Designing and helping to organise the collection of a clinician questionnaire to refine the parameter estimates for the GP behaviour model.

The initial findings of the GP behaviour model suggest that the DocAbode® concept is a feasible approach to meeting peaks in demand for OOH services.

Since this initial phase of the project was completed around mid-2016, D4D has continued to work with Doc Abode Ltd to help deliver the Project Development programme, and to continue putting together the consortium necessary to deliver and validate the complete DocAbode® solution.

Impact

At present, the validation work, modelling and trial for the DocAbode® concept has helped to gain the commitment of a pilot organisation that aims to start using the DocAbode® platform during the first half of 2017. A rigorous assessment of the effectiveness of the technology will simultaneously be undertaken to support its wider adoption across the NHS.

Partners

  • Doc Abode Ltd
  • Digital Health Enterprise Zone Ltd
  • Answer Digital Ltd.
  • Local Care Direct Ltd
  • Devices for Dignity HTC at Sheffield Teaching Hospitals NHS Foundation Trust
  • Nine Health CiC
  • Medipex Ltd
  • X-Labs Ltd (NETIMIS Software)
  • Yorkshire and Humber Academic Health Science Network (Y&H AHSN)

Investment

This work has received support from the Yorkshire and Humber Academic Health Science Network (YH AHSN).