Urgent and Unscheduled ‘Primary Care at Scale’

DocAbode® is a real-time clinician deployment platform that safely connects a multi-disciplinary clinical workforce to NHS patient needs based on availability, proximity and expertise.

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 the initial phase of the project was completed, D4D 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

Doc Abode have announced a partnership with Local Care Direct to launch the first Doc Abode service in Leeds in 2019. Local Care Direct was part of the initial pilot and evaluation of the Doc Abode platform, and plans to extend the implementation to other areas of West Yorkshire are in place.

Partners

  • NIHR Devices for Dignity MedTech Co-operative at Sheffield Teaching Hospitals NHS Foundation Trust
  • Doc Abode Ltd
  • Digital Health Enterprise Zone Ltd
  • Answer Digital Ltd.
  • Local Care Direct Ltd
  • 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) and the Small Business Research Initiative (SBRI).