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W3C-validated transitional XHTML 2.7 First steps: What are your staff able to do?
It is vital to involve professionals in helping
identify the information needs of their patients and carers. They
should also actively participate in the project planning and process
design essential for the successful implementation of IPs locally.
Pilots discovered that organisations could only gain the active and
enthusiastic participation of professionals by involving them from
the very beginning. Many pilot sites found that involving professionals in stakeholder processes with users, carers and the voluntary sector helped professionals to buy into the process. They could hear at first hand what users felt they were missing and what they could gain.
Once you have decided where you want to focus your efforts, think about the network of people you need to work with to prescribe, dispense and provide reliable information. Draw on this network to organise your project team. Win over one or two professionals and use them to influence others.
Depending on the setting and the focus of the project, project teams could either allow other colleagues to 'opt in' to the process or make doing so a requirement.
Either way, most pilot project members found they needed to win over their colleagues. Many adopted a staged approach. In some cancer sites, for example, Clinical Nurse Specialists (CNSs) were involved in the development of the process and only later broached the idea of prescribing with the consultants.
Whilst users and carers are likely to be responsive to requests for feedback or invitations to participate in the project in various ways, the involvement of professionals will be more difficult because of time pressures.
Here are some examples from the pilots who successfully engaged professionals.
Hammersmith and Fulham PCT: Engaging GPs
This trust has recent experience from other projects of seeking the engagement of staff. The learning from this, as expressed by the chief executive, is that you need:
- money – direct financial compensation for additional tasks
- QOF incentives – either directly or indirectly through the local assessment process
- to make it easy – ensure it can be delivered through existing systems, anything which requires training (more than about 10 minutes) or extra preparatory reading, or logging into or out of new IT systems will not work.
- to show it will reduce pressures – give evidence that it will reduce the number of patient visits or reduce the level of support necessary for people with long term conditions. This could be done through hard evidence-based studies (which would have to be done later), or through case studies with named doctors.
Suffolk: Making connections with stakeholders
Having met some initial resistance from clinicians, especially GPs, the Suffolk team developed a PowerPoint 'script of reassurance'. This script emphasised that no power is being taken away from GPs, indeed that IPs could help improve the efficiency of GPs services rather than add to the time given to each patient. The concept of 'selling' the IP has been successful so far, with GPs becoming more responsive.
Aware that the size of the IP 'audience' is very large (users, clinicians and the voluntary sector), the Suffolk team have held county-wide workshops for voluntary, health and social services to raise awareness of the project. The team have also made links with the Expert Patients programme, and Expert Patients now form part of the project's user panel. These engagement activities have helped the project build strong relationships with the Alzheimer's Society, which has facilitated user consultation, and Age Concern, which might dispense information.
Darlington: Getting buy-in from primary care
The project manager convened a meeting of key leads in primary care and explained her vision for IP. She picked leads from certain conditions that did not seem to be covered by other sites at the time, namely diabetes, hypertension and depression. Having persuaded them to be involved, the project manager set up a Steering Group with representation from voluntary bodies, social services, libraries, 'First Stop', practice nurses and community matrons.
In 'selling it' to primary care practitioners etc, the project manager emphasised the following:
- keeping it simple
- that it's not going to increase their workload
- that it's not about re-inventing the wheel.
On the next page: What information sources do you already have or need
