What did the codesign process change?
| Ideas or learning identified by participants | Change to the process |
| Technical | |
| Near Me may not be accessible for patients due to its technical specification | Provided information about the technical specification on the Near Me website Near Me platform provider has lowered bandwidth requirements to improve accessibility—technical requirements are low |
| Patients’ equipment may not be compatible with Near Me system | Added a ‘line check’ step into the process before first scheduled appointment |
| Need to provide support for patients who encounter difficulties with using Near Me | Telephone support in place (local number first but as a team of two insufficient, national back-up added) Introduced Friday afternoon virtual ‘drop in’ sessions for anyone wanting to try out accessing Near Me for an appointment from home Link made with charity AbilityNet who will support individuals with technical difficulties on a one-to-one basis |
| Concerns over security of system and privacy | Increasing awareness of safeguards in place (local and national) and highlighting that there is no recording of consultations |
| Unexpected connectivity issues on the day of the appointment | Text reminder sent trigger patient to check connection Telephone consultation used as a contingency |
| Information | |
| Near Me information leaflets not fully understood | Posters and leaflets about NHS Near Me were tested and codesigned with participants and distributed across NHS Highland |
| Patients did not know what to do when their call was not connected quickly | Information added to the main NHS Near Me reception waiting screen which included a phone number to call if not answered within a specific time frame Capacity doubled at the Near Me reception process by installing a second computer terminal |
| Provide a direct link so that once people click on their appointment it will take them directly to the receptionist Provide a Near Me app | Single point of access for all appointments, so specific links are not needed: https://www.nhshighland.scot.nhs.uk/NHSNearMe/Pages/Welcome.aspx This is sent in text reminders (appointments are by letter not email) Patients can add a shortcut to the webpage to their phone/tablet, which is faster than an App. |
| Patient and clinician decisions | |
| Video appointments are not always clinically appropriate. Concerns highlighted included patients receiving difficult news, some mental health conditions and the need for physical examination | Clinician makes the decision whether to offer, or not, Near Me on an individual appointment basis and the patient can choose to opt out |
| Patients may not get a choice over whether to use Near Me or have an in-person consultation | The method of returning appointments should be discussed between clinician and patients, allowing the patient to choose. For new appointments, patients will be contacted to allow them to opt out of the Near Me option and choose a traditional appointment |
| Concerns over the technology being too difficult for some people to use | Staffed NHS Near Me rooms set up where people can go to have a member of NHS staff support them to call, that is, Local GP practice |
| Suggestion to register patients with the Near Me service so only these patients are offered consultation using Near Me | After exploring this, it became apparent that this was not a suitable option. It would have prevented patients from being offered a Near Me appointment who had not heard of the system previously and it there was not a complete list of patients to contact to offer the service. However, learning from this initiated a new system of annotating patients records as to whether they had opted for Near Me appointments. This remains a patient choice as they can still request a physical face-to-face consultation |
| Near Me enables patients to have a family member or friend present | All clinicians are made aware of this function in training so they can offer it to patients Patients and patient groups informed whenever there is an opportunity to discuss Near Me |
| Spread use | |
| Patient suggestion to promote NHS Near Me from ‘word of mouth’ using the patient experience | Patient stories have been captured and shared anonymously via the press and social media. A short film has been made with a patient |
| Lack of awareness among secondary care clinicians—participants recommended face-to-face meetings with clinicians to encourage them to offer patients the Near Me option | Every clinical service in NHS Highland was contacted and offered to meet to discuss NHS Near Me. There are now 27 services providing Near Me appointments, with more meetings to follow. |
| Obtain buy-in from local clinicians—patients said this was essential as patients are more likely to trust a local clinician whom they know | Information sent to all GP practices across NHS Highland. Meetings held at some GP practices. Difficult to visit all practices due to the number of practices and geography. Alternative meeting options are being explored, that is, web casting. |
| Continue to evaluate Near Me to gather further feedback and adapt as required | A patient feedback survey was added to the NHS Near Me system, which pops up automatically after each call. |
GP, general practitioner; NHS, National Health Service.