eConsult - eHub

Alliance for Better Care – Benefit of federated working in an eHub using the Smart Inbox

eConsult eHub

• Sussex ICB
• 15 practices
• 169,178 patient list size
• Live with eConsult since October 2022

The eConsult Health detailed change management programme enabled Alliance for Better Care (ABC) to set up a highly effective digital-first eHub that manages the routine online consultation work for 15 practices within Sussex ICB. The structured approach to training and process development, combined with the use of the eConsult Smart Inbox, enables ABC to manage safely all inbound eConsults. This has a significant impact of reducing the pressure on the practices. 

Careful and structured planning is required for eHub success 

The initial reason for setting up the eHub in Sussex ICB was to help practices manage their winter pressures during core hours. The centralised hub would take on additional demand that came in via online consultations utilising a specialised team, made up of GPs, ANPs, Clinical Pharmacists and Care Navigators, to remote close or direct online consultations back to their practice with triage information. With such a successful start, the eHub has expanded past the winter period and is now taking on further practices, growing from 12 to 15 practices. 

The ICB and Alliance for Better Care wanted to create an eHub which would both help practices handle demand, but that could also be implemented with as little disruption to practice staff as possible. To ensure this would be possible the eConsult Transformation team worked closely with the Alliance for Better Care team to design an eHub which worked across all practices. 

“Tom really helped that because he had the headspace and the knowledge of the products and solutions to common issues. And that is why it’s worked. If we had not actively made improvements to the model once the project went live, the eHub would not be as successful as it is

Rebecca Slattery-Kavanagh, Head of Projects, Alliance for Better Care

ABC started by speaking to other eHubs to take onboard their suggestions and learn from their experience. The Transformation team at eConsult led the ABC team through a structured programme of change management sessions designing the new workflow process and an initial roll-out plan. This started with a smaller group of practices who had voiced their desire to be part of the eHub from the go-live date. 

Looking back, the team have made a lot of changes to their workflow processes, but because of the structured approach led by the Transformation team and the ongoing support provided, the focus has been to evolve the eHub rather than fix issues. 

Since going live in October 2022, the eHub has grown from an initial 8 practices to recently adding their 15th practice as the benefits of managing online consultations in this way have been recognised in the local area.

The eConsult smart inbox enables an eHub with different clinical systems across the practices to function effectively

Alliance for Better Care is in the unusual position of setting up an eHub with practices using different Clinical Systems and requiring the eHub to manage their eConsults in different ways. Allowing this flexibility has only been possible using the Smart Inbox. Normally when setting up an eHub, practices would decide if eConsults are initially directed to the eHub which reviews and triages eConsults first, or, if the eConsults are sent first to the practice, which would then triage certain work to the eHub to manage and close. 

In the case of ABC, the team have enabled both. This has given practices the flexibility to decide how they use the eHub as a service, and the eConsult Smart Inbox gives ABC the ability to do this. 

“The Smart Inbox pulls all the online consultations together, without differentiating between the two clinical systems which makes it easier for us to manage”

Rebecca Slattery-Kavanagh, Head of Projects, Alliance for Better Care

With the Smart Inbox, the practices no longer have to email everything to ABC, instead, everything flows directly into a shared inbox, which can be filtered and sorted based on a number of criteria. This gives the centralised team the power to prioritise work, review all online consultations within the required time and triage as required. 

With such a diverse demographic across all the practices, this flexible approach has been essential to ensuring the eHub has been a success. 

The eHub now deals with approx 45% eConsults, sending 55% back to practices with triage notes. This takes a huge workload off practices and means at least 98% of eConsults across the whole eHub are now reviewed and triaged on the same day. 

Ongoing support is key to success 

Throughout onboarding and post-go live the eConsult team has been on hand to help ABC develop their eHub and fix any issues that have arisen. 

Following the successful implementation, eConsult’s customer operations team is available 8 am to 8 pm, Monday to Friday, via online chat, email and on the phone. ABC and all practice teams also have access to a wealth of training materials, guides and FAQs. The ABC team also noted how quick the responses were from the eConsult team when compared to other suppliers in the market (the customer operations team work to a 5-minute response rate).

Looking back – the journey so far

Looking back on the process of getting to where they are, the team had some key advice to give to other PCNs, federations or clusters looking to set up an eHub.

• Planning is crucial – to ensure that the eHub works in an efficient way and delivers the desired benefits takes time and planning. Using a team with expertise in this area will speed up the time it takes to realise the benefits. 
• Implementation and operational services are the crucial cost – While it will require funding to bring in staff to manage the eHub and incoming online consultations, the crucial cost to a successful eHub is in its implementation. Spending on a team with expertise will bring a greater return on investment.
• Build the team to manage your needs – Different eHubs require different teams. Understand the critical success factors of the eHub and build a team capable of delivering these targets. For example, if you want to use local signposting you will need a team that understands the local signpost options. This can be difficult when working in a large federation.