With the publication in January 2024 of the Near Me Final Report, Hazel Archer (Head of Programme) and Marc Beswick (Digital Education and Adoption Lead) reflected in their first blog on the rise of video consultations and embedding them as part of Business as Usual across healthcare settings in Scotland.

In this, follow-up blog, they focus on some of the work in the social care sector, the use of Group consultations some of the underpinning enablers that allowed the rapid scale-up.  They complete their round-up by launching two new E-Learning Modules.

Social Care

Use within Social Care and wider public services started later and is less well developed but was tested in several areas.

• The new benefits system established by Social Security Scotland is now routinely using Near Me for a range of client contacts including identify verification and assessments.

• The Institute for Research and Innovation in Social Services (Iriss) enabled five Social Service organisations to embed the use of Near Me across a variety of services.

• Care home care reviews were another area explored. This was a joint programme with the Scottish Government’s Office of the Chief Social Work Advisors and 11 Health and Social Care Partnerships. This was in response to a national requirement to accelerate care reviews for all people living in Care Homes during the period of COVID-19 imposed visiting restrictions.

• The Scottish Prison Service is aiming to install in cell digital devices in 2024. This will make digital services such as Near Me accessible to individual prisoners without the need to move them to a dedicated space within the prison campus.

Until Near Me is further embedded in social care there will be ongoing support from the National Video Conferencing Service (NVCS).  They will continue to have access to the tools and technical support necessary to help them grow and eventually move to Business as Usual.

Group Consultations and Consult Now

Group consultations are delivered by a clinician to a peer group of patients with similar health issues. This includes conditions like diabetes, COPD, ante-natal clinics, and mental health such as anxiety. Typically, they replace routine return appointments (in primary and secondary care) or provide an alternative to in-person groups.  They are different from self-help, and peer-support groups in that ‘their’ clinician leads the session. The facility to hold Group Consultations was fully launched in January 2022.

Before this innovation, group consultations weren’t always easy to access for many and had the associated challenges of finding suitably sized venues with parking not to mention the added inconvenience of people having to travel.

There have been around 11k group sessions held and over 51k callers attending. Near Me continues to scale-up as more patients opt for remote consultations | FutureScot

The Consult Now feature is another development based on feedback from clinicians.  This allows providers to immediately invite people into a call, bypassing the normal waiting area. This is particularly useful where there is a need to escalate from a phone call to a video consult e.g. in Primary or Urgent Care. In addition, Consult Now calls are easier for callers to join therefore increasing accessibility for those with sensory, cognitive or motor difficulties.

Equalities, Engagement, and Evaluation

National public engagement and the Equality Impact Assessment process have reinforced the benefits of using video including across all protected characteristic groups.  It has also helped to inform ways to increase accessibility. This includes the development of the provision of over 60 Community Hubs in libraries, community halls, and NHS sites. This enables people who cannot have a call from home (for whatever reason) to have a Near Me call near home. Information on locations of Community Hub is accessible from the public Near Me website. It was nice to see this highlighted in the recent Audit Scotland Report NHS in 2023 as an example of good practice in addressing digital exclusion.

The Near Me service has been independently (and positively) evaluated by Oxford University both pre-COVID and during covid.  In their publication, ‘Scotland the Brave: A national case study of rapid scale-up of remote video consultation services in the Covid-19 Pandemic’, published in June 2021, Wherton et al concluded “Scotland provides an important case study from which other countries may learn.”

Scotland the brave: A national case study of rapid scale-up of remote video consultation services in the Covid-19 pandemic (Preprint) — Nuffield Department of Primary Care Health Sciences, University of Oxford

Guidance and Learning

Working in partnership with colleagues in the Digitally Enabled Workforce Team in NHS Education for Scotland, Shared Guidance and learning programmes were developed. Using a multi-channel approach, information has been disseminated via published reports and guidance documents, case studies, videos, webinars, presentations at conferences and events, and social media activity including blogs.

Building on this work two eLearning Modules were launched in January 2024

E-Module 1: New to Near Me Video Calls?

E-Module 2: Near Me: Video Consultation Skills

We were delighted to see our colleagues in the Digitally Enabled Workforce Team @nes_dew receive the Digital Health and Care Team Award. Also short-listed in this category was the work of NHS Grampian to reduce waiting times in Oral Maxillofacial and Oral Surgery by adopting the use of Near Me and NHS Greater Glasgow and Clyde’s work on Flow Navigation Centre, more on that below.

Looking Forward

The Audit Scotland Report published on 22^nd February highlights that significant service transformation is required across Scotland’s health and care service, commenting “Adopting digital healthcare solutions is one way the NHS can identify efficiencies and increase productivity, both in response to immediate pressures and to enable longer-term changes in how health services are administered and delivered.”

For our part, we are hopeful that the use of Group consultations will go from strength to strength. We believe it has the potential to be transformational once scaled up.  As touched on earlier, we have more to do with colleagues in social care and social work. The comments from Councillor Paul Kelly at Digital Health & Care Scotland Conference in February highlighting support for Near Me was encouraging.  Finally, the Use of Near Me in Unscheduled Care by NHS Greater Glasgow & Clyde  is groundbreaking.  Their virtual A&E allows thousands of patients to access emergency care without having to attend hospital. The potential for greater use of this model across Scotland should be considered, Feedback on the service has been very positive. Over the past year, 4,226 patients responded to their survey, with 98 percent saying they would use the service again if they needed advice, care, or support with their health.

One person responded: “Being able to have a video call and show my injury was a lifesaver.”

Thank you

The scale-up of Near Me offers a great example of delivering a Scotland-wide service benefiting both citizens and service providers.  It required a team Scotland approach, and we are grateful to each and every one for all their efforts to embed Near Me as a choice for our citizens. Please continue to offer this as a choice and encourage others to do so. Thank you.

Further information

Visit www.tec.scot/nearme to find out more and get started or contact nss.nearme@nhs.scot

Hazel Archer

Marc Beswick