Case Study: NHS Near Me

About

My name is Laura Cowan and I work for Sense Scotland. I have worked in the field of Deafblindness for 25 years. I support Bella age 77 who has a severe visual impairment, mental health difficulties, and increasingly deteriorating mobility due to arthritis. She also struggles with social anxiety, and fear around NHS and Doctors. Bella’s vision is deteriorating due to having poorly managed type 2 diabetes. Bella also struggles with understanding spoken words she will misunderstand and misinterpret what people say and requires much of what people say to her to be clarified and repeated.

Aims

Bella’s difficulties make it very hard for her to engage with medical professionals. I have tried strategies around providing transport, wheelchairs, asking a family member to accompany her, and I have had separate discussions with medical professionals prior to Bella’s appointments to explain the communication & physical support she requires, but in the last few years, she is choosing more and more not to engage. Due to a new, possibly serious health concern, I felt it important that on this occasion we needed to ensure Bella understood exactly all the pros and cons of any decision she made around her treatment. Due to Covid-19 doing this face to face was even more of a challenge.

Actions

I tried working with the consultant, his admin support team, the ambulance service, two of Bella’s family members, the GP, the mental health team, and the care providers, to encourage Bella to attend an appointment at the hospital. None of this was effective.

I was then asked to look at the Near Me/Attend Anywhere service offered by NHS by my manager. Near Me, powered by Attend Anywhere, is a secure NHS video call service for patients with pre-arranged appointment times. The service is best accessed using the Google Chrome web browser on a PC or Safari on Mac (webcam required), or on an Android or Apple smartphone. I downloaded the Google Chrome search engine into my Android Tablet and called the consultant’s secretary requesting a Near Me consultation with him. His secretary talked me through how to access the service, and with my own skills in IT, I had a practice session to see how accessible this would be for Bella. It seemed like a great solution.

Outcome

On the day of the appointment I had arranged a visit by the Mental Health Team. They explained how important it is for Bella to take care of her health. Bella was given time to say how she felt and express any worries she had about her health. 10 minutes prior to the appointment I logged into the NHS Lanarkshire webpage. The Near Me logo/button is on the right-hand side at the bottom. It was too small for Bella to see she needed my support to locate and click on this.

To find the correct clinic you need to scroll down quite far I supported Bella to do this. There is a subtitled video on the home screen which explains in simple terms how to use the app.

There are boxes with the names of the clinic available. Each hospital department has their own virtual waiting room. To start the video/call click on the icon for your chosen clinic. It’s best to practice before the day. Once Bella and I pressed the start video call, we had to wait for 35 mins for the doctor. The phone number on the letter from the consultant can be used if there is a problem, when I called they reassured me that the appointment was going ahead, so I reassured Bella that it would be ok and supported her to wait. The Consultant was trying to locate a room and IT equipment for the call.

The Outcome was that Bella had her discussion with the Doctor. Bella was relaxed in her own home and was able to concentrate on what the doctor said and listen and retain the information. Having my support to translate the medical terms the Doctor used into something Bella understood was important. Bella is now considering whether to go through with the procedure the Doctor suggested, although it was a difficult conversation for her, being at home reduced her anxiety levels.