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It is a startling fact that one in four people will suffer some form of mental health illness in the course of a year, and that 10 per cent of children will experience problems with their mental health at any one time. Yet against this backdrop, spending on mental health services has actually fallen in England for the past two years.
Facing up to these tough financial times, and the challenges posed by the unprecedented changes in the way the NHS manages and commissions services brought about by the Health and Social Care reforms, means there is a strong focus by mental health trusts on streamlining services to increase efficiency and improve care.
One such pioneering trust, the Lincolnshire Partnership NHS Foundation Trust (LPFT) has redesigned and re-engineered access to its services to connect people with the right care option as quickly as possible. Using an innovative single point of access service – underpinned by a virtual contact centre hosted by BT in the cloud – the trust is delivering higher quality care at lower cost.
LPFT, which provides specialist health services across the county for people with learning disabilities, mental health, and drug and alcohol problems, is placing greater emphasis on prevention, increasing independence and providing more care at home while reducing admissions and length of stay.
Serving a population of 735,000 in Lincolnshire, the trust’s work is increasingly community based. It provides a wide variety of mental health and social care services in partnership with local councils, primary care trusts, charitable and voluntary organisations, as well as regularly working with and consulting services users, carers and their representatives.
Top of LPFT’s agenda over the next few years is the implementation of its clinical transformation plan which has been devised to ensure that it is best placed to withstand the financial challenges and structural reform of the NHS.
Developed in consultation with its staff, governors and the people who use its services such as carers, patients and GP clinical commissioning groups, the plan provides LPFT with a better informed view on how it needs to change and adapt its services to meet the changing needs of patients and to improve the quality of care.
Managing referrals more effectively and efficiently
One of the key initiatives coming out of LPFT’s clinical transformation plan is its Single Point of Access (SPA) project which first went live in the south west of Lincolnshire and aims to manage referrals more effectively and efficiently to make it easy for people to access its services.
Unlike similar projects of its kind where trusts offer a single point of access for a specific specialism, LPFT’s solution is very different and covers every service it offers.
Designed for both routine or urgent referrals and enquiries, the SPA is staffed by 13 fully qualified and skilled healthcare professionals 24 hours a day, seven days a week, 365 days a year. Based in Grantham, the team provide advice and guidance through a triage process, where the urgency of care required is assessed.
The SPA provides a first point of contact for medical professionals and people aged 18 and over who wish to use its services in Lincolnshire. This ranges from GPs wanting to refer a patient to one of LPFT’s specialist services to members of the public.
The project represents a radical departure of how referrals used to be handled within the trust, when callers would contact the various services it offers directly from across the county. It was then largely the clinicians’ responsibility to triage patients, enter them into the system and arrange appointments.
This not only tied up clinicians with unnecessary administrative work but also, having so many different ways of contacting the trust, meant that accessing mental health services could sometimes be confusing and time consuming.
The new SPA project means that users of LPFT services, both medical professionals and the public, will no longer have to phone around to find the right service to meet their needs – the SPA will provide direct access to all LPFT’s specialist and wide-ranging services.
How it works
Once the contact centre receives a referral, an agent will contact the patient directly to organise a triage assessment to determine which service would best suit their needs. Based on the information received, and in line with commissioning guidance, they will then be automatically signposted to the most appropriate team for assessment/treatment, or in the case of an emergency, referred to the crisis resolution and home treatment team.
Once fully implemented, all referrals will be channelled into BT Cloud Contact, a pay-as-you-go cloud-based contact centre which has enabled the trust to create a multi-channel contact centre at minimal cost. Users of the system can use whichever method they prefer to get a referral. This can be by phone, post, email, the web or the electronic booking service, Choose and Book.
Already, the response from users of the service has been positive. Patients, carers and GPs have been impressed at just how quickly and easily they can get in touch to arrange appointments. Typical of the many sentiments expressed was one patient who wrote to thank LPFT for their help, saying they “couldn’t believe how quickly the referral was managed.”
The reaction from GPs has been equally as favourable. They say the system is working well and that in some cases appointments are being made on the same day as the patient saw his GP.
The SPA service is currently being rolled out across the county over the year and is aligned to the new Clinical Commissioning Group areas. The first area to go live was South West Lincolnshire, which includes towns such as Sleaford and Grantham. This was followed by South Lincolnshire covering towns such a Spalding and Gosberton and will be followed by Lincolnshire East and finally Lincolnshire West.
The SPA project has already had a major impact on the way the trust delivers services, transforming the way clinicians work.
Steve Lidbetter, deputy director of performance and information and technical lead for the project at LPFT, explains: “The strategy behind the SPA project was very much about improving the experience of users of our services – patients and referrers – and this is already bearing fruit. Since the service was launched we have already noticed a reduction in inappropriate waits and duplicate referrals. By directing each referral to the most appropriate treatment pathway in the first place we are reducing the time our clinicians spend on administration and freeing them up so they can spend more time with patients.”
Previously, clinicians were making all the referrals and inputting patient details into the system. This is all now done by the SPA teams and so clinicians now have that element of time back.
“As a result the clinicians’ workload has changed and they are seeing more patients and consequently increasing productivity,” confirms Steve Lidbetter. “For patients it means that referrals are being handled more efficiently which means in some cases waiting times for assessment are now down to a couple of weeks and in a few examples just a few days.”
Trust business manager for general adult mental health services, Martin Vokes, says: “When we first started looking at introducing a single point of access service the last thing we looked at was the technology. The project was all about connecting care. It was about redesigning the way we provide services so we could connect people with the right care option as quickly as possible. It was only when we were at the final stages did we consider the technology.
“We chose BT Cloud Contact because it ticked all the boxes. Because it is cloud-based, the infrastructure element is taken care for us so we didn’t have to build and maintain a load of servers. We also wanted a system that was easy to use and could handle a variety of different channels ranging from voice, email, web, and Choose and Book.”
In these financially challenging times a key priority for the trust was cost. As it is a pay-as-you-go service there was no big upfront investment and the cost was significantly below a traditional self-hosted contact centre,” reports Martin Vokes. “Flexibility was a key priority. With BT Cloud Contact we only pay for what we need. We can flex up and down on a monthly basis to react to demand without tying up significant capital investment.”
- BT Cloud Contact