Operational Support Session 05/02/2025
On 5 February we held our first Operational Support session, this was a opportunity for people to share what has gone well for their DESMOND services recently, as well as any challenges/barriers they are currently facing. There was a focus on ‘working with primary care’ but we also covered other topics. Below are the key points and some potential solutions - also above is video copy of the discussion should you want to watch this back.
CURRENT CHALLENGES AND SOME POTENTIAL SOLUTIONS (apologies that we didn’t get time to discuss everything on the call - some ideas have been added below and if you would like to discuss further, please contact your DESMOND Account Manager or email desmondnationalprogramme@uhl-tr.nhs.uk ):
High DNA rate - ELFT reported 82% DNA and that face-to-face is better attended. (Note - from DESMOND HQ - we are generally hearing that patients are wanting face-to-face options again, which in some areas is impacting attendance at virtual groups or digital options - this in itself presents some challenges to ensure have enough spaces available for everyone that wants f2f, when resources and funds are scarce)
Use of self-referral - create a QR code link to a means for potential participants to self-refer to your service (e.g. email/MS Form) - this can then be shared by the referrer, and rather than the referrer spending time completing the relevant referrral form they can use the time to have a conversation with the patient about the benefits of attending and the options available to support them locally. Further ideas related to Self-Referral can be found here including ideas for ‘direct to patient’ promotion and how the South Manchester DESMOND team took the plunge into self-referral and the positive impact this has had. We discussed creating FP10s/prescription sheets that could be given out by primary care staff - here is an example - get in touch if you would like something like this localising.
Regarding self-referral, however it would be worth considering how you screen for appropriate referrals based on your local eligibility criteria. Plus, you may need to work through the practicalities with your ICB about how you measure referral numbers and how GPs track this, maybe retrospectively adding relevant read-code (we discuss this topic on the video above at about minute 40).
Localised promotional resources with your Trust/organisations logos on, so when you calling or send letter to patients they know who to expect these from - using lines such as “brought to you by XX nhs Trust”
Running all-day/6-hour face-to-face sessions rather than splitting - participants then attend once and are deemed completers.
Think about your pathway - what is your local process once you receive a referral? From Northants, as well as our own locally, we have seen greater success in uptake and attendance when patients are called on referral, so you have the chance to discuss the benefits of attending and what a group is like. This is then backed up with an email or letter confirming the booking and a copy of the Preparing for DESMOND leaflet. Northants also found attendance improved when such calls were made quickly after referral.
If you do not have the administrative resources to call all patients you may want to consider using an ‘opt-in’ process - this is where on receipt of referral you send a letter/text to the patient with details of their options for diabetes education and ask them to contact you (call, email or text back). With a caveat that if not heard within 4-weeks they will be discharged back and notification sent back to GP.
Other pathway ideas can be found here Your Pathways & Processes — DESMOND
Nudging - If you don’t already, think about calling or texting people who are booked 24/48 hours before. You may want to include the approximate cost to the NHS for not attending - this has had a positive impact on update of NHS outpatient appointments so might be helpful here.
Reduced number of referrals to service / Low referral numbers.
See suggests below regarding ‘working with primary care’
You may also want to investigate what/if patients are being referred to other services - for example, are they being referred to national digital provision (e.g., the NHS Healthy Living programme)
Are primary care/referrers recording if patients have turned down a referral and if so, do they note reason for this? If so, is it possible to get this information.
You may want to try to survey your local population to ascertain reasons for low uptake - work with your local ICB to look at this and use their channels to spread the message - here is an example of such work in Greater Manchester
Consider training up Practice Nurses/staff as Educators - in Northamptonshire this has helped increase uptake/attendance from patients within the Practice where the Educator works - this helps with the ‘selling’ of the idea of education to patients.
Thinking of ways to engage differently with younger age referrals - we discussed this very topic with delegates at the 2024 Awards event - click here to read what they came up with.
Engaging with GP Practices. - see section below for ideas.
GPs re-referring people that have DNA’d previously (i.e., were booked but did not attend on the day)
ELFT shared how they are looking at working with GP practices to offer space at their practice where groups can be held and then it would be the practices responsiblity to fill the group. Cumbria have also tried this approach. (Note - DESMOND can help you develop a tailored evaluation form for this, so you can capture information that will be helpful for future offer).
ICB are querying DESMOND for patients with mental health conditions.
We have had some organisations that have offered DESMOND through their local recovery teams as well as to in-patients. There are a number of key considerations such as concentration time - click here to see our suggestions or contact your DESMOND Account Manager to organise a call with our training team for further details (additionally we can support you in the evaluation of any bespoke delivery/groups - please get in touch if you would like to discuss this also)
New DESMOND Service.
Welcome to DESMOND! We hope the discussion, this article as well as other articles on the Embed DESMOND portal will be useful in helping you get set-up - please do not hesitate to get in touch with your Account Manager or via desmondnationalprogramme@uhl-tr.nhs.uk with any questions you still have.
Figuring out admin/sign up for BABYSTEP app.
Please contact us on mydesmond@uhl-tr.nhs.uk with any questions about getting started with offering any of our digitial programmes.
Here is a link to the Northamtonshire article from when the team won the IMPACT award; this has some great ideas of how technology and working closely with your ICB can enhance the administration of your DESMOND services. Improving administration efficiency to increase uptake of DESMOND in Northamptonshire — DESMOND
Other news articles which include case studies from other award-winning DESMOND sites can be found here News — DESMOND
WORKING WITH PRIMARY CARE: Here are some ideas for how to work more closely with primary care and support the use of better quality referrals:
Allow practice staff to book and observe a group in action
Develop a poster about staff observations - like this example from Nottinghamshire (if you would like one developing by us for your area - get in touch with your DESMOND Account Manager providing all relevant replacement text and information pertinent to your organisation).
Write a regular newsletter - including what DESMOND is and its benefits to patients, referral process, ideas of how they can promote the service in their practice and how you can support them with this, some evaluation data and quotes from participants, plus any comments from staff that have observed also.
Provide flyers/posters/banner stands.
Advertise on the practices websites - provide some standard text, images & logos to help them with this.
Create an animiation or PowerPoint slide set for use on the waiting room screens - here is an example you can amend and you can then save this as an MP4 file depending on the file type needed by the practice.
Create a document or video for staff about your service inc any FAQs you regularly get from primary care staff/referrers about group programmes or you may want to share this presentation about MyDESMOND and its key functionality
Attend any local protected-time events - try to get a short slot on the agenda or a stand where you/your educators can role-play a section of the curriculum so they get a feel for what it is like for participants to attend.
Or similarly find out if each practice/PCN has staff meetings and seek to get a slot on the agenda.
Consider how to embed your referral forms within GP system so they self-populate with a few clicks - provides more time for discussing the benefits of attending and next steps.
As mentioned above consider the use of self-referral with QR codes directing patients to booking themselves - taking the onus off primary care filling in paperwork. This article includes how the South Manchester DESMOND team worked with GPs/Primary care when they launched their self-referral only route.
You may also find some additional ideas on these two articles:
If you would like to explore any of the above further, would like any of the promotional information localising or have any other challenges currently please get in touch with your DESMOND Account Manager in the first instance (if you aren’t sure who your assigned A/C Manager is please email desmondnationalprogramme@uhl-tr.nhs.uk to find out). We will then work with you to support you in any way possible.