This discussion expands on a impromptu twitter conversation some of us took part in a couple of weeks ago looking at productivity and efficiency and technology in district nursing, you can catchup here. We Invited Nick Chinn (@NRCUK) to expand on the tweets in a formal #WeDNs chat. 

Nick has provided this pre-chat information for this #WeDNs taking place at 8pm on October 25th, please take a read and join the chat too that Nick will be co-hosting with us. 

Nick writes:

I’ve recently started working in London, a stone's through away from @DHgovUK and @NHSEngland, it's great seeing Parliament buildings, Big Ben, London Eye and the Thames regularly in my day, not everyone's cup of tea, but I like it. I used to do trips up from Bristol regularly but am now here more days than not; I’m about 2 months in and finding my feet.

“Wow it takes a while to get around” is my standard response when I’m asked “how’s it going?” by my new found local peers. Their helpful retort is “Are you using ‘this’ app, it’s free, live and will save you loads of time, I used to use a different app but this new one is so much better.”

On another note...

A friend of mine is getting a smart meter fitted today, to be honest he’s not really 100% sure why, we kind of worked it out in the end though His energy company can most likely lay off quite a few meter readers. He got sent the message the day before the appointment

In essence the text message says “We aren’t paying our meter installers to stand around and shift your stuff around and we want to get as many of these meters fitted in one day, so please help us out by not slowing us down when we get there.”.

We move on...

Who’s ordered a parcel recently, did you know what time it was going to arrive, who’ll be delivering it and how easy it would be for you to be there and not miss it, complete with information about what to do if you aren’t there?

What great "customer service", or is this all driven by the delivery company only being paid once to get the parcel to you? So getting it right first time manages their capacity and demand and profit?

Let's get back to where we started,  I’m heading back to London now from Bristol, I’ve a few choices:

1 - Train – 7am, I need to pay to leave my car near or at the train station, I might not get a seat, it’s quite time efficient and will cost me £102 plus car parking, so around £120 1hr 45mins
2 - I could drive, 6am, use my own diesel, park in London, takes a little longer than the train, can be a nightmare if there’s an accident or heavy traffic (there always is), around £30 and 3hrs on a good day
3 - Coach, 5:30am, I get free wifi, a plug and a table, if I’m lucky and have been good I get a lift down to the bus station, it takes a while, there’s 19 a day to choose from, I book via an app, £8 and  3hrs (I can sleep, work, or watch Netflix,or chew the ear off a fellow passenger)  

It is worth noting I remember traveling on the coach as a teenager “some years” ago, to see a girlfriend in Croydon, there were 2 coaches a day and if I recall it cost around £8 then too. And yes, I pick option 3 that gives me more choice, at a lower cost, and despite being slower gives me great value with more frills, they have used great tech to deliver an efficient service at a profit and enter the market with big blue coaches!

If you’ve made it to the end of the prechat you’ll see a theme, if you’ve not guessed it then it looks something like this:

All around us in our lives we are being presented with choices from companies that are made to look like they are helping us, increasing our choices and driving up the quality of these companies’ offerings, adding convenience and reducing costs to us; but in fact they are the result of the efficiencies being made in their organisations that often increase productivity and quality simultaneously, organisation that are great at maximising what they get out of the money they competitively receive from us their customers .

This discussion will explore why this efficiency, productivity and profit can be achieved all around us, yet there is a huge gap in this word and that of community care where IT/productivity/efficiency seems to have comparatively and significantly stalled.

I've some questions I hope you can help answer, indenting to help you by coming up with solutions from your answers:

Why is there still a huge gap, often void, on evidence and proactive value in areas of delivering care around capacity and demand, right skill/place/time/priority/acuity/continuity visit scheduling?

Why is caseload reporting still not accurate nor driving effective commissioning, coupled with skill gap analysis leading to quality workforce planning, training and recruitment?

Why is there still a need to evidence the complexities and impact of district nursing at a national level, highlights as a key theme at this years @TheQNI conference?

Why is the cry "we need more money" acceptable when we can't benchmark where we are now and where that money will take us, where's the data and evidence to support the cry?

Why can I see where parcel delivery Dave is on a map but a patient sits and wait for a DN and a workforce has no idea where all it's lone workers are?

Why is district nursing still, after all this time, "under so much pressure" yet working in the same way technology wise as it has done for "quite some time"?

Why have we not managed to use technology in the way other sectors have to either deliver more productivity or build cases to show investment impact potential?

About our host

Nick is the co-founder of WeCommunities, helping 100 volunteers to support over 300,000 healthcare professionals in the WeCommunities. With a database of over 4million tweets, over 1,000 archived tweetchats and many 100s using #MyWe for CPD and Revalidation Nick has helped put the technology in place to help us gather value from being tweeting healthcare professionals; Nick has been innovative in raising funds to pay for the technology, through evidencing value to funders, to make this unique technology work for us, all happening in his spare time.

In Nick's day job he is determined to transform the information we use to plan, deliver and evidence the care delivered in the community across district nursing, mental health, AHPs and socially delivered and prescribed services via low cost tools to schedule and evidence safe care making sure patients and staff needs no longer fall through the technology gap.

You can tweet with Nick via @NRCUK