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Meet the team: Debbie Johnston

The Four Eyes Insight (FEI) team is made up of over 40 consultants, subject matter experts, analysts, project managers and administrators and we want to shine a light on how wonderful they are.

This month, we spoke to Debbie Johnston, FEI’s Endoscopy Subject Matter Expert about her passion for optimising endoscopy services, which is a critical step in a patients’ diagnostic care pathway, her career highlights (including why she’s known as ‘Mrs JAG’!) and what she gets up to in her spare time.

Background

Having trained as a registered nurse, Debbie held several NHS nursing and managerial roles, starting in A&E before taking a more specialist interest in endoscopy.

In 2001, Debbie was recognised for her endoscopy work and asked to take on the role of National Endoscopy Programme Operations Director, leading an NHS endoscopy improvement programme. Working alongside Dr Roland Valori, Debbie spent 10 years reforming endoscopy services across the UK, in which time she and Dr Valori were the recipients of national leadership awards. Debbie took a holistic approach to system improvement which resulted in the creation of a national framework for endoscopy. This framework included national standards for the endoscopy accreditation programme launched in 2005 by the Joint Advisory Group on GI Endoscopy (JAG). Through the design and implementation of patient-centred standards, tough but achievable productivity and waiting time targets and a focus on training and workforce management, the national endoscopy team reduced average wait times for endoscopy services from three years to six weeks.  Much of this methodology has been adopted internationally, in particular Canada and the Republic of Ireland.

Alongside her role at FEI, Debbie still holds a national role as Head Assessor for the JAG Accreditation, taking responsibility for training and development of the JAG assessors and conducting   assessments. This, along with her involvement in the development of the accreditation and training programmes is the reason Debbie is fondly known as ‘Mrs JAG’ by many endoscopy teams.

Debbie has also co-authored several publications on quality improvement in endoscopy services.

What are the common challenges NHS endoscopy teams face? 

“The pandemic has had a significant impact on many aspects of endoscopy service provision across the UK with waits and backlog recovery being a key focus whilst trying to balance quality and safety standards. Productivity remains a real challenge for many services and having access to good quality data is essential if services are to become more efficient. Whether common or unique, endoscopy challenges are often exacerbated by the fact that many services don’t have the ability to collect, store and analyse productivity performance data.

 “The unprecedented Covid-related workforce challenges we’re seeing across the NHS are also affecting endoscopy services. With a 40% vacancy gap, we need to build a long-term strategy to address this to make sure services can run at full capacity and sustain low wait services.”

What attracted you to the FEI team?

“Throughout my career, I have chosen roles where I can positively impact patient experience and this was no different when joining FEI.

 “The demand for endoscopy services has grown exponentially over the last 30 years and having implemented the national framework, my consulting career has enabled me to provide personalised support to NHS trusts, helping them on their service development journey.   

 “When looking at the market, none of the other consultancies were even close to matching the experience and subject matter expertise that FEI had. Also, in the knowledge that data is key to unlocking productivity gains, the fact that FEI’s performance, capacity and forecasting technology underpins its consultancy offer really appealed to me. I saw an opportunity to develop this further to deliver insights into productivity, demand and capacity modelling and business planning.

“But ultimately it was the people that convinced me FEI was the right consultancy to join – they all shared my passion for improving endoscopy services and wanted to invest in me and the rest of the team to achieve this.”

 Why do NHS trusts work with FEI?

“As a specialist consultancy, we are leading experts in unlocking productivity gains for healthcare organisations. Many of the FEI team have a clinical background and lived experience of the challenges they’re trying to solve which sets us apart from other more generalist consultancies Complemented by the analytical capability within the organisation, I think this gives FEI a greater authority when working with healthcare organisations as we can see the world through our clients’ eyes.

“To deliver on this promise, we invest heavily in the development of our consultants. One of the first things I did when joining FEI was designed an internal eight-week endoscopy training programme to provide a baseline knowledge of endoscopy, promote knowledge transfer within the business and ensure that all our consultants are able to tackle the challenges specific to endoscopy teams.

 “As Endoscopy Subject Matter Expert, I am responsible for quality control across all our endoscopy improvement programmes which gives our clients the assurance that we are delivering the most effective services and products.” 

What does a typical programme of works look like when working with an NHS endoscopy service?

 We initially focus on three core areas of data including (a) Patient Treatment Lists (PTLs), (b) productivity and (c) demand and associated activity. This would be followed by an infrastructure audit including the clinical and environmental capacity to deliver on the referral demands being placed on the service.

 “We review processes and procedures where admin productivity is as important as clinical productivity. Consideration needs to be given to booking processes, list management and patient flow.

 “Sometimes we might be asked to carry out a workforce model review and how well services are using their clinical capacity.

 “Once we’ve determined what needs to be improved and how, we can deliver a programme of works to help the service realise their improvement plans and measure their effectiveness.”

What is your most memorable FEI achievement?

“Driving the development of FEIs technology for the endoscopy market; providing teams with easy-to-use dashboards and data that help them understand their performance at the touch of a button.”

If you could give an NHS endoscopy teams one piece of advice, what would it be?

“Data is king. You need to measure and understand performance before you do anything else. So, ditch the spreadsheets and get the right technology in place to make data collection and analysis easy and accessible.”

What does ‘Mrs JAG’ like to do in her spare time?

“I’m at the final stages of studying towards an MBA in consultancy, leadership and innovation so that keeps me very busy! Travelling is also a passion of mine but most importantly, I always make time for socialising with friends and family whether that be cooking and entertaining at home or watching a show.”

 About Four Eyes Insight

We use the combined power of people, data and technology to get to the root cause of NHS elective care pathway inefficiencies; working collaboratively and engaging with all stakeholders to get buy in for change from the ground up. We implement interventions that optimise elective care pathways and provide tools to monitor their effectiveness ensuring that a culture of continuous improvement to drive long term, sustainable change is embedded along the way.

If you would like to find out more about our endoscopy services or discuss your requirements, please email info@foureyesinsight.com