Royal Free London NHS Foundation Trust board has noted plans to introduce an emergency department digital front door and has highlighted how digital is supporting patient flow initiatives.
In September A&E four-hour performance fell below the 78 percent target, with the trust sharing that a “high number” of patients could not be discharged promptly when no longer requiring hospital care, committing to working with community partners to address this with improved discharge pathways and increased virtual wards capacity.
As part of work to address this challenge, the trust also plans to rollout an ED digital front door, offering automatic data transfer from the ambulance service to provide clinicians with faster access to patient information.
In urgent and emergency care, digital and e-triage remain on track for delivery, with Royal Free agreeing a roadmap with NHSE and suppliers. Flow improvements are being supported by weekly specialty-specific deep dives into length of stay and daily mental health escalation calls.
Winter plan priorities cover establishing real-time ED performance reporting at RFH and BH using the NCL RAIDR system to provide system wide visibility. Virtual wards and hospital at home capacity will be scaled up and developed to deal with patients of increased acuity. Work with system partners is also in progress to continue the development of the NCL integrated care coordination hub model to reduce unnecessary admissions and “improve streaming into appropriate acute and community services”.
Elsewhere, in outpatient service transformation, the trust shares details of an upcoming three-year transformation programme set to focus on the primary care interface, patient communication technologies, and patient-initiated follow-ups, with specific attention paid to equality in access and user-centred design.
Early work on an AI strategy is being led by the trust’s CDO, focusing on governance, risk alignment, and small-scale pilots. In response to an internal audit on AI benchmarking, committee members reportedly “emphasised the need for balanced implementation, clear governance, and effective communication to ensure safe and productive use of AI tools”.
Wider trend: Improving waiting times and patient flow
NHS Greater Glasgow and Clyde has shared plans to develop its virtual hospital, with the aim of having 1000 virtual beds and remote monitoring in place by July 2026. An investment of £20 million has been made to support the delivery of the NHS Renewal Urgent and Unscheduled Care and Improving Flow Commission, with a further £2.56 million for Hospital @ Home, GGC revealed. Key focuses for improved patient flow include a flow navigation centre offering direct assessment and navigation to services such as eTriage.
East London NHS Foundation Trust has outlined its use of data in informing patient care and patient flow, deploying digital screens, interactive dashboards, and PowerBI. 22 wards across the trust now have digital screens showcasing real-time data on aspects of flow, safety, care plans, observation status, Mental Health Act status, key assessments, and expected discharge date. Co-designed with clinicians and service users, the screens update every 15 minutes, supporting safety huddles, team meetings, and handovers.
Barts Health has shared how a real-time data dashboard, linked to its EPR, has made an impact on patient safety, patient flow, and delivery of care. The M-BRACE project presents key information in a single place, including data relating to risk of falls, low blood sugar, and delays in assessment or transport, to support structured check-ins through the day. At 8-9am ward teams meet with support of the data, 10-12pm best practice reviews of every patient’s care take place, with check-ins 3-4pm, to review and track progress on discharges and identify any patients becoming unwell.
