University Hospitals of North Midlands (UHNM) NHS Trust has shared an update on first-year outcomes from its in-house developed digital discharge tool, designed to reduce the occurrence of delayed discharges and improve joined-up care.
The High Risk of Delayed Transfer of Care (HRD) tool was first launched in December 2024, in partnership with local NHS providers, Staffordshire and Stoke-on-Trent ICB, the North Staffordshire GP Federation, and Keele University. On launch, it was reportedly in use at the Royal Stoke University Hospital, being trialled in areas including the emergency department and older adults wards.
Since then, the tool has helped to reduce average length of stay by 1.2 days, using anonymised real-time information from GPs, social care, and hospital records to identify patients at risk of longer stays.
Andrew Davy, GP lead for research and development in the emergency department, explained how teams review cases identified on a daily basis. Davy noted: “HRD has allowed us to review hundreds of patients, including almost 850 by the ED front of house frailty team and over 200 therapies patients, helping to reduce their length of stay by over a day on average. This timely access to information allows the right teams to step in sooner, easing pressure on beds and improving patient flow. It’s helping us rethink discharge planning and work more closely with local authorities and community partners to ensure patients can return home safely and efficiently.”
In palliative care, HRD has doubled referrals and strengthened collaborative working, allowing the identification of patients needing support earlier, Charmaine Butcher, palliative care nurse practitioner, said. The Acute Care at Home service is also seeing benefits in improved patient flow, admission avoidance, and patient experience.
Similarly, in COPD, it has offered instant visibility of patients needing intervention, with the trust’s respiratory team launching a new clinic to review patients following a flare-up of COPD that would normally see them attending the emergency department.
Katy Thorpe, chief operating officer at UHNM, said: “Celebrating a year of HRD is about recognising the real difference this innovative tool is making for patients and staff, and shows how UHNM is leading digital innovation to deliver safer, more joined-up care for our patients and local community.”
Wider trend: Digital tools and pathways
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 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.
NHS Sussex has committed to improving its dermatology services and making care “easier to access, more consistent and better connected for people with skin conditions” through the use of digital technology and AI. As part of the NHS Sussex Improving Lives Together strategy, the ICS aims to transform services for patients with eczema, psoriasis, acne and moles by introducing digital tools that can support the delivery of “faster, more joined-up care”. The implementation of teledermatology and AI has been highlighted as a key driver for this initiative and will be used to help review skin images and support clinicians with making decisions.
North East and North Cumbria ICB has awarded a contract with a total value of up to £2.4 million to Accurx for the provision of digital tools to support digital pathways in line with modernising general practice requirements. The contract, covering an initial period of six months and a value of £809,622 excluding VAT, is for an online consultation, video consultation, appointment booking, and text messaging tool.
