Find out more about our finalists at the HTN Now Awards 2022. We’re dedicating a feature to each of our awards categories this year – showcasing the fantastic work being done across industry and NHS, in terms of health technology.
Here we’ll look at the entries in the ‘Supporting Integrated Care System Transformation’ category and discover more about a wide range of projects – from collaborative staff banks and clinical letter sharing, through to eConsent, and more.
Once you’ve read up on our submissions, join us at 7pm on 20 January 2022, to find out who the winner is!
Locum’s Nest
The North Central London Sustainability and Transformation Partnership (NCL STP) is setting up a cloud-based, medics collaborative staff bank solution, across 10 acute, mental health and specialist London NHS trusts. By adopting a collaborative model, NCL STP aims to see a shift in better resource planning, increased staff engagement and ultimately, more shifts being filled.
Six weeks after NHS England/Improvement published the Integrated Care System Design Framework, the NCL STP announced their plan to create London’s largest medics collaborative staff bank supported by their unified workforce vision.
Sharing their individual staff banks to form an overarching collaborative, each hospital will be able to instantly access a much larger pool of doctors. The collaborative approach will enable the 10 trusts to build long term and significant resilience into operational workforce processes. The entry stated ‘a collective commitment across the NCL STP to challenge workforce inefficiencies via collaboration to maximise capacity and improve patient care with the ultimate goal to take forward key high impact workforce priorities’.
Locum’s Nest was awarded the tender to create a cloud-based solution that allows each of the 10 trusts to share their individual clinician staff banks and access a huge pool of available doctors.
Bolton Care Partnership
Building upon the successes of the Greater Manchester Care Record, Bolton has adopted a system enabling all clinical correspondence to be viewable across health and care settings. Clinicians gain a complete picture of their patient for delivery of direct clinical care, including out of hours.
In 2017, the Bolton locality worked with Graphnet to implement a system that allowed sharing of clinical information across all Bolton health and social care partner organisations – the Bolton Care Record project. Bolton then procured the add-on ‘Docman Share’, an Advanced product which enables clinical letters to be shared within the borough. Put simply, a patient can attend Royal Bolton Hospital and the clinician responsible for their care can access any letters sent to their GP, including any referrals, discharge notes, screening and other diagnostics.
The Share functionality allows GP practices in Bolton to choose which letters they wish to share, so it is not a blanket share. GP Practices can select correspondence to include using set criteria and keywords, or by setting an excluded words list. The Share feature also allows health care professionals in Bolton to directly view GP letters within the record via an API integration. It means, there is now no need to phone, fax or email GP practices, supporting decision making, and time released to deliver direct patient care, improving both patient experience and patient safety.
The Bolton project team worked with their professional leads in the Professional Reference Group (PRG) which had representation from all partner organisations, and the Information Governance Board, as well as technology partners Advanced and Graphnet, to carry out a data protection impact assessment (DPIA).
Since the onset of COVID the record has expanded to become the Greater Manchester Care Record (GMCR), allowing this functionality to be adopted across the 10 localities in the city region. This technology allows a person to be registered at a GP in one area of Greater Manchester and their records be viewable if they attend any hospital in the region.
The next steps for the Bolton locality are to support partners in Greater Manchester to rollout this technology further across the area. They will be looking to Bolton to emulate its approach to ensure consistency, and because of the successes the project has realised to date. Having worked with Advanced to develop the solution, it is now available as part of their solution portfolio for use not only across Greater Manchester but other Advanced customers who use the Graphnet shared care product.
Isla Care
The Isla platform has supported transformation and innovation of teledermatology services across the North West London Integrated Care System (ICS). The project was funded by NHSX and its aim was to standardise the ‘Two-Week Wait’ pathway across the patch, including Chelsea and Westminster, Imperial and London North West.
The teledermatology pathway gives patients an appointment with a medical photographer, with a high-resolution camera, and photos are reviewed by the consultant the next day. The aim of Two-Week Wait Telederm is to streamline the pathway and allow for shorter appointment times which addresses waiting lists and maintains the 14-day standard.
Both Chelsea and Imperial have teledermatology services in place and so Isla’s introduction was aimed at optimising the process. In the new pathway, through Isla, patients complete their required NUCA questionnaire (outcome measure) in advance of their appointment. These questionnaires were sent via SMS with an encrypted link and SMS’s were generated in the platform entirely automatically using clinic codes and appointment dates – therefore resulting in no admin burden. These questionnaires are then captured digitally within Isla.
After an appointment, photos are then uploaded onto the Isla platform. This allows for annotations, notes and labels and stores images in high resolution. The quality of images is paramount in this area as clinicians need to be able to zoom into image to assess the details of moles and lesions.
From over 8,500 cases at Chelsea and Westminster there have been the following time-saving impacts: 10 per cent reduction in non-attendance (DNAs), 15 per cent reduction in the number of minor operations, 50 per cent reduction in medical photographer time. Furthermore, 75 per cent of patients completed their outcome measure forms in advance of their appointment, adding to efficiency in the service. The platform has reportedly delivered a twofold increase in the quality of images presented to clinicians.
These successes have been mirrored across the ICS. At London North West, where a telederm service was introduced, patients are now on average being booked in with medical photography the next day.
Wellbeing Software
Determined to transform the patient experience digitally, Royal Berkshire NHS Foundation Trust partnered with Wellbeing Software to implement eConsent, a clinician-led, paperless solution to radically streamline consent to the treatment processes during COVID.
Royal Berkshire, like so many up and down the country, are on a journey to digitally transform their workflow in line with the HIMSS electronic medical record adoption model. This is to not only increase the efficiency of their workflows but to ensure that patient care is being continuously improved upon at every point of contact.
Determined to become more digitally mature, they sought the help of leading connected healthcare specialist Wellbeing Software to implement eConsent, a clinician-led, digital solution that enhances patient consent consultations. In addition to this, being a part of a wider national scheme, Royal Berkshire wanted to use eConsent to improve the patient experience, optimise consultant time, as well as improve access to standardised and up to date information throughout their consent to the treatment process.
By introducing eConsent, the trust has also been able to report on, analyse and further optimise the consent process, which would not be available via a paper process. For example:
- Consent form usage across a specific date range showing them the number of procedures by department, which can then be further filtered down to show both procedure type and numbers by consenting clinicians.
- Remote form access shows which forms have been accessed, downloaded and/or signed by a remote link across a specific date range.
- Access to ‘raw’ consent data that is provided weekly for the trust, for analysis, by their own Business Intelligence team.
accuRx
accuRx developed Record View to overcome a central problem for the NHS and its communication infrastructure: the ability for everyone involved in a patient’s care to easily and securely access relevant medical information.
The aim was to build a solution that enables informed patient care with an immediate and secure view of the GP record. The entry stated: “For healthcare professionals working in acute care, specialist wards, mental health, care of the elderly and many other parts of the NHS it is important for such a solution to complement any regional Shared Care Records with a system that is exceedingly simple, useful and quick to use 24 hours a day on any device.”
This year, accuRx rolled out Record View in accuRx Web. It is free to use for NHS professionals and uses a patient permission model endorsed by the National Data Guardian (NDG) to let GP practices enable Record View for its patients, letting each individual patient approve record requests from their healthcare providers when the need arises.
Record View with was launched with selected NHS trusts in late October 2021, while at the same time contacting GP practices around the country to ask them to enable the feature for their patients. In just a few weeks they have seen NHS professionals in mental health care, acute care, pharmacy and primary care use Record View and already 50 per cent of all GP practices in England and Wales have chosen to enable it for their patients.
