At the HTN Now Awards 2022 so far, we’ve seen many fantastic finalists focused around trusts, organisations, companies, innovations, case studies and even leaders. But now, it’s time to take a group-perspective and acknowledge the efforts of teams working together across industry and the NHS.
Who could be about to take the crown for top teamwork? Find out more about our awards entrants below…
Royal Papworth NHS Foundation Trust
Royal Papworth Hospital is now located on the prestigious Cambridge Biomedical Campus. The successful hospital move, as well as a key mention in a CQC report, digital exemplar work, the creation of a bi-directional interface between the Dedalus EPR and Epic, a wholesale EPR move to the cloud, and the implementation of GP connect, signify just some of the capability the digital team has to offer.
Ranked as a top 100 global hospital [by American magazine Newsweek], Royal Papworth has a history which showcases the best in cardio thoracic surgery. At the heart of this effort, says the hospital’s Chief Information Officer, is its people. ‘Located in this hospital, always hard at work, is a digital team with the drive, stamina and talent which has enabled a truly transformational experience’, the CIO says, before noting ‘most significantly…their team work’ and ‘effort to respond to the pandemic with dedication…remaining positive throughout’, to show ‘an example of true excellence in digital services…given the many unusual and significant changes this team has seen, [I] believe them to be truly inspiring.’
Welsh Ambulance Services NHS Trust
Developed through a global pandemic with the system under more pressure than ever before, the Welsh Ambulance Electronic Patient Clinical Record (EPCR) programme team have delivered an EPCR that is making a difference to over three million people across 8,000 square miles.
The Welsh Ambulance Services NHS Trust (WAST) was one of the few remaining UK Ambulance services without a full electronic patient record, which has provided both local and national challenges, particularly in terms of access to clinical data. Throughout the COVID-19 pandemic, the EPCR programme team successfully developed and procured a new solution delivered on over 3,000 new personal devices that integrates with wider NHS Wales datasets to pre-populate and share data securely and effectively with other providers.
This has involved liaison with all acute care providers across NHS Wales to improve handovers at Emergency Departments; GPs to link datasets more effectively; and, Digital Health and Care Wales (DHCW) to develop a roadmap of integration points that will link the EPCR to national NHS Wales system, enabling greater collaboration and visibility of the entire patient pathway.
In addition, the clinically-led team have recruited over 100 EPCR champions from frontline staff to co-develop the new product from the point of procurement through to go live. All of this has been achieved throughout an intense, sustained period of system pressure, which has included the need to co-opt military support. The team ultimately delivered a new clinical system that supports over three million people through over 400,000 clinical interactions per year, and has taken a ‘huge amount of dedication and sacrifice from the team involved’.
Medication error is a major challenge, with some 237 million errors every year. In addition to this, there is considerable effort required to reconcile patient’s medicines when accessing care and particularly where they move between different care sectors. There is no single source of the truth from a digital perspective. At every transition of care, manual transcription of medicines information is undertaken leading to lost time to care (circa 1.2 million hours of hospital clinical time and 9,000 weeks of GP clinical and admin time per annum), errors and omissions when translating information and delays to care.
The interoperable medicines team, working across NHSX and NHSD, set out to define a standard that the NHS could use to enable fully interoperable messaging for medicines (including dosing). The underpinning principle to the work has been to ensure that medication safety is improved.
Working with the NHS, system suppliers and technical experts, the team has now defined a fully interoperable medication standard. This can be used to: support the transfer of medicines information on admission to, or discharge from, hospitals; enable standard interfaces to support medication supply; and ultimately underpin the development of a consolidated shared medication record supporting access to an individual patient’s medication information at the point of care.
This reduces the number of times that patients have to repeat information about their medicines, and the likelihood of errors being made – both during transcription and also errors of omission. It also supports the optimisation of medicines and enables work to address overprescribing, medication waste and improved predictive decision support for prescribers.
The first sites are now live with interfaces using the standard and the team is now focused on supporting the adoption over the next 12 months. The team have been submitted in recognition of their hard work, stakeholder engagement and inclusion, and the ‘sheer determination to move beyond the previous attempts’.
Gloucestershire Hospitals NHS Foundation Trust
During one of the most important years for healthcare in history, the Gloucestershire Hospital Foundation Trust (GHFT) Business Intelligence Team have stepped up to the trust’s varied challenges and met them head-on in an ‘innovative, timely and insightful way’, ‘fuelled by an incredible amount of hard work and sheer determination’.
This ranges from creating real-time dashboards with data flows in order to support the trust operationally during COVID, to a multi-facetted approach to providing intelligence to support the post-COVID strategy and landscape.
Over the last 12 months, the BI Team have provided analytics to ensure the trust had enough oxygen and PPE, enabled movements in green/red wards, and modelled COVID projections which were used to manage beds effectively. Very early on in the first wave, the analyst team set up data models to predict the volume of PPE and oxygen which the hospitals would need. This was used operationally and GHFT were never in a position of running out of PPE or oxygen, although its admissions were some of the highest in the South West.
All of this was achieved whilst still moving forward with development of the department and pushing intelligence and the rollout of new systems, enabling more granular clinical data to be made available for analytical purposes (example NEWS2, falls assessments, MUST values and Waterlow scores). The GHFT BI Team continued to develop their innovative COVID dashboard, which continues to be vital every single day to determining how the trust manages pandemic.
During the pandemic, BI Team staff worked every weekend and bank holiday (including Christmas Day) to help monitor COVID patient levels within the trust’s hospitals, provide analysis to operational staff and to ensure key NHSE submissions were completed on time. All of this assisted Gloucestershire Hospitals Trust operational staff with navigating the pandemic as effectively as possible and ensuring the correct bed capacity was available at the right time.
The team also ensured that the day to day analytical business of the team still continued to an ‘exemplary standard’ and ran alongside the COVID support projects. A new Electronic Patient Record system was devised and implemented which required analytical support 24 hours a day, seven days a week, for a month. Analysts were working nights and weekends, often sat in the Emergency Department alongside clinicians, to ensure this system was deployed effectively and ensuring that the data was robust and meaningful. This system is now enabling all clinical patient records to be recorded digitally, which is already showing improved patient outcomes and advanced digital maturity within the trust.
Medway NHS Foundation Trust
Medway NHS Foundation Trust’s Electronic Patient Record (EPR) team worked collaboratively with programme and clinical teams to implement its EPR in under five months, across 24 inpatient wards. The team were ‘innovative and flexible’, tackling challenges head on, and delivering to schedule despite the pressures of the pandemic.
The trust was experiencing a period of sustained pressure in the month leading up to go-live, which could have seen the project de-prioritised in order to tackle the pressures they were facing. Instead, the team united under the common goal that the EPR was a strategic objective and that, once implemented, it would help the trust to avoid reaching such levels in the future.
The EPR rollout was treated as a cultural change project, not just an IT project. IT understood that what may work in theory, doesn’t necessarily make sense in practice. Clinicians, IT and operations all had a somewhat symbiotic relationship, learning from one another so they could build the most effective blueprint possible.
The day before go-live, operational, IT and clinical teams all conducted a ‘dress rehearsal’ so they were as familiar as possible with how the day would go and so they could pre-empt any issues that could arise. Doing so meant that on the day of go-live, the entire team and staff on the wards were very calm and the roll-out went incredibly smoothly. In the first 24 hours, more than 2,000 documents were created in the system. Just three weeks in, almost 115,000 documents had been created, with more than 1,000 daily users. For on call doctors, between 20 and 30 minutes of clinical time is being saved per patient, as they can access their notes from anywhere through the portal.
Leeds and York Partnership NHS Foundation Trust – Thrive by Design
Hosted by Leeds and York Partnership NHS Foundation Trust, and for half the year known as mHabitat, Thrive by Design works with partners from across England to co-design digital innovation to tackle health inequalities and ensure digital transformations in healthcare services do not compound existing inequalities.
Thrive by Design is a multi-disciplinary NHS Design Studio that uses an inclusive co-design approach. In the knowledge that 14.9 million people are not easily able to use digital in the UK, its mission is to ensure that rapid digital transformation does not result in a two-tiered system which excludes the people who most need health and care support.
The team started last year by launching an Inclusive Digital Transformation co-design challenge. Over the last 12 months, with a small core team of 12 and a network of expert associates they have ‘travelled’ from Devon to Newcastle, and Liverpool to Norfolk, working with integrated care systems, provider trusts and national bodies to put inclusion at the forefront of digital transformation. This included leading three national programmes with NHS England and Improvement, NHSX, and the NHS Confederation.
Examples of their work include:
- Leading the joint NHS England and Improvement’s health inequalities team and NHSX’s flagship ‘digital health inequalities pioneers’ programme, supporting 10 Integrated Care System teams to embed inclusion into digitally-enabled care pathways.
- Delivering NHS England and Improvement’s digital mental health teams ‘mental health and digital inclusion’ discovery programme, where they co-designed and delivered a research and learning programme and a guide for local systems and providers.
- Being commissioned by the NHS Confederation to develop a collaborative digital skills guide for the mental health workforce. The practical guide aims to help build digital confidence and skills across the mental health workforce.
- Working with Oxford University to explore what inclusive remote video consultation looks like.
The team’s flagship MindWell platform, which they deliver with Volition, a voluntary sector partner, is a mental health information service for Leeds and has had over two million page visits since it was launched. Since the lockdown, its use has increased by 30 per cent.
This year, they have worked with the national Children and Adolescent Mental Health Services (CAMHS) taskforce, and young people with living experience, to co-design a prototype which uses an integrated digital approach to supporting young people to avoid hospital admissions.
They are also part of the West Yorkshire and Harrogate Health and Care Partnership and have carried out various co-design projects with different stakeholders across the patch, including co-designing: a whole system digital and data poverty blueprint; a decision tree for primary care to help support people living with mental health illness; a prototype app with autistic children and young people and their families and carers to help share their social and communication needs with services.
Royal Orthopaedic NHS Foundation Trust
Since its creation just over 12 months ago, the five members of the digital team at the Royal Orthopaedic NHS Foundation Trust (ROH) have led on, and been involved in, a range of projects that have had significant benefits for departments across the trust and a direct impact on improving patient care.
The team consists of: Gavin Newman – Digital Programme Manager & Staff Governor; Timothy Cox – EPR Configuration Analyst; Charlotte Tattam – Business Data Analyst; Vickie Pring – Senior Web and Systems Developer; Manisha Patel – Project Support Officer.
Their projects include:
- DrDoctor – Digital Letters, SMS appointment reminders.
- RMS – Digital Referral Management Solution.
- PICS/Clinical Portal – EPMA implementation (Assessments, Observations, NEWS2 alerting).
- Office 365 – Delivering Microsoft Teams, SharePoint and the Office suite to the trust.
- Theatre utilisation requests – a system that allows surgeons to book ad-hoc sessions in our theatres, such as private cases, allowing theatres to manage requests and get back to them if the time slot is available.
- X-ray patients – there are occasions where outpatients being seen need an x-ray, as decided on the day by the person they are seeing. This FX form allows Outpatients Department nurses to put in a request for an X-Ray. This is added to a list that both X-Ray and the Outpatients Department can see, allowing both to see when a patient has been sent down and who have been seen.
- FX forms – there is a core group of three staff members working on creating e-Forms as part of a mission to become paper-free. Although this work can only be carried out on an ad-hoc basis around more urgent and regular duties, to date the team have received 36 requests and transformed many paper processes already, including assisting the Patient Advice and Liaison Service (PALS) in creating online surveys for patients.
Moorfield’s Eye Hospital
The Moorfields digital and A&E teams launched a virtual A&E service to respond to the coronavirus pandemic. With their work, the programme has inspired widespread adaption and delivered patient safety levels similar to in-person triages and saved almost eight out of 10 patients a trip to Moorfields.
The virtual A&E service was introduced within 48 hours of the first wave of the coronavirus pandemic to give patients access to the vital eye care they needed remotely. This was crucial to support Moorfields’ number of complex patients who frequently use A&E, patients who are medically immunosuppressed, and patients who live further away from London.
To this day, the team has delivered over 26,000 virtual consultations. Everything that would be presented in face-to-face A&E can have a presence virtually. In some cases, they have been able to triage patients more effectively, as they have been able to direct cases to closer eye units or community optometrists that they could see instead of coming to the centre of London.
“The virtual A&E platform has revolutionised the way we receive emergency patients and has been so successful that we will keep it running on a long-term basis,” said Dr Gordon Hay, Service Director for A&E.
This year, a study published in the peer-reviewed journal, eClinicalMedicine, highlighted the positive impact of the virtual A&E service and explored its safety compared to in-person triages in emergency ophthalmology. The researchers found that the virtual A&E eye service delivers patient safety levels comparable to that of an in-person triage.
The team has been able to deliver a high-quality service, with 95 per cent of patients giving a maximum rating of five stars. They can get around lengthy waits in A&E and be assured by an experienced ophthalmologist within minutes of without having to visit the hospital. Almost eight in 10 patients have been able to get the treatment they need without travelling into hospital. The average saving per patient in travel distance and time saved is 41 km and 1 hr 43 minutes.
It also meant that staff could work safer with fewer potentially infected patients visiting A&E, and that members of the team who were shielding or were unable to work face-to-face could still contribute to patient care.
The project required many different teams to work together to use technology to provide a rapid solution. This included collaborative working between digital, IT, clinical, admin and communications teams. Moorfields staff have also included ‘smart surveys’ in the service, which allow patients to submit symptom and satisfaction information before and after video consultations. The data from these is constantly being used to implement improvements to the system to make it the best possible service for patients and staff.
Finally, the success of this service has contributed to the Moorfields A&E team being rated best in the country in the recently published CQC survey of patients at the height of the pandemic (November 2020 – March 2021).
Beyond the success of the team’s delivery in virtual A&E, they have supported the national rollout of this technology:
- Contributing towards the production of the national clinical safety report template for the platform.
- Sharing their experience via the North Central London group of trusts to support those earlier in their adoption of video consultations.
- Taking part in regional and national webinars describing how the technology was implemented and is used.
- Producing a written case study for the national NHSE video consultation team to describe the deployment.
- Providing advice to other eye units via the Royal College of Ophthalmologists and UK Ophthalmology Alliance.
Alder Hey Children’s NHS Foundation Trust & Liverpool Heart and Chest Foundation Trust
In 2021, Liverpool Heart and Chest Foundation Trust, and Alder Hey Children’s specialist hospitals, came together to create an Integrated Digital Service called the iDigital Joint Service Team. This has represented an organisational and cultural shift for the teams, and a considerable effort went into the preparation and planning for joining the services together.
In the Cheshire and Merseyside region, the four specialist trusts (Alder Hey Children’s Hospital, Clatterbridge Cancer Centre, The Walton Centre, Liverpool Heart and Chest Hospital) worked together to agree how services can be shared to maximise resource and benefit from savings that come with larger scale projects.
With this in mind, the digital teams at Alder Hey and Liverpool Heart and Chest created a new integrated digital service. The new service offers both trusts dedicated support teams, as well as central teams to manage projects and infrastructure. This not only provides savings to the trusts, but also offers the benefits of a consistent approach and the opportunity to share learning. Both trusts have exciting and ambitious digital strategies and have most recently achieved HIMSS Level 7 (Alder Hey) and HIMSS Level 6 (LHCH). Combing the digital services teams offers huge benefits to staff with increased chances of progression and an opportunity to input into how the new service is designed via a cross trust staff council.
Staff recognition played a huge part in each of the organisations. Making a ‘Virtual High 5 Board’ and monthly staff awards joint across the two sites aided the smooth transition, as this was seen as a really positive activity and a way for the teams to get to know each other and recognise achievements across the joint service.
‘Nurturing Enthusiasm’, ‘Making it Better’ and ‘Aspirational’ workstreams were established and activities within in these assigned to joint leads from each trust. Activities included the production of a Health and Wellbeing Strategy for the partnership, exercises to involve all in branding decisions and an away day workshop to bring both teams together once the partnership had been established.
The integration of the Digital Service will enable a wide variety of benefits for both organisations. Most notably, there is now an even bigger range of digital expertise at each trust’s disposal, improving the service provision in both organisations where applicable.
Royal Brompton Hospital, Guy’s and St Thomas NHS Foundation Trust, and ISLA
Isla worked with Royal Brompton Hospital to help develop their ideas and use their expertise to create a powerful and easy to use system. They transformed surgical site surveillance services across Guy’s and St Thomas’ NHS Foundation Trust and King’s College NHS Foundation Trust. The platform now allows nurses to document wound progression with meaningful description to support continuity of care – including the importance of documenting a baseline wound photograph at the point of discharge, coupled with bespoke advice for the prevention of surgical site infection (SSI).
Patients are able to submit photos of their post-surgical wounds at key intervals. This helps to get patients the care they need with the relevant staff and community colleagues and establish a patient centred-approach. The platform is highly relevant for end-users such as clinicians, specialists, nursing teams and patient and carers.
The Isla team supported the hospital to create patient and clinician pathway templates, including for wound assessment (for any wound types) as well as building new forms, often within just a day of requesting. The platform also contains the ability for activity reporting, automatic quality alerts to detect blurry photos, as well as a dashboard of structured datasets, notifications and referral mechanisms. The platform also adapts to patient preferences, supporting a range of communication channels such as text messaging, email links etc.
Maidstone and Tunbridge Wells NHS Trust
Maidstone and Tunbridge Wells NHS Trust’s (MTW) 10-year digital transformation strategy jumped forward during 2021. Despite the pandemic, its digital team have shown what can be achieved by working together on a significant number of programmes, to realise benefits for clinical staff in delivering patient care.
During the last 12 months, Maidstone and Tunbridge Wells made huge strides in delivering ‘digitally seamless enhanced patient care’. They continued to support over 1,000 staff to work remotely from home at the beginning of the year, as the second wave of COVID pandemic took hold. Additionally, their programmes of work included:
- Ive Programme – a significant investment to improve the speed and security of the systems used within the trust, including the equipment, was approved. In January 2021, the work to upgrade and roll out over 4,000 new computers and 1,800 laptops began in earnest. Alongside this, the team deployed new mobile devices, computers on wheels and printers, as well as upgrading servers and network capability. They were instrumental in using this equipment to enable the trust to set up a centre within 48 hours to give vaccinations to staff. All this was achieved while simultaneously supporting the launch of a new electronic patient record during the summer of 2021.
- Teletracking – a bed management system, Teletracking, was introduced in November 2020, to help improve the flow of patients, providing real-time visibility of over 2,000 COVID positive patients, giving 2,740 hours of nursing time back to care through dedicated Bed Turnaround Teams, and releasing 1,167 hours of bed time early through improved efficiency in patient transfer times.
Alongside this and supporting EPR, work has progressed to set up a pilot of an eConsent module, implementation of OpenEyes for Opthalmology, as well as extension of self-check-in kiosks and virtual consultations.
Leeds Teaching Hospitals
The Electronic Health Record (EHR) development team at Leeds Teaching Hospitals NHS Trust (LTHT) is responsible for the on-going development of PPM+, LTHT’s electronic health record system. Over the past year, the team has delivered a huge amount, from COVID response support to new functionality, features and enhancements, working closely with clinical colleagues. The dedication, skill and hard work of the wider team ensures the trust can continue to build a digital environment that supports staff in providing excellent clinical care.
PPM+ supports everyday nursing, medical documentation and clinical processes for two of the region’s largest NHS trusts – Leeds Teaching Hospitals and Mid Yorkshire Hospitals. The system is used daily by over 11,000 clinicians, with more than 1.5 million eForm submissions every month.
PPM+ is designed to consolidate data from a number of separate systems, allowing clinicians to view a single patient record which includes city-wide information from a number of different organisations. This provides a rich, informed view of patient’s wider needs. Leeds Care Record is a great example of this in practice, bringing together important information about patients who have used services provided by their GP, at a local hospital, community healthcare, social services or mental health teams. The development team is in the process of migrating PPM+ to the cloud, offering flexibility, scalability and resilience and delivering a huge benefit for a system which is relied on across the region.
Over the past year, the team has developed and launched a number of new features. These include: a new radiology alerts system; criteria-led discharge; digitising the paper record; redesigning the current electronic discharge advice note; an ePAWS scoring system; enhancing e-from capability; paediatric growth charts; Personnel Connect for mobile devices; Point of Care testing; a Reason to Reside campaign; and new functionality to transfer patients and assign beds.