How technology can improve the delivery of social care services

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How technology can improve the delivery of social care services

With a growing population of older and disabled adults, London’s demand for care is placing the social care system under huge strain. Further to this, London Councils estimates that boroughs across the city have experienced a combined loss of more than £4 billion in core funding since 2010 (a reduction of around 63%). We need to think differently about how and where services are delivered, utilising digital solutions to maximise the workforce and care provided.

Health and social care systems are critical to maintaining the physical and mental wellbeing of Londoners. We need a digital revolution in adult social care, starting with exploring how social care services could be delivered digitally. Technology has the potential to help free up staff time by enabling users to access services digitally, thereby improving their independence, efficiency and wellbeing and reducing the need for in-person care visits simply for reassurance. Where this type of digital solution has been implemented, service users report that it helps to increase their digital literacy and independence and reduces their social isolation. It has also led to more flexible working for social care staff.

We are working with our members in south London to host an Innovation Exchange event on the ‘Digital Revolution in Social Care’ on the morning of Friday 13 March 2020 at St Thomas’ Hospital. The event will bring key stakeholders in this field together and showcase the most cutting-edge digital innovations to both inspire and practically help our industry partners to shape the future of social care delivery.

If any social care commissioners or members of local authority want to attend, please email karla.richards@nhs.net.

If you are interested in speaking to our Healthy Ageing team email Lesley.soden@nhs.net

The urgency for digital innovation in urgent and emergency care

Blog

The desperate need for digital innovation in urgent and emergency care – sparking connections and inspiring innovations

Written by Lesley Soden, Programme Director, Innovation Theme, Health Innovation Network

This winter has once again been a record-breaking one for A&E departments across the country —but not in a good way. Programme Director of Innovation, Lesley Soden, reflects on how technology, and not targets, needs to be the centre of the discussion to really support health and care providers delivering urgent care.

According to data and analysis published in the Health Service Journal earlier this month, overall type-one performance in emergency and urgent care units—the turnaround time for treating the most critical patients in A&E—has fallen nearly 11 percentage points since December 2018, while some individual trusts have experienced a year-on-year slide of between 20 and 30 per cent.

But how can anyone be surprised when in London alone, A&Es saw over 25,000 more patients in December 2019 than they did in December 2018.[1] Service expectations and pressures grow higher, while clinical staff continue to be spread thinner.

But instead of joining in the discussion on whether the targets need to change, I want to talk to you about the impact that existing technology could have on the urgent and emergency care system. Last October, at Health Innovation Network (HIN), we partnered with the DigitalHealth.London Accelerator programme to host an Innovation Exchange event to debate exactly the question I believe is the most important to answer – how can technology help? At the event, we brought together key stakeholders from the urgent and emergency care sector in London and creators of some of the latest innovations tackling ever-growing issues with the wait times and overall efficiency  The event sought to achieve two things; firstly, to share a deeper understanding of vital NHS needs with the health tech innovators, and secondly, to start the conversation about how digital innovations that are already transforming other areas of healthcare might be able to help.

An honest discussion

Determined not to present an idealistic view of transformation, we started the day discussing the complexities of digital innovation. There are 32 CCGs across London, each with different systems, providers, patient pathways and data flows. This lack of cohesion across the board can result in real challenges for the introduction of new innovations, particularly digital ones. For example, a product may fit into one hospital easily, but be incompatible with another. Similarly, a product may require or generate specific data that we don’t have a standard process for sharing across multiple settings. These challenges are best appreciated when you look at urgent and emergency care. It is here that speed and effectiveness can make the difference in highly pressurised life or death situations.

It was eye-opening to hear about the level of activity that the London Ambulance Service (LAS) experiences. LAS handle approximately 5,000 emergency calls every day in London and has approximately 6,000 staff, 65 per cent of them front line staff responding to emergencies. On average, the LAS responds to all Category 1 calls (the most serious of emergency calls) within 6 mins 28 seconds. In these often-chaotic situations, bandwidth, hardware and human factors such as the staff’s experience of the technology, are all integral to a successful A&E handover.

Where technology is already helping

Stuart Crichton, Chief Clinical Information Officer (CCIO) at the LAS, described one of the challenges they experienced when implementing the use of iPads. The issue lay with ensuring that paramedics remembered their most up-to-date passwords. As we all do on occasion, staff kept forgetting their login details or couldn’t access their most up-to-date credentials (a password reminder was sent to an email address they couldn’t easily access). To resolve this issue, LAS removed the need for usernames and passwords, opting instead for using fingerprint recognition, the same type of technology many people use day-to-day with smart phones and tablets. Stuart described this as an exciting breakthrough, and a simple solution the LAS believes will have a positive impact in crucial life and death situations.

Dr. Gabriel Jones, Consultant of Emergency Medicine at St George’s NHS Foundation Trust, described the lightbulb moment he had when looking around the waiting room one day and noticing that almost all the patients who were waiting were using their smart phones. In the UK, 78 per cent of adults now have a smartphone. Dr. Jones recognised this as an opportunity to try something new. They designed a digital solution and set up a pilot, known at the hospital as ED Check-in, that enables patients to input information to a secure mobile website via their smart phones while they wait. A doctor can then access that information instantly, and it follows the patients through their hospital journey, keeping clinicians informed at each stage. Sometimes, clinicians with an entrepreneurial nature can design the best solutions to challenges within their health services, which is why it’s so important that they’re included in conversations around digital innovation.

… to create positive change, it’s imperative that today’s innovators understand the complications as well so they can deliver the most appropriate digital solutions

At the event, we were lucky enough to have guest speaker Eileen Sutton, Head of Urgent and Emergency Care at the Healthy London Partnership (HLP) and London Regional Integrated Urgent Care (IUC) Lead at NHS England. Eileen is a District Nurse by background and has a range of experience across the IUC system. She identified the need to reduce the number of people turning up at A&E with conditions or illnesses that could be treated at home, by a community pharmacist or other care professionals, and the need to improve patient flow to reduce the time spent waiting to be treated upon arriving at A&E as some of the greatest challenges. We know that NHS expert staff are the only ones who really understand the high complexity and nuance of these situations, but in order to create positive change, it’s imperative that today’s innovators understand the complications as well so they can deliver the most appropriate digital solutions.

Working with the DigtialHealth.London Accelerator Programme, we were able to identify 11 companies that offer solutions to these two main challenges. We held a rigorous and open application process for innovators to attend this event, during which they had the opportunity to pitch their innovations to London NHS commissioners, trusts and other NHS expert staff.

The companies selected to present were:

To demonstrate the real-world application of the innovations, we created some fictional scenarios in which the innovators present could help to reduce A&E attendance and improve patient flow.

Scenario one: Reducing A&E attendance challenge

We discussed Ahmed, a frequent visitor to his A&E for a number of minor ailments that could be managed by a pharmacy or primary care. At his next visit, he is referred to the Health Navigator solution and assigned a Health Coach, with whom he speaks weekly. He now rarely visits A&E and has joined local classes.

And Claire, who is worried that she has a UTI. We offer her a virtual and confidential consultation via Q Doctor with a doctor at a local urgent care centre instead. The doctor refers her to the local pharmacy to use the Dip-IO test from Healthy.io, which tests positive and the pharmacist then prescribes antibiotics.

And then Bob who calls 111. He is re-directed to the MedicSpot station at his local pharmacy, where he is given a remote consultation with a virtual doctor, who takes his blood pressure checks for other vital signs.

All three patients are given the care they needed in a timely and effective manner, without the need for ambulance or a prolonged wait in A&E.

Scenario two: Improving patient flow and reducing waiting times challenge 

For our next challenge, we talked about Mary, who has multiple complex co-morbidities and goes to her local A&E when she experiences tingling in her legs. In the reception area, there are tablets with the eConsult triage system. Mary checks in using a tablet, by answering a few brief clinical questions about her symptoms. The system automatically triages Mary by her clinical symptoms within five minutes of her arrival.

While Mary is in the waiting area, she also inputs her symptoms, medication and medical history into the MedCircuit app, which helps save the doctor time and uses Mary’s wait more efficiently.

Mary sees the A&E doctor, but the light isn’t working in one of the consultation rooms. She uses the MediShout app to report this logistical issue, which links to the estates helpdesk and reports it immediately. She receives a notification that it will be fixed in two hours.

The doctor runs a full blood count test using Horiba’s Microsemi CRP device, which gives test results in four minutes. Mary is transferred to the x-ray department using the Infinity ePortering system to request a porter, saving critical time for herself and the doctors.

The A&E department also uses CEMBooks, which allows the consultant managing Mary’s case to plan her care and predict the demand for inpatient beds if this is required.

Mary deteriorates rapidly and requires a transfer to a specialist hospital. During her transfer in the ambulance, the MediVue platform provides real-time data taken from her monitor and active correspondence between the transferring doctor and the receiving hospital.

When she arrives at the specialist hospital, staff are prepared to smoothly transfer her to the appropriate unit, having already been informed of her history and symptoms.

These may be fictional scenarios, but they represent just a fraction of the real-life attendances to emergency care that technology could be helping make safer, more efficient and a better experience for both staff and patients. And most significantly, whilst time and efficiency were intended benefits of the digital solutions presented at the event, the focus of our discussions were about patient outcomes and supporting staff to deliver. Maybe if we changed the focus from targets to technology nationally too, we’d get to a clearer solution more quickly.

About the author

Lesley Soden
Programme Director – Innovation Theme, Health Innovation Network

Lesley has led the HIN’s Innovation Exchange function since 2017. She has over 20 years’ experience in the NHS and public sector working in senior business/strategy and programme management roles. Her roles have included work with transformation, contracts and commercial, programme delivery, business development/ planning, bid writing and clinical service re-design, all delivered in collaboration with a variety of partnerships. She is interested in new ways of working and maximising technology to improve patient care.

Invitation to pitch: digital workforce transformation showcase

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Invitation to pitch: digital workforce transformation showcase

We all know that the NHS is facing increasing demands on its services. Alongside the challenges of recruiting and retaining clinical professionals, there is a role for technology as a driver of productivity within the clinical workforce.

Working in collaboration with NHS England, and NHS Improvement, the DigitalHealth.London Accelerator is running a showcase event for HR Directors exploring how technology can help NHS staff and employers to improve workforce productivity, recruitment and retention.

We are looking for ten companies to present their innovations, and in particular, innovations that are already being used by NHS employers and that meet workforce challenges including:

  • Recruitment / time to hire
  • HR transactional tasks / HR productivity
  • Workforce capacity management / clinical workforce productivity
  • Retention
  • Staff wellbeing (physical and mental health)

If selected, you will give a three-minute pitch to the audience on how they could adopt your innovation(s) in their organisations. You will also participate in our “world café” session to discuss your solution in more detail. We aim to help you generate warm leads by curating a receptive audience for workforce innovations.

We are looking for innovations that are already well-developed – this is not an event for innovations at the idea stage.

Please apply to take part by downloading and completing this short form and returning it to geraldine.murphy8@nhs.net by 5pm on Friday 10 May.

Event details

  • Date and time: Tuesday 11 June, 17:00 – 20:30
  • Venue: DAC Beachcroft, Walbrook Building, 25 Walbrook, EC4N 8AF

Agenda

  • 16:30-17:00 Registration
  • 17:00- 17:05 Welcome
  • 17:05-17:15 Clinical Productivity – Andy Howlett, Clinical Productivity Operations Director, NHS England / Improvement
  • 17:15-17:25  Can technology and artificial intelligence help to improve workforce productivity and create a more agile workforce? What can be done now? – Lesley Soden, Head of Innovation, Health Innovation Network
  • 17:25-17:35 NHS Trust Case Study: Lessons from transforming our medical workforce – Alfredo Thompson, HR Director, North Middlesex Hospitals NHS Trust; Dr Frances Evans, Medical Director, North Middlesex Hospitals NHS Trust
  • 17:35-17:50 Q&A
  • 17:50-18:20 Company pitches
  • 18:20-18:30 Close – Lesley Soden, Head of Innovation, Health Innovation Network
  • 18:30-20:00 Refreshments and networking

Top Tips for innovators

Resources

Top Tips for Innovators

Got a great innovation that could radicalise the health care system but overwhelmed by the complexity of the NHS? Lesley Soden, Head of Innovation gives her top tips on how to build relationships with NHS and local authority contacts so you can get your innovation successfully implemented.

With Secretary of State for Health and Social Care Matt Hancock’s increased focus on the advancements of digital and technological solutions for the NHS, the market for health innovations is booming. Whilst it is an exciting time for health tech, for innovators themselves it makes for a crowded marketplace. In addition to the competition you face, you are also expected to navigate the complex landscape of the NHS.

Getting your innovation adopted in the NHS sphere can feel like opening a sticky door that requires the hinges to be oiled continuously. At the Health Innovation Network, we are approached by about 3-4 innovators every week looking for advice and support with getting their innovation bought by the NHS. Whilst every innovation requires different proof-points, we have learnt a number of lessons through our experience of improving the take-up of the Innovation and Technology Payment products across South London, and developed some key steps that all innovators can follow to increase their chances of getting their innovation, product or service adopted.

Target the right people

Having an engagement plan to target the right people at the right time, will stop you wasting yours. For example, if the innovation helps with managing referrals more effectively then a General Manager or Operational Director will be your target audience. If your innovation addresses a patient safety issue, then the Medical Director of Director of Nursing will be the decision-maker you need to approach. Work out which part of the system your innovation will save them money and then work out who is in charge of spending for that department.

Tip: if your innovation has the potential to save money for an NHS provider don’t target commissioners. Also, Trusts often have transformation teams who could help with getting your innovation adopted if there is evidence that it will improve patient care.

Tailor your message

In general, all NHS Trusts or Clinical Commissioning Groups will have the same system pressures as everyone else. These could be A&E waiting times, or the increasing demand caused by more patients having more complex conditions. However, individual decision-makers will have different priorities that concern them on a daily basis. To make sure your message is getting heard you should tailor it to the specific pressures or problems that your innovation could help them with.  For example, the Director of Nursing will probably be concerned with their nursing vacancies and agency costs, or patient safety while the Director of Finance and Performance’s priority is more likely to be addressing long waiting lists, or meeting their savings target.

Tip: trust board reports and Clinical Commissioning Group board reports are all published via their website; by scanning these board papers you can identify their specific issues and make it clear that your innovation solves their problems.

Get clinician approval first

Don’t even think about approaching any director or commissioner if you don’t have sufficient clinician buy-in. After all, they are the people who will be using your innovation on day-to-day and will need to be convinced of its value if you want it to get implemented properly. Approach the clinical teams to highlight the clinical and patient benefits of your innovation, and test their interest, before trying to get it bought for their hospital.

Tip: you are more likely to have an impact with this audience if you show that you’ve done some research. Do the testing, build up an evidence-base and then make your approach.

Learn about procurement

Don’t underestimate the potential for procurement processes to slow down or even stall getting your innovation into the NHS. Procurement is often a lengthy process in trusts, (for very good reason given it is taxpayer money that is being spent) the complexities of which need to be understood and respected.

Tip: engage with procurement teams to understand the process for buying your innovation, so you can don’t delay getting the sign-off for your innovation being adopted.

Refine your pitch

Contrary to popular belief, products generally aren’t so good they sell themselves. I hear 2-3 pitches a week from individuals with a health innovation and the majority of them fall down at the same hurdles. Firstly, don’t start your pitch with the generalist tabloid problems with the NHS. An NHS manager hearing for the third time that week that the NHS has no money and national targets are consistently not being met they will disengage. Instead, touch upon the challenge that your innovation will solve and then give detail on how your innovation is the solution. And the devil is in the detail. All too often pitches include vague statements about an innovation rather than actual detail. The best pitches are those that give overview of the innovation, clinical evidence, quantify return on investment and give an example of past or current implementation within the NHS. Spell out the real benefits using robust data and evidence, but don’t promise you can solve all their problems if you don’t have the proof.

Tip: return on investment is extremely important to highlight early on in your pitch. For example, one company recently included the fact that a different maternity unit had commissioned their online platform because it would save them money on public liability insurance. This type of evidence is impressive, clear and makes it easy to forecast the exact numbers by which your product will make them clear savings. This will always grab people’s attention.

Show how your innovation works

This sounds simple – and it is. People don’t just want to hear about how a product works, they want to see it and even try it out where possible. If it’s a medical device, make sure you bring it with you. Or if it’s a digital solution, do a short demo to help people to visualise your innovation.

Tip: have a quick pitch on your product ready and ensure that it clearly explains how your product works. Practise a 60 second pitch for meeting potential customers on an ad-hoc basis at networking events.

Be persistent, but polite

It’s unlikely that the first email you send will result in a bulk order of your product. It’s probably unlikely it will even result in a meeting. But that doesn’t mean you should stop knocking on doors. ‘No replies’ are not the same as rejection. And rejection can sometimes be ‘not now’ rather than a straight ‘no’. If you believe your product can transform the health care system for the better, then there’s a good chance you can convince someone else of that too.

Tip: don’t assume the worst in people when they don’t respond. Your target audience are busy and overwhelmed by pitches. Maintaining your professionalism and manners at all times will always go further to getting an answer than aggressive chasing.

As I said, getting your innovation adopted in the NHS can feel like opening a sticky door that requires the hinges to be oiled continuously. If you take a hammer to it, it’s unlikely you’ll be able to repair the damage caused to relationships in the future.

Lesley Soden is the Head of Innovation within the Health Innovation Network. She has over 20 years experience in the NHS and public sector. She has worked in senior business and strategy roles in mental health and community NHS Trusts involving programme management, business development, bid writing and service re-design, all delivered in collaborations with a variety of public and private health partners.

For more information on how we work with innovators, visit our Innovation Exchange page or read about our funding opportunities here.