Evaluating emergency department digital front door solutions
The NHS England London Digital Urgent and Emergency Care (UEC) programme is accelerating the adoption of emergency department digital front door (ED DFD) solutions across London to support wider UEC transformation and recovery. The HIN is leading an independent evaluation.
Background
In England, emergency departments (EDs) continue to face sustained pressure driven by rising demand, constrained capacity and workforce challenges. These pressures contribute to longer registration and initial assessment times, increasing risks to patient safety and affecting the flow of urgent and emergency care (UEC).
Digital transformation is a key part of NHS strategy to improve UEC performance and build long-term resilience. As part of this approach, trusts are encouraged to support the introduction of digital innovations that support streaming and triage, such as ED digital front door (DFD) solutions.
What is an ED DFD solution?
ED DFD solutions are electronic systems (typically tablet or mobile format) that use touch screen interfaces and algorithm-driven questions to capture patient-provided information and support check‑in, triage, streaming and redirection.
Project overview
The NHS England London Digital UEC team is leading a programme to accelerate adoption the ED DFD solutions at scale across London, supporting wider transformation and recovery of London’s UEC pathway.
The HIN was commissioned to evaluate the implementation of ED DFD solutions across London independently.
The evaluation is being delivered in four phases.
- Evaluation design and scoping – co-develop the programme logic model and evaluation approach
- Evidence and ecosystem review – examine the policy and evidence landscape and early experiences across London
- Formative evaluation – generate early insights at King’s College Hospital NHS Foundation Trust (KCH) to support implementation across the programme
- Summative evaluation – evaluate implementation, impact and value for money across multiple programme sites
Project outputs
The evaluation is producing a series of outputs that present key findings and learning from different stages of the evaluation. Together, these outputs aim to support local implementation, inform programme development, and contribute to the wider evidence base for ED DFD solutions.
Evidence review and the London ecosystem
This report explores how ED DFD solutions fit within England’s wider UEC transformation agenda. It summarises the evidence base and presents insights from London trusts that had already deployed ED DFD solutions before the programme.
The report concludes with key considerations for successful deployment, and wider system foundations required for sustainable UEC digital transformation.
Early implementation insights at King’s College Hospital NHS Foundation Trust
This formative evaluation provides early learning from the implementation of the ED DFD solution at KCH. It describes the model, explores the conditions shaping implementation and outlines early evidence of impact and learning.
Practical recommendations are provided for trusts, suppliers and NHS England London.
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