Social care monitoring tech could free up two million bed days and save over £1.2bn for the NHS, new report finds
By Integrated Care Journal
New report highlights major potential of lifestyle monitoring technology to address immediate system-wide crisis across health and social care, finding that thousands could avoid hospitalisation from earlier detection of illness, avoiding more expensive residential care.
The NHS could save more than £1.2 billion through widespread use of new non-intrusive lifestyle monitoring technology in social care according to a new independent report. More than two million hospital bed days could be saved, and the extra capacity created in social care able to fund the equivalent of 10,000 additional full-time carers in the system by 2035.
These findings are part of new analysis commissioned by health-tech company Lilli to make the case for urgent digitisation across the health and social care sector. The report uses data from multiple local authorities across the UK who are currently using the AI-driven monitoring technology to address the growing care deficit and mounting social care crisis.
Entitled From passive to proactive: How monitoring technology can help to solve the health and social care crisis, the report follows recent social care promises from the new government to accelerate the adoption of technology in health and care and highlights the ‘domino effect’ that proactive monitoring employed in social care can have not just on council resources but also the NHS and patient outcomes.
It identifies hospital discharge as a key area that can see a significant impact from the technology. Earlier discharge would amount to 2.3 million additional bed days and almost £1.2bn in savings for the NHS, due to reduced costs of providing beds for patients over the next ten years – enough to pay the salaries of 2,000 nurses over the period. It would also lead to better health outcomes for the many thousands of people experiencing delayed discharge every day, with extended stays linked to higher risk of infections, adverse drug reactions and readmissions to hospital.
The report also finds that adopting monitoring technology now would save councils £3bn by 2035 by supporting people to live independently at home for longer and preventing thousands of people entering more expensive care settings, such as residential care. The productivity benefits would help to address the workforce crisis in care, by generating additional capacity equivalent to 94 million hours of carer time across the UK, or to having 10,000 extra care workers. These productivity benefits would be worth an estimated £1.8bn to councils, allowing vital resources to be redistributed to where they are most needed.
Lifestyle monitoring technology works by tracking patterns of behaviour and key indicators of health, such as movement, eating and bathroom activity, and alerting carers to any changes. This allows care professionals to quickly make accurate care assessments, and safely monitor people’s health at home remotely, while being on the front foot to proactively spot signs of health decline before conditions require hospital treatment. Urinary tract infections (UTIs) have been identified as a key area where monitoring technology can help prevent hospital admissions, and the report estimates that the NHS could make savings of £1.8m each year through reduced hospital admissions from UTIs, due to earlier intervention, which could pay for half a million hours of nursing time.
Rebecca Andrew, Service Improvement Manager from Nottinghamshire County Council, said: “The rollout of remote monitoring technology across Nottinghamshire allows our social care staff access to real time data, giving insights into a person’s behaviour over a period of time. This helps them to build a clear picture of what is going on in a person’s life and draw their attention to any potential change in their social care needs. This ensures we can put appropriate care and support in place that is personalised to the individual, and respond quickly to prevent crises, meaning fewer ambulance call outs and hospital admissions.”
According to the report, produced by economists at Policy Points, “there is strong evidence that lifestyle monitoring technology can generate essential, big-ticket savings for both the NHS and for social care, creating a digital dividend by protecting scarce hospital resources at the same time as boosting the productivity of carers”.
Kelly Hudson, Chief Executive Officer at Lilli, said: “Right now, the people who need care are not getting the help that they should, and the problem will only get worse as the population ages. The numbers in this report speak for themselves. The savings and productivity figures highlight the profound difference that an investment in technology now would have not just on the system but on the lives of people up and down the country.”
Lifestyle monitoring technology from Lilli is currently being used by multiple councils across the UK, including Islington, Nottingham and Reading, to enable people to live safely and independently at home.
The report goes on to explain how over the next ten years, the older population will ‘grow by millions’, increasing demand for its services, and for the health and care system to be sustainable, a commitment to overhauling the system at pace and scale is urgently needed. The alternative is a broken system that will continue to be reactive and is unable to meet the care needs of those who need it most.
Kelly Hudson adds: “We are supportive of the new Health Secretary’s ambition for a ‘different politics on social care’ and we urge the new government to tackle the current crisis proactively as they have pledged, by addressing the root cause of the issue. We are urgently calling for more support for the sector to adopt a technology led approach to better support the people in need, reduce wasted costs and deliver better outcomes.”
From fragmentation to integration: Lessons for the NHS from New Zealand
By Gabriel Blaazer
When David Meates became CEO of New Zealand’s Canterbury District Health Board in 2009, he took charge of a system that was “broken and fragmented”. 11 years later, the system’s fortunes were transformed. At a recent event, Meates shared his experiences and lessons from Canterbury’s transformation, offering vital insight for the NHS as it continues its own journey from fragmentation to integration.
On 14th August, Public Policy Projects (PPP) held a dinner for a group of carefully selected stakeholders to share lessons from international and devolved nations on the delivery of integrated care. Speaking to the assembled guests was David Meates, who, while current interim CEO of Rowing NZ, was CEO of New Zealand’s Canterbury District Health Board (DHB) from 2009-2020. During his tenure, Canterbury DHB undertook an ambitious series of reforms aimed at integrating the fragmented elements of the health service, which turned the ailing system into one of the most integrated health systems anywhere in the world.
Many of the issues Canterbury faced have parallels within the NHS, and as such, it provides valuable lessons for UK health and care transformation. Prior to Meates’ arrival, Christchurch Hospital (the district’s largest) was regularly ‘gridlocked’ due to a shortage of beds, while a fragmented system and growing demand for services were damaging staff morale and the system’s ability to deliver effective healthcare.
Meates took charge of Canterbury DHB in 2009, and noted that by 2007, leaders had already realised the system was unsustainable and needed change. He described it as “broken and fragmented”, siloed by profession, dominated by providers and lacking clear purpose. Exponential increases in funding over preceding years had led to little-to-no improvement in service delivery, productivity or patient outcomes.
Christchurch Hospital, Christchurch, New Zealand
Without reform, the system would have required another 600-bed hospital, a 23 per cent increase in GP practices, 2,000 more aged care beds, and 9,000 additional healthcare professionals (HCPs), simply to meet demand. Meates remarked that even with the necessary funds, the workforce to do this was simply not available. What was needed, Meates determined, was a new blueprint for delivering healthcare to Canterbury’s more than half a million residents, as well as a burning platform that would inspire substantial change.
First steps: identifying the vision
Much of Canterbury DHB’s early work – under the umbrella of Project 2020 – focused on understanding the shared challenges that affect large and complex systems in other sectors, and how these insights could be applied to a healthcare environment. One key initiative was Xceler8, an eight-week experiential leadership development programme that involved 1,500 doctors, nurses, and allied healthcare professionals from across the Canterbury system. Participants, convened in cross-disciplinary groups, spent time with leaders in other sectors to understand their challenges. At the end of the programme, these groups presented ideas for system improvements to a chief executive, with some being subsequently implemented. Beyond the positive changes this brought about, the programme also helped to embed principles of system thinking among the workforce and demonstrated that each part of the system has a role to play in broader system improvement.
Other programmes included Particip8 (a six-week night-school course focusing on change management techniques), and Collabor8 (a short course focusing on skills management).
These programmes also sought to familiarise staff members with Lean and Six Sigma methodologies – prioritising customer value and continuous improvement – as well as chaos theory – the idea that beneath the apparent randomness of complex systems, there are underlying patterns and constant feedback loops that can be quantified, measured and understood.
Through these initiatives, system leaders began identifying commonalities and principles that extended beyond traditional approaches to healthcare system transformation, such as the concept of ‘value.’ While ‘value’ in other sectors might refer to profit or market capitalisation, it was determined that in a healthcare context, creating ‘value’ could be understood as not wasting patients’, and by extension, the system’s, time. This realisation led to the establishment of three strategic goals, forming a framework for “a connected system, centred around people, that aimed not to waste their time”.
People take greater responsibility for their own health
Prioritising the development of services that support people and families to stay well and take increased responsibility for their own health and wellbeing.
People stay well in their own homes and communities
Prioritising the development of primary care and community services to support people and families in community-based settings, close to home, and to provide a point of ongoing contact and continuity – for most, this is in general practice.
People receive timely and appropriate care
Enabling the freeing-up of hospital-based specialist resources which can be responsive to episodic events and the provision of complex care and specialist advice to primary care.
These initiatives also led to a realisation that regardless of how fragmented a system may seem, all components form part of the same ecosystem. Shuffling patients around to meet ‘activity’ targets benefits the system little, whereas prioritising the patient’s best interests—minimising their time spent while achieving the best possible outcomes—benefits both the patients and the entire system. This insight gave rise to the principle of “One system: One budget”, which became the foundation for all subsequent reforms within Canterbury DHB.
One system: One budget
These guiding principles informed the first series of practical changes that Canterbury DHB implemented to better integrate the system and create better value both for patients and the wider system.
A crucial development was the creation of the community-based HealthPathways, aimed at improving the interface between secondary and primary care. This programme was initiated by clinicians who, after reviewing a backlog of referrals, identified that many common issues could have been prevented through better communication between hospitals and primary care providers. General practitioners and hospital specialists were then brought together to agree on optimal management and referral pathways for specific conditions. These pathways were subsequently presented to larger groups of hospital doctors, GPs, nurses, and HCPs for their input. Meates reflected on the traction that HealthPathways was gaining as an approach in the Northern hemisphere, with systems in England and Wales adopting the methodology as the operating system for their integrated systems.
A key lesson from Project 2020, as Meates has argued, is that “too often, we confuse activity with progress,” a criticism frequently directed at the NHS’s Payment by Results tariff system. To better align incentives across the Canterbury system, this approach was abandoned in favour of the newly established Canterbury Health System Outcomes Framework. This change supported the principle of “One System: One Budget,” ensuring that the various components of the system would now be rewarded for achieving the best outcomes for the system or the patient, rather than merely moving patients around and being compensated for this ‘activity.’
Another change was the establishment of the Canterbury Clinical Network – a collaborative of HCPs, health system users and cross-sector partners using a principles-based framework to decide how, when and where health services are provided. These principles included taking a whole systems approach to ensure the integration and sustainability of services, ensuring that people and communities were at the centre of any changes, enabling clinically led service development, and the system operating within its financial means. Crucially, while commissioners were involved, their role was to support the process and then work out how to realise the objectives, not to prescribe the objectives themselves.
An important step towards service integration was also made by the establishment of a connected data platform – HealthOne – an electronic shared care record combining GP, hospital and community pharmacy records, along with laboratory and imaging results. Since this was not replacing existing systems, but drawing on them, its implementation was relatively non-disruptive and enabled the scope of the records to be increased over time. Citizens could opt out of all or part of the system, with the process led by the system’s Consumer Council, while regular “dynamic” automated privacy audits ensured that patient privacy was always prioritised.
Reflections
In reflecting on Canterbury DHB’s transformation journey, Meates was wary of simplistic quick fixes to complex, systemic problems, and the importance of taking a holistic and long-term approach with any proposed solutions. “You need a whole system to work for the whole system to work – focusing on part of the system will not effect the change required,” he told the assembled guests. Considering this, during its transformation Canterbury DHB paid special attention to the language it used to refer to the system and its workforce, emphasising the use of “we” in official communications, and deliberately halting the use of language which went counter to the narrative of a single system.
The principles of integration and collaboration must also be reflected in the redesign of services and pathways by actively involving relevant stakeholders and ensuring their voices are heard. Meates emphasised that “change happens at the speed of trust,” which requires meaningful engagement with frontline teams, as well as input from the clinicians who will deliver the services and the communities who will use them.
Meates also cautioned that in any large-scale system transformation, facilitating cultural change among the people involved is as crucial as any change in process or structure. With the introduction of integrated care systems and their emphasis on collaboration over competition (a significant departure from the previous way of commissioning services), this is a point the NHS could do well to acknowledge. “You can’t expect the same people that have worked in a competitive environment and who have seen their success tied to the success of their organisation to suddenly collaborate,” said Meates. This is a case of both instilling that necessary cultural change, but also of facilitating systems to be collaborative, such as by realigning incentives towards system outcomes as opposed to individual organisational sustainability.
The cultural dimension is also highly relevant to funding issues, as “too often, these involve win/lose discussions” where different parts of a system manage their activity levels to safeguard their budgets and maintain status within the broader system. While outcomes-based remuneration is undoubtedly a key solution, it is equally important to embrace the idea that the best outcome for patients is also the best outcome for the system and its individual components.
On a practical level, Meates emphasised that although reforming contracts can be the most challenging area, it is perhaps the most critical. Contracts significantly limit what healthcare providers can do and how they operate, making them essential enablers of any strategic change. “While the goal is integration,” Meates argued, this is undermined if “existing contracts and reporting requirements continue to move in the opposite direction. Contracts give you all the reasons why you can’t change what you are doing.”
Conclusions for the NHS
The transformative journey of Canterbury DHB under David Meates offers critical insights for the NHS as it continues its transitions towards integrated care. The success of Canterbury’s reforms, driven by a commitment to collaboration, system-wide integration, and a focus on patient-centred outcomes, illustrates the importance of addressing systemic fragmentation holistically. According to Meates, people in Canterbury were “30 percent less likely to be admitted medically unwell compared with the rest of New Zealand” because of these reforms.
Canterbury DHB’s experience shows that applying process and quality improvement techniques like Lean and Six Sigma to complex systems such as healthcare is no simple task; it demands a long-term vision and strong commitment from leadership to act. For too long, the NHS has been consumed by day-to-day pressures, and the introduction of ICSs has not been accompanied by the necessary cultural changes that can only clear, top-down strategic direction can bring.
Additionally, while the NHS has sought to place greater emphasis on citizen-centred care, it still often fails to adequately engage marginalised communities and provide co-designed, holistic care services that meet their needs. The establishment of community diagnostic centres is certainly a positive step in this regard, more needs to be done to ensure that these services are accessible and tailored to the unique challenges faced by marginalised and underserved groups. This includes overcoming language barriers, addressing cultural sensitivities and ensuring that services are easily reachable for those most in need. Citizen-centred care required continuous engagement with these communities, fostering trust and enabling them to have an active role in shaping their own health outcomes.
Key lessons from Canterbury DHB include prioritising cultural change, realigning incentives to emphasise system-wide benefits, ongoing community and patient engagement and leveraging technology like shared care records to enhance communication across care settings. By adopting these principles, the NHS can achieve meaningful, sustainable reforms that deliver value for both patients and the wider healthcare system.
Labour urged to support and protect NHS’ temporary healthcare workforce
By Integrated Care Journal
The UK’s temporary healthcare workforce needs championing and protecting, suggests the Recruitment and Employment Confederation (REC), as it launches its people-first ‘Voice of the Worker’ campaign.
The Recruitment and Employment Confederation (REC) is urging the government to champion the UK’s temporary healthcare workforce, with the launch of it’s people-first ‘Voice of the Worker’ campaign.
The campaign comes as the new government is pushing on with its Employment Rights Bill within its first 100 days in power.
The move has sparked robust debate regarding recruitment and employment, because highly regulated agency work already offers employment rights and in-work progression. There are fears that anticipated changes to employment rules could put the temporary worker market at risk.
Further, the new government’s launch of Skills England will also create more opportunities for temporary and contract workers to upskill as the Apprenticeship Levy is reformed. Although not confirmed, the government is expected to expand the Apprenticeship Levy into a ‘Growth and Skills Levy’, allowing companies to use 50 per cent of their levy contributions to fund training via routes other than apprenticeships.
Temporary healthcare work is key in helping the NHS deal with disparate and fluctuating demand, and with the right regulations in place, enable workers greater flexibility in work and control over their work-life balance.
Neil Carberry, REC Chief Executive, said: “Flexibility at work is something to feel optimistic about. It is working for millions of people. Individual choice and employers’ need for a versatile workforce can be brought together to deliver better careers and higher productivity. The government must ensure new rules support temps and that means having a real understanding of their lives.”
REC’s campaign aims to show how and why temping can work for many individuals by placing the real-life stories of temps, including those working in healthcare, at its heart. The campaign urges government, employers and unions to collaborate more closely to support the UK’s growing temporary workforce.
For the campaign, REC commissioned Whitestone Insight to interview 520 temp agency workers across different sectors – not just health – in Britain in June 2024, to hear their thoughts about agency work and why it matters to them. Polling found:
Almost eight in 10 temp agency workers (79 per cent) said their work provides an important need for flexibility.
More than two thirds of temp agency workers (68 per cent) said that their work provides a greater work-life balance.
More than half of temp agency workers (53 per cent) believed that this is the right kind of role for their current stage in life – an active choice.
REC says it hopes its ‘Voice of the Worker’ campaign will prompt far more discussion about reform of the public sector, with public services clearly struggling with demand. Temporary workers are critical in enabling the NHS to deliver services, helping to retain skilled people in the workforce and provide solutions to NHS trusts. But NHS policies for frameworks and banks have reduced the attraction of working for the NHS for medical staff – and forced trusts to use more and more emergency shifts. By reforming frameworks, their rates and the approach taken to permanent staffing, the new government could reduce costs and get better results for patients and the Treasury. But a proper partnership is needed to achieve this, the REC argues.
Neil Carberry added: “Government has repeatedly made the same mistakes in NHS staffing for almost a decade – trying to pay agency staff less year-on-year than they pay substantive staff. And pretending that Banks are cheaper to the exchequer. The result of this is that there are more emergency shifts as medics reject shifts, and spending overall has gone up. Moving on from demonising agency nurses and doctors and other clinicians – and the agencies that supply them – and working in partnership with the sector on a new approach to procurement will give the new government a unique opportunity to build a sustainable supply of short-term staff, at high quality and value for both patient and taxpayer.
“Good and lasting workforce changes that are effective for workers and employers, happen when employers and government work together to determine what works for everyone. Our case studies show the difference talented agency and contract staff are already making in our health service.”
This autumn, the REC will highlight video and written case studies of temporary workers, in which they explain the reasons for wanting flexibility and the benefits of temp working, across a variety of sectors.
Is the UK health system underfunded and underprepared?
By Ross Brewer
Managing patient care in a digital environment is a challenge to navigate for any health services. The need to store accurate patient healthcare records and share these electronically is undeniable. However, the ability for these systems to communicate across platforms while remaining secure is a bottleneck yet to be unplugged.
The recent cyber attack on Synnovis – a company that provides diagnostics, testing and digital pathology services for hospitals, GPs and other NHS healthcare providers – has highlighted the vital importance of cybersecurity and the potential disruption supply chain organisations can cause.
Consequently, to minimise future disruptions, the Labour government has introduced a Cyber Security and Resilience Bill. While this is a step in the right direction, before enhancing cybersecurity, the government must first ensure that the NHS receives the necessary funding to modernise its IT infrastructure.
Arguably, while the significant disruption across the NHS caused by incidents like the Synnovis attack and the CrowdStrike outage – the largest outage in history – are not the result of strained budgets, some healthcare organisations do struggle to make the necessary investments in cybersecurity when the priority lies with bettering patient outcomes.
While the NHS Chief Executive has warned that there is no financial headroom this year following a £22bn deficit in the nation’s finances, it is imperative for the government to prioritise and allocate increased funding to the NHS or else take a risk with the country’s healthcare.
The importance of adequate funding
The Cyber Security and Resilience Bill is a good start towards better cyber defences. However, it overlooks how critical it is to dedicate adequate funding to public service IT operations, including cybersecurity. The reliance of UK public service organisations on outdated IT systems and insufficient resources for basic cyber hygiene make it an easy target for cyber attacks.
Enlisting the latest AI-enabled cybersecurity technology without first preparing IT foundations is a misstep many organisations make. Existing architectures and systems must first be interoperable in order to integrate new software into the infrastructure. Without taking the first step to overhaul and modernise legacy systems, we essentially plaster over the cracks that will inevitably appear.
The UK government faces a tough challenge here, particularly considering that the volume of cyber attacks on critical infrastructure is on the increase. To prevent potentially catastrophic breaches like those we have witnessed across the NHS in recent years, officials must make funds readily available for critical infrastructure organisations like the NHS, to build cyber resilience and protect its citizens.
The value of our health
There are various industries under particular threat from cybercriminals with nefarious agendas. Telecommunications is a core industry that criminals can use to gather and sort information that provides intelligence on individuals and organisations. Transport is critical infrastructure, but it’s now rooted in IP (Internet Protocol) which lays out the location of vehicles, containers, delivery addresses and tracking systems among other sensitive information. This crosses over when you think about healthcare and the emergency services. Blue light services like ambulances are also at risk of being hacked and derailed if not protected properly but healthcare overall is essentially a high value data industry.
Healthcare organisations handle extensive personal health information, comprising medical histories, lab results, and insurance details. This data is extremely sensitive, potentially embarrassing and holds significant value for cybercriminals. The risks are further amplified by the growing connectivity within healthcare systems, where patient data is shared across networks and accessed through various applications, including APIs (Application Programming Interfaces). Hence, protecting sensitive patient data is the top priority in the healthcare industry.
Enabling digital and physical health
Maintaining confidentiality in healthcare involves ensuring the security and privacy of electronic data. To do this, NHS trusts need tools. However, with limited budgets in place this can be a challenge.
In this situation, using technology that is multifaceted rather than solely focused on security offers the ability to monitor security but also document compliance, while providing visibility into performance and availability.
Additionally, trusts would do well to collect the data that matters. Collecting reams of data with limited tools will only serve to overwhelm systems and professionals. The NHS should first determine its risk tolerance level and then seek to collate data from a minimum of six areas – Identity and Access Management, Audit and Accountability, Continuous Controls Monitoring, Configuration and Change Management, System Communications and Protection, and Incident Detection and Response. Minimising the data collected allows for better governance of that data.
The use of forensics from previous attacks also provides an insight into the vulnerabilities of systems. Reviewing the details of past cyber breaches is a great way for organisations to examine their security posture to find gaps that need filling with tools, processes or people that can reinforce their cybersecurity strategies.
Considering the vast amount of information contained in a single electronic health record, it’s no surprise that they continue to be a target for cybercriminals. Unfortunately, despite an organisation’s risk posture, a cybersecurity event, to varying levels of severity, is inevitable. In those instances, properly collected event log data can provide visibility into the hackers’ journey through infrastructure, networks, devices and software.
While there are some preventable steps that healthcare organisations can take to protect their patients’ trust within critical infrastructures, ultimately the robustness of a cybersecurity posture depends on the intricacy of the policy, the depth of the strategy, and the accuracy of the tools implemented. The strategy is free, the implementation however, is priceless. Our new Labour government would do well to bear this in mind while considering the UK’s digital future and its safety.
Ross Brewer is VP and Managing Director EMEA at Graylog.
Preventing tragedies: The role of advanced sensors in mental health units
By Clive Hudson
Clive Hudson, CEO of Programify, discusses the importance of door tampering and proof-of-life sensors in mental health units, giving staff the tools they need to provide the best possible care and to prevent tragedies.
CW: This article contains mention of suicide.
A critical issue facing mental health units is the need for advanced safety measures. Indeed, mental health units face unique challenges when it comes to patient safety. One report from the UK showed that 77 per cent of in-hospital suicides between 1999 and 2007 were by hanging. The most common anchor points were doors, hooks or handles, windows, belts, sheets or towels. The use of shoelaces, doors and windows increased over time.
Despite rigorous efforts to eliminate these potential ligature points, mental health units face an ongoing challenge with a crucial weak spot: the patient room door. While other fixtures and items that could be used for self-harm have been systematically removed or redesigned, doors remain an essential yet vulnerable element in the care environment.
A report on suicides that had taken place in Veterans Affairs Hospitals in the US showed that a door, door handle, or door hinge was the most used fixture point (53.8 per cent) in hangings.
Traditional safety measures, while important, have limitations. Hourly checks and standard door alarms may not be sufficient to prevent determined individuals from harming themselves. This is where innovative technology, such as door tampering sensors and proof-of-life sensors, can play a crucial role in enhancing patient safety.
Advanced technology for continuous monitoring
Door tampering sensors are sophisticated devices designed to detect any unusual pressure on any one of the three exposed edges of a door. Unlike simple alarms, these sensors use advanced technology to continuously monitor the door’s status and the integrity of the sensor circuits themselves. One key feature of these door tampering sensors is the use of end-of-line resistors. This technology allows for constant monitoring of the electrical connection between the sensor and the central system. If the line is cut or shorted, the system immediately detects the issue, ensuring that the sensor is always operational.
The sensors are designed to be sensitive enough to detect even slight pressure changes, which could indicate a suicide attempt, while also being robust enough to avoid false alarms from normal door usage.
Implementing door tampering sensors in mental health units offers numerous advantages. By providing real-time monitoring, these sensors can alert staff immediately to potential suicide attempts, allowing for rapid intervention. Sensors can be installed on all doors, including ensuites, ensuring no blind spots in monitoring.
While not replacing human oversight, these sensors provide an additional layer of security, allowing staff to focus on patient care with the assurance of technological backup.
These sensors can provide valuable data on door usage patterns, potentially helping to identify at-risk behaviours or times of increased vulnerability such as sickness. It is also critical that anti-door tampering sensors can be integrated with central monitoring systems, providing a comprehensive view of the entire unit’s safety status.
Future innovations and ethical considerations
The field of mental health safety technology is continuing to evolve, and door tampering sensors are just the beginning. At Programify, we’re also developing “proof-of-life” sensors that use high-resolution radar technology to detect subtle movements indicating breathing or other signs of movement within a room.
These sensors, when combined with door tampering sensors, could provide an even more comprehensive safety net. Imagine a system that not only alerts staff to potential door tampering but also monitors patient movement and can flag unusual periods of inactivity.
While implementing advanced monitoring technology, we must always be mindful of patient privacy and dignity. Our systems are designed to be as unobtrusive as possible, avoiding video surveillance in favour of movement detection. The data collected is anonymised, focusing on patterns and alerts rather than individual identification.
It is crucial that mental health units implementing these technologies have clear policies on data usage and storage, ensuring that patient rights are respected while maintaining safety.
Choosing your technology partner
Mental health units considering the adoption of door tampering sensors or other advanced safety technologies should work directly with the designer-manufacturer to ensure they get technology specifically designed for mental health environments. The designer-manufacturer must also be willing to be flexible to allow for customisation to the hospital’s specific needs. This approach offers several advantages. Firstly, it ensures that the technology is purpose-built for the unique challenges of mental health settings, rather than being adapted from other applications. Secondly, it allows for a more streamlined service and direct access to the expertise behind the product.
When selecting a supplier, it is important that health care procurers enquire about their design process. Have they developed the technology in-house, or are they reselling off-the-shelf components? A company that designs, manufactures and programs their own systems is better positioned to provide tailored solutions and ongoing support. It will also be easier for them to adapt the technology to integrate with existing systems and processes.
It may also be worth starting with a trial implementation. Many companies, including Programify, offer trial programmes where you can test the technology in one or two high-risk rooms before committing to a full rollout. This allows staff to become familiar with the system and provides an opportunity to assess its effectiveness in your specific environment.
Remember, the goal is not just to install sensors, but to create a comprehensive safety system that enhances your staff’s ability to protect patients. The right technology partner will understand this and work with you to achieve it.
It is also important that any new sensors can be integrated with your current monitoring and alarm systems for seamless operation. Proper training is crucial to ensure that staff can effectively use and respond to the new technology. You must also continuously assess the effectiveness of the system and be open to upgrades or adjustments as needed.
As we continue to face the challenge of ensuring patient safety in mental health units, innovative technologies like door tampering sensors and proof-of-life sensors offer a promising solution. By providing constant, reliable monitoring, these sensors can help prevent tragedies and give staff the tools they need to provide the best possible care.
AI study seeking to improve the prevention and management of pressure ulcers
By Integrated Care Journal
The new research study has launched at Doncaster and Bassetlaw Teaching Hospitals (DBTH), with researchers hoping to share their findings across the NHS to help diminish the incidence and severity of pressure ulcers.
A new AI-powered research project is using patient data, including age, height, weight, pressure ulcer risk factors and stage of ulcer, to help improve clinical understanding around the prevention and management of pressure ulcers.
Pressure ulcers are when an area of skin becomes distressed due to prolonged contact with another surface, causing an injury to the underlying tissue. They are sometimes known as ‘pressure sores’ and ‘bedsores’. Daily, the NHS spends over £1.4 million on treating pressure ulcers.
The study aims to tackle this using an AI tool to develop for each patient a personalised care plan based on expected outcomes, suggesting a treatment plan which is also the most efficient and effective treatment, as well as holding the lowest carbon and economic cost.
The study, conducted by Scientists at Tunley Environmental, is currently in its early stages at DBTH, the only NHS Trust involved. Tunley Environmental’s team also works on initiatives in other sectors such as healthcare optimisation, utilising in-house PhD specialisations in artificial intelligence development.
This work was commissioned and funded by SBRI Healthcare. SBRI Healthcare is an Accelerated Access Collaborative (AAC) initiative, in partnership with the Health Innovation Network. The views expressed in the publication are those of the author(s) and not necessarily those of SBRI Healthcare or its stakeholders.
The study is currently in its data collection stage, meaning that clinicians are collecting anonymised data about patients with pressure ulcers, pressure ulcer prevention and treatment plans, and the outcomes and then feeding this data to the AI tool.
An example of required data that is collected is as follows:
Basic patient data
Category of ulcer
Clinical pathway
The data collection phase will last for around a year and then move into the second phase, where, based on the past data it has collected, the AI tool will suggest a personalised clinical pathway for a patient based on all the factors above and considering the economic and carbon cost.
Kelly Phillips, Lead Nurse for the Skin Integrity Team at DBTH, said of the study: “We’re so excited to be involved in this research project, not only will it enable the associated economic and carbon impacts of pressure ulceration incidences and severity to be established but will ultimately be able to predict a truly personalised prevention or treatment pathway for our patients at risk of or living with a pressure ulcer.
“Removing clinical judgement when it comes to developing a personalised prevention or treatment pathway will not only save time, reduce variation in care but will be based on data and evidence, thereby providing that assurance to the patient and the healthcare professional that the right care is being provided at the right time’’.
Dr Nathan Wood, Senior Scientist and LCA Lead at Tunley Environmental, said “It is an exciting project with a lot of scope to make a positive difference to the management of pressure ulcers and make a meaningful impact on patient care”
In the future, the researchers hope to share their findings and tools across the NHS to help diminish the incidence and severity of pressure ulcers and to address the associated economic and carbon impacts of treatment pathways.
Hall Green Health’s new ‘Check and Cancel’ telephony system optimising appointment management
By Integrated Care Journal
The new ‘Check and Cancel’ feature was integrated into the practice’s existing cloud-telephony system, reducing the number of missed appointments and boosting patient access to GP services.
Hall Green Health (HGH), a large family practice within the NHS Birmingham and Solihull Clinical Commissioning Group, has recently achieved substantial success with the implementation of its ‘Check and Cancel’ system within its Surgery Connect Cloud-telephony framework.
This new approach to appointment management has not only improved patient accessibility but has also significantly reduced administrative burdens and missed appointments (DNAs), a critical issue in the industry.
The need for innovation
With a patient population of approximately 28,500, Hall Green Health, like GP practices across the country, has been undertaking the long journey toward digital transformation. One of the pressing challenges faced by the practice was the inefficiency in managing appointments. Traditional methods, which often relied on phone calls during limited office hours, led to a high number of missed appointments.
According to NHS England, the financial impact of patient no-shows is substantial, with the average nine-minute GP consultation costing £42. In just one month, these missed appointments cost the NHS well over £7 million in the Birmingham and Solihull region. HGH recognised the need for a solution that would not only make appointment management more efficient but also ensure that patients who are not as digitally literate or lack digital access could still easily manage their appointments. The ‘Check and Cancel’ system was introduced in March 2024 to address these challenges head-on.
Implementing ‘Check and Cancel’
The ‘Check and Cancel’ feature was integrated into HGH’s existing cloud-telephony system, providing patients with a 24/7 service to verify or cancel their appointments. This system was designed with simplicity and user-friendliness in mind, allowing patients to navigate the call flow without needing assistance from the practice staff.
Jamal Syed, Operations Manager at Hall Green Health, described the implementation process as swift and seamless. “Within 15 minutes of working out where to put it, it was successfully set up to work with our slot types and tested ready for patients to use,” Syed noted. This quick integration was critical in ensuring that the system could start delivering benefits immediately.
Positive outcomes and impact
The introduction of the ‘Check and Cancel’ system brought about immediate and measurable improvements in appointment management at Hall Green Health. By providing patients with round-the-clock access to manage their appointments, the system significantly reduced the number of missed appointments. In July 2024 alone, 292 appointments were checked, and 92 were cancelled using the system.
The system’s impact extended beyond just reducing missed appointments. It also proved to be a valuable tool in saving time for both patients and staff. Based on average call durations, the system saved the practice approximately 10 hours and 53 minutes in July 2024. “This time-saving aspect is particularly beneficial during the morning rush when the administrative workload is typically at its peak,” Syed added.
Patient and staff satisfaction
The success of the ‘Check and Cancel’ system was not only reflected in the numbers but also in the feedback from users. Of the 26 users who reviewed the system in July, 76.2 per cent expressed their willingness to use it again, and 47.8 per cent reported that the system saved them time; with an overall satisfaction rating of 3.71 out of 5, these early results are promising.
The ability to handle appointment-related queries efficiently and independently contributed to a higher level of patient satisfaction. For many patients, particularly those unable to access digital services during regular hours, the system offered a convenient and reliable alternative. “The significant number of appointments checked and cancelled indicates that patients utilised the system effectively, potentially reducing the number of missed appointments,” said a representative from HGH.
Future prospects and conclusions
The ‘Check and Cancel’ system at Hall Green Health exemplifies the potential of digital innovations in healthcare to enhance service delivery and patient satisfaction. By automating key aspects of appointment management, the system has not only relieved the administrative burden on staff but also empowered patients to take control of their healthcare needs.
Looking forward, the architecture used to build this system provides a strong foundation for future developments. As healthcare practices continue to face immense pressures, the ability to further automate and streamline tasks, particularly those involving patient verification, will be crucial. Hall Green Health’s success with this system highlights the importance of integrating simple, user-friendly digital solutions into healthcare practices to improve efficiency, reduce costs, and enhance patient care.
The implementation of the ‘Check and Cancel’ system at Hall Green Health has not only improved appointment accessibility and reduced missed appointments but also set a new standard for how digital solutions can be effectively integrated into primary care practices and its journey provides a blueprint for other practices aiming to embrace the future of healthcare.
Labour needs a preventative health strategy to transform public health
By Tina Woods
Business for Health Founder and CEO, Tina Woods, discusses the crucial role that business can play in improving the nation’s health, and calls on the Labour government to adopt a shift towards evidence-based prevention.
As the new Labour Government enters its early stages in power, it is increasingly clear that the party has inherited a sick workforce, rising levels of economic inactivity and unsustainable pressure on the NHS.
Tackling our current broken health system requires a long-term, multifaceted approach that shifts the UK’s societal attitude from reliance on the NHS to a culture of prevention. Going forward, creating a comprehensive preventative health strategy should be Labour’s focus.
Laying the foundations for a ‘prevention first’ revolution
Labour’s Health Mission in their manifesto states the aim to “deliver a ‘prevention first’ revolution”, and with the right partners and a clear strategy, this vision can become a reality.
While the ambition to halve heart attacks and strokes, create a smoke-free generation, and reduce health inequality are commendable, translating these goals into tangible policy and action will be crucial.
A preventative health strategy must go beyond individual behaviour change and address the wider determinants of health. This includes creating healthy environments, reforming the food system, and ensuring good work and housing for all. Crucially, it requires coordinated action across government departments, and wider businesses.
Easing pressures on hospitals
The UK’s poor public health is placing immense pressure on the NHS, resulting in many hospitals having far too many patients, with far too long waiting lists.
Despite over 95 per cent of the NHS budget being spent on treatment, with little ring-fenced for prevention, preventable conditions like obesity, heart disease, and lung cancer account for a significant proportion of hospital admissions and healthcare costs.
The government should set a target to allocate a specific percentage of the total health budget to evidence-based prevention programmes within 5 years, rising by 2030. Moving more pathways of care into community health will alleviate pressure on hospitals and create a more sustainable healthcare system. To support in setting and managing these targets, Business for Health has partnered with the Office for National Statistics (ONS) to deliver an enhanced ONS Health Index which will be vital in tracking against the Government’s health and wellbeing plans.
Business is essential in prevention
Alongside the NHS, businesses also have a crucial role to play in this agenda, and the Labour government must work to cultivate meaningful partnerships with the private sector.
By creating incentives and frameworks for improving health, small and medium-sized enterprises can be encouraged to do more; exploring legislation, such as making workplace health reporting mandatory for larger companies, is another driver. To support businesses in creating these strategies, the next iteration of the ONS Health Index will include additional data and tools which businesses will be able to use to understand the health of their workforce and customers better.
Looking ahead, business leaders and employees alike will be eager to see legislation and clear targets from the Labour government, accompanied by investment to support a prevention economy. Businesses are essential partners in creating healthy workplaces, promoting active lifestyles, and tackling issues like obesity and mental ill-health.
A prescription for the future
Ultimately, Labour’s health agenda must move beyond short-term fixes and invest in long-term system change. This will require bold political leadership, a willingness to tackle vested interests, and a collaborative, cross-party approach bringing together government, business, communities and individuals. Only then can we build a healthier, more prosperous future for the nation.
Optimising medication management: lessons from an NHS Trust
By Hardeep Bagga
Hardeep Bagga, Director of Pharmacy at University Hospitals Coventry and Warwickshire NHS Trust, discusses how best to manage the implementation of new technology following the success of digitalising pharmacy services.
University Hospitals Coventry and Warwickshire (UHCW) NHS Trust is one of the largest acute teaching Trusts in the UK, comprising University Hospital in Coventry and the Hospital of St Cross in Rugby, and working in partnership with Warwick University Medical School and Coventry University. It has more than 10,000 staff and delivers services across the West Midlands region. This includes hosting region-wide services such as the Coventry and Warwickshire Pathology Network and Bowel Cancer Screening programme.
In 2018, the Trust launched an ambitious target to begin a journey of digitising their medicines management systems, starting with a Trust-wide implementation of Automated Dispensing Systems to drive safe and legislative compliance with storage. At the time, medication storage was time and operationally intensive on pharmacy and nursing teams. The Trust was on a journey to establish Electronic Patient Records (EPR), and it was agreed that a solution was needed to bring together both challenges; improving medicines storage and security to fully leverage the power of a hospital EPR system.
Initially, we had to present a business case within the Trust, which included recognising the external and internal scrutiny required to ensure we had robust medicines storage; assessment of security, nurse-led audit work, as well as acknowledging the impact of medicines handling on Time to Care. A number of enthusiasts supportive of the programme were recruited from ICT, Nursing, Pharmacy and Estates teams.
Following a competitive tender process, we made the decision to partner with Omnicell UK, who provide advanced automation, data intelligence and professional services, in order to transform operational efficiency and improve patient experience in hospitals.
Omnicell initially worked with us on our first stage installation, which included introducing more than 70 Automated Dispensing Cabinets (ADCs) on wards, in theatres and clinics. Such was the scale of the operation that at the time, it was one of the largest and fastest European rollouts.
Unbeknown to us at the time of committing to the project, but we were inadvertently helping to prepare ourselves for the biggest healthcare challenge the NHS has ever witnessed – the Covid-19 pandemic. Since implementation, the Trust has improved management of medicines during shortages, taken waste out of operational delivery of the supply of medicines, informed teams around medicines safety during temperature deviations, and is now progressing towards closed-loop medicines administration.
Project and installation highlights include the following:
All wards and departments have automated dispensing systems for medication storage (72 units in total), including two in pharmacy for controlled drugs and after-hours support.
Medication Safety Officers (MSO) used a live view to track high demand, essential treatment medicines throughout Covid and beyond.
Temperature monitoring gives an overview of real time temperature of all stock areas to support informed decision-making during temperature deviations.
Digital ordering by automated dispensing systems has reduced nurse time handling medicines by using pharmacy team time saved from ordering medicines redeployed to fill cabinets instead of nurses.
Increasing breadth of stock holding as top up occurs thrice or more weekly, rather than just weekly, across the Trust.
Such was the success of the project, that over the entire pandemic, the wards never ran out of stock of essential Covid treatments by utilising this technology.
Essential elements in the change management process
An effective and well thought out change management process was crucial in gaining buy-in from internal stakeholders and in particular, the nursing team who would be day-to-day users and large beneficiaries of the new technology.
The Pharmacy team at University Hospitals Coventry and Warwickshire NHS Trust (9th from left: Hardeep Bagga)
Valuable best practice lessons can be taken from trusts such as ours, to help support the successful adoption of technologies across the healthcare sector. First and foremost, this includes the need to have a solid change management plan in place to drive employee engagement – employees haveto be part of the planning as much as the execution.
Adaptations to technology also tend to go more smoothly when applied from the ‘bottom up’. This can be done by assigning and engaging ‘change champions’ or representatives within different departments. The key overriding factor remains: be the lead on the timeline and rules of the technology, but let your employees decide how to run the show.
A good way to start, as we did at UHCW, was to encourage internal stakeholders to make a list of their wishes and goals from the project at the outset. This was supported by a clear communication and adaptation strategy which emphasised the value and usage of digitalising and automating pharmacy services, and the impact this would have on internal teams, as well as our patients. This helped to ensure the implementation process went smoothly and served to remind us all of the end goal when at times, the project ate into our time or we hit a bump in the road.
It’s important to work closely with your technology partners to ensure effective communication. Omnicell was key to understanding our workflow, mapping this out to ensure systems benefited the way we work, as well as providing ongoing education and training. As partners on the project, the post ‘go live’ support, which included floor walking and handholding for ‘live day’ and the week afterwards, was imperative.
The project is by no means complete and currently we are working towards a key milestone which will be to link the ADCs and our robotic dispensing system to Oracle-Cerner. This will mean that our patient record system will provide a live/real-time view of what’s stocked in cabinets, as well as streamlining workflow and retrieving medications. All with enhanced security and removing process waste to support closed-loop administration.
More recently…
Further enhancing the Trust’s technology adoption, we recently installed two large dispensing robots in pharmacy – Tom and Jerry – with a joint capacity to hold more than 50,000 packs of medication. Importantly, they have allowed for the automation of nearly two million medication transactions which were previously ‘hand-picked’. The time saved allowed a skill mix change within the department, releasing time for Medicines Management Assistants (MMAs). As a result, MMAs are now working directly on wards, and utilising automated cabinets to improve patients’ medication journeys. Dedicated medicines returns units have helped drive the better use of medication and recycling of stock medication at a ward level. The impact has been staggering, saving large amounts in waste prevention.
In addition, all ward stock medication top-ups are now fully automated; the ward ADC sends a message to the robots at 6am and all ward boxes are picked and packed by the robots before the staff come into work. This process previously required manual picking and an accuracy check by another senior colleague, but is now fully automated.
The Pharmacy team last year celebrated winning the CEO Team Award at the Trust’s Outstanding Service and Care Awards (OSCAs), which is positive recognition of its digital transformation.
Digital staffing initiative unlocks flexible working for London medics
By Integrated Care Journal
Thousands of junior doctors in London are to gain access to greater flexible working, following the introduction of a new digital staffing initiative being launched by Barts Health NHS Trust to tackle workforce pressures.
From September, more than 4,000 medics working across the Bart’s Health NHS Trust will be invited to join a new ‘digital staff bank’, which has been designed to make it easier for approved clinicians to pick up vacant shifts and work flexibly across each of the trust’s hospital sites.
The platform will enable the trust to instantly broadcast vacant shifts to a vast network of approved medics. Clinicians who are registered with the bank will then be able to apply for their preferred shifts via a connected app.
Use of the digital staff bank – which is being delivered in partnership with doctor-led staffing specialists Patchwork Health – will reduce time-intensive administration for staffing teams, by making it quicker and easier for them to source temporary workers. This will help them to reduce reliance on external agencies to fill vacant shifts, while giving clinicians greater control over when and where they work.
A connected data analytics tool, Patchwork Insights, will also give workforce teams at the trust access to a wealth of metrics and reporting capabilities generated by staff bank activities. It will surface valuable insights on staffing trends from across the trust, including the number of vacancies, shift fill rates, and pay rates across departments and sites. This will provide increased oversight and help the trust to deliver improved data-driven staffing.
The digital staff bank is being rolled out across the trust’s five main hospital sites: St Bartholomew’s, The Royal London, Mile End, Whipps Cross, and Newham. Following this initial roll-out, the initiative is set to expand to support additional clinicians and increase workforce collaboration in the capital.
John Simon, Head of Temporary Staffing at the Trust, commented: “The Trust is quite excited to partner with Patchwork on this innovative platform which will enhance the working experience of our staff and by extension, benefit patient care. We are encouraged by the positive results seen by some of our neighbouring organisations and look forward to a productive partnership.”
Dr Anas Nader, Co-Founder and CEO at Patchwork Health, commented: “We’re delighted to be working in partnership with Barts Health NHS Trust to support more flexible, sustainable staffing through the creation of this bespoke digital staff bank. Initiatives like these are paramount to supporting clinician wellbeing and boosting retention, while helping NHS teams weather rising workforce pressures and keep services running in line with patient demand. They are vital to building a strong, healthy and happy NHS workforce for future generations to come. We’re excited to continue innovating to support this with Barts Health NHS Trust, alongside our other fantastic NHS partners.”
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