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 The reliance of UK public service organisations on outdated IT systems and insufficient resources for basic cyber hygiene make it an easy target for cyber attacks.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.

To read a full overview of the project and the AI tool, visit Tunley’s webpage here: https://www.tunley-environmental.com/pu-cpa-tool-for-pressure-ulcers

To find out more about how you can be involved in Research at DBTH please visit the dedicated page: Research and Innovation at Doncaster and Bassetlaw Teaching Hospitals – Doncaster and Bassetlaw Teaching Hospitals (dbth.nhs.uk)

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.

*Tina Woods, CEO and Founder, Business for Health*

News, Secondary Care August 7, 2024

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 have to 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.

Find out more about the new MES initiative: Omnicell.co.uk or email: Sales-aa@Omnicell.com

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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.”

Prioritise patient safety in design and rollout of EPR systems: report

By Integrated Care Journal

New report sets out emerging patient safety concerns relating to the implementation of electronic patient record systems in the NHS and calls for patient safety considerations to be at the heart of the design, development and rollout of EPRs.

A new report from Patient Safety Learning, a charity and independent voice for improving patient safety, has called for changes to the process of developing and rolling out electronic patient record (EPR) systems, emphasising greater prioritisation of patient safety and experience. The report, Electronic patient record systems: Putting patient safety at the heart of implementation, is based upon the observations and insights from a group of experts convened for a roundtable in June 2024 by Patient Safety Learning.

EPR systems collate patient data, including medical history, test results, clinicians’ observations and prescribed medications, from various sources, making it easier for healthcare professionals to access patient information. EPRs can vary from covering a single GP surgery, a single specialty area, or multiple areas within an NHS Trust serving hundreds of thousands of patients.

Their introduction into the NHS was identified as a key priority in the Department for Health and Social Care’s 2022 policy paper, A plan for digital health and social care, and as of November 2023, 90 per cent of NHS trusts had introduced an EPR.

However, the report outlines that there are significant patient safety risks associated with planning, implementing and using EPRs, as well as concerns around incident reporting.

The report explores several instances where avoidable harm has occurred due to poor implementation or usage of EPR systems. These include an example where a four-year-old received 10 times the intended dose of a coagulant on five separate occasions due to an undetected prescription error recorded on a medicines EPR system. Another incident, which resulted in a National Patient Safety Alert being issued in 2023, occurred when an EPR system being used in the maternity departments of at least 15 NHS trusts was found to be overwriting existing patient record data with new information and displaying incorrect safeguarding data, putting maternity patients at risk.

In another case from February 2024, a Coroner’s Prevention of Future Deaths report highlighted how a new EPR system contributed to the death of Emily Kate Harkleroad, a 31-year-old woman who died of a pulmonary embolism after delays in treatment at Country Durham and Darlington NHS Foundation Trust. The report found that “errors and delays in [her] medical treatment resulted in her not receiving the anticoagulant treatment that she needed, and which would, on a balance of probabilities, have prevented her death.”

The report offers ten principles for consideration for the safe implementation of EPR systems:

There should be robust standards for ensuring safety in EPR implementation and operationalisation. These standards should be accompanied by strong quality assurance and accountability mechanisms.
Patients should be engaged and involved in each stage of the implementation and delivery of EPR systems.
EPR system implementations should be planned and delivered as major organisational change programmes, not simply technical IT projects.
Healthcare professionals and those who will be the primary users of EPR systems should be involved in each stage of their design, planning and implementation.
There should be Board-level and senior leadership champions for EPR implementation programmes. These staff should be properly trained and experienced with the expertise to guide, support, and if necessary, challenge.
Communities of practice in EPR system implementation should be established to share knowledge, provide support and access to guidance.
Human factors experts should have a central role in EPR implementation, from design through to product selection and operationalisation.
Clinical Safety Officers, who play a key role in the success of EPR implementations, need to be expertly trained, resourced and supported.
Incident reporting and investigations should capture EPR-related safety issues and this should inform improvement in the future design and implementation of EPR systems.
Learning from EPR implementations should be shared transparently and widely across the healthcare system to ensure that risks are mitigated and managed, and to inform safety improvements. This relates to both NHS and independent sector organisations as well as with suppliers and procurement staff.

Commenting on the report, Patient Safety Learning Chief Executive, Helen Hughes, said: “EPR systems have significant potential to improve patient care and treatment. However, we are increasingly seeing cases where poor implementation of these new systems results in direct and indirect harm to patients. If we are to fully realise their benefits, patient safety must be at the heart of their design, development and rollout.

“To ensure the safety of EPR systems, it is vital that patient safety incidents associated with them are reported and acted upon. We need more transparency in reporting and sharing knowledge, of both errors and examples of good practice.

“We hope that this report can kick off an informed and transparent debate about these issues, leading to action that supports the safer implementation of EPR systems and reduces avoidable harm.”

The full report can be accessed here.

ONS and Business for Health partner to enhance the ONS Health Index

By Integrated Care Journal

The Index will capture a wide range of health inputs, including wider societal and economic determinants, to fill the evidence gap on the interplay between health, business and work and encourage businesses to take responsibility for their impacts on health.

Business for Health and the Office for National Statistics (ONS) have announced a collaboration to develop the next iteration of the ONS Health Index – a tool to support businesses, local authorities, integrated care boards, and government on decisions to ‘invest for health and economic growth’ and inform the Treasury on the economic case for prevention.

The ONS Health Index, last published in summer 2023, measures health in its broadest terms and seeks to understand how it is changing over time. It tracks health in clinical terms (i.e. the prevalence of certain conditions), but also looks at the wider social, economic and environmental drivers of health, together with personal circumstances.

Building on these measures, the enhanced ONS Health Index will include additional data and tools relevant to businesses and their practices. These could range from capturing direct health impacts on employees and customers, to environmental impacts of a company’s products. This will increase the understanding of the interplay between health and business and work life and fill an important evidence gap. For example, it could be used at a local level to help measure corporate progress against key health and wellbeing aims.

More broadly, the additional business themed metrics will inform strategies around the link between health and wellbeing and workforce productivity, and the role of health within the Environmental Social and Governance discussion.

Business for Health, a business-led social venture, in collaboration with Lane Clark & Peacock (LCP), have identified demand from businesses and organisations for the continuation and enhancement of this tool to define their role in the economy and wider society.

They will engage with businesses to develop the next iteration of the Index that provides high-value data on the health and well-being of the nation, including the workforce. One of the key goals will be to encourage businesses to understand and take responsibility for their impacts on health. To this end, the next iteration of the ONS Health Index will seek to bring businesses into its core audiences and provide health-relevant data to the public that measures the impact of businesses on population health.

These additional data will aim to highlight key determinants influencing employee health, and in doing so, inform business decision-making and support organisational and corporate culture with health at its core.

With the UK’s general population currently facing significant health challenges, leading to long term economic inactivity and pressures on the health system, the enhancement of the ONS Health Index will enable focus on facilitating system change to improve health and wealth outcomes. This is vital for enhancing the health and economic resilience of the nation.

Tina Woods, CEO and Founder of Business for Health, said: “There is a clear need from businesses to receive better data on the role of health within wider workforce planning. The link between corporate culture and individuals’ physical and mental wellbeing is irrefutable and our role on the new ONS Health Index will act as a crucial tool in understanding how businesses can improve, report and measure their impact on health linked to economic growth.”

Lord Bethell, Former Health and Innovation Minister and Chair of Business for Health, said: “We are delighted to be working with the ONS and LCP to develop the next iteration of the ONS Health Index, which will differentiate itself by allowing companies to understand and define their social purpose alongside measuring their economic contribution.”

Jonathan Pearson Stuttard, Head of Health Analytics at LCP, said: “There is a need for employers, businesses and industry partners to work collaboratively with the government to ensure that long-term health challenges are tackled with the urgency that is required.”

Dr James Tucker, Deputy Director of Health, International and Partnerships, Office for National Statistics, said: “The importance of high-quality data to inform strategies and reporting on the health of our workforce is crucial. Working with businesses as core users of the next ONS Health Index will be key in accessing granular data from businesses to feed into the index and provide relevant health data.

NHS staff say new tech could help 18.6 million more patients a year get treatment, reveals new report

By Integrated Care Journal

Survey of 1,000 NHS staff finds that while progress has been made on digital integration and maturity within the NHS, millions more patients could benefit from further adoption of technology.

New research from Virgin Media O2 Business has found that three in five (61 per cent) NHS staff believe new digital solutions could help at least 18.6 million* more patients receive treatment annually. Surveying 1,000 senior decision-makers in public healthcare across the UK, the Bridging the digital gap in UK healthcare report shows nearly two fifths (38 per cent) believe that new digital tools could help the NHS to reach 3-5 per cent more patients each day – potentially benefitting at least 51,000 more people daily.

Technology is recognised as a key enabler of positive change in the health sector. According to the report, digital technologies, like electronic health recording and Internet of Things (IoT) devices for monitoring vital medicine, could significantly reduce the workloads of frontline staff and decrease patient waiting times, as noted by 4 out of 5 (86 per cent) NHS staff members surveyed. Nearly a quarter (23 per cent) of surveyed healthcare workers, ranging from clinical to admin and IT roles, believed that technological improvements could drive at least a 5 per cent increase in patient consultations, potentially helping up to 31 million additional people per year.

Since the introduction of integrated care systems across England in 2022, there has been significant digital progress building on wider integration approaches across the devolved nations. Nearly all (98 per cent) respondents acknowledged this has positively influenced hospital technology adoption in their locality. A further 51 per cent of staff felt that there has been significant progress in the standardisation of digital systems since January 2023.

With NHS structures varying across the UK, a clear regional divide persists as respondents identify varying levels of digital maturity. Over four-fifths (85 per cent) of surveyed staff in London, Belfast and Edinburgh agreed that current connectivity solutions in their area are effectively supporting efficient patient care. Yet, this number dropped to 65 per cent of staff in the South East, South West and Yorkshire and the Humber.

Mark Burton, Health and Social Care Lead, Virgin Media O2 Business, said that: “The introduction of integrated patient care has already had a positive impact on digital progress across the NHS. However, our findings demonstrate there is still a huge untapped opportunity to use technology to drive operational efficiencies for patients and staff across the UK.

“As the NHS becomes increasingly digital, prioritising digital skills and confidence for staff, fostering open communication and adopting a strategic approach to technology investment will be critical to continued progress. Public-private partnerships can help here, playing a significant role in delivering robust connectivity for an NHS that is ready for anything.”

Virgin Media O2 Business currently works with 174 NHS Trusts & Boards, representing about 70% of all those in the UK, to develop and deliver core connectivity solutions. These solutions allow teams to drive efficiencies within the NHS to enable a smoother delivery of patient care.

To further support frontline staff with efficiency and patient waiting times, Virgin Media O2 Business recently launched its ‘Care-ready Connectivity’ suite of health solutions in a move to help tackle the digital gap in British healthcare. The telco has also committed to partner with the UK Government and charity, Supporting Children with Diabetes, to donate recycled smartphones to help children of low income families access technology so they can monitor their blood glucose levels.

Learn more about Virgin Media O2 Business’ support for the sector here.

*Based on The King’s Fund’s findings: In total there was an estimated 1.7 million patient contacts with GP, community, mental health, hospital, NHS 111 and ambulance services in 2023/24. To calculate this for a 3 per cent annual increase, the sum is 1.7million daily interactions x 0.03 x 365