How the ICS can unify data and relieve elective care

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How ICSs can unify health data

In taking decisive action to bring down elective care backlogs, Mid and South Essex Integrated Care System has demonstrated the value of industry collaboration – made possible by the new ICS construct.


With over seven million people on elective care waiting lists, unifying data strategies and enhancing visibility across health providers has never been more important. UK health and care transformation has long been hampered by historically fragmented approaches to data infrastructure and these complex vulnerabilities were laid bare nationally throughout the Covid-19 pandemic and the resulting aftermath.

With such vast numbers of people stranded on backlogs, providers need data infrastructure to illuminate patient waiting lists, to provide absolute clarity as to who is waiting for what and to ensure that those who are in most urgent need are prioritised.

“There are opportunities for a partnership-based approach to care reform, allowing innovators to innovate as part of a cross-sector team”

In many respects, the development of integrated care systems (ICSs) has been fortunately timed to deal with such an issue. Central to the population health mission of ICSs is integrating data strategies and overcoming the obstacles posed by legacy data systems. There is also an opportunity for a revitalised provider-supplier relationship – with the ICS onus on collaboration over competition, there are opportunities for a partnership-based approach to care reform, allowing innovators to innovate as part of a cross-sector team.

This is in part the mindset that has defined the approach from Mid and South Essex Integrated Care System (MSE) to deal with its own elective care backlogs. MSE is responsible for the care of 1.2 million people, across Basildon and Brentwood, Mid Essex, South East Essex and Thurrock. According to the latest referral to treatment data from NHS England, there were 153,000 people across MSE waiting for non-urgent surgery in August 2022. Like in many other systems, MSE’s backlog covers multiple disciplines and as such requires a multifaceted solution to aid with prioritising those in most urgent need while pushing for further optimisation wherever possible.

To meet this challenge, system leaders across MSE have harnessed the new ICS framework to lead a data led transformation. In May 2022, system leaders kickstarted a partnership with leading NHS data solution specialists, Insource Ltd, to combine data from three acute sites to optimise waiting list management across the MSE system.


Articulating the problem

The core objective of the project is one of visibility. Historically siloed approaches to health data infrastructure have left a fragmented data landscape across the NHS, and this is no different for MSE. Competing legacy Patient Administration Systems (PAS), used under the former CCG constructs, had made it more difficult for providers to develop holistic plans to deal with issues such as elective backlogs.

“You can’t address the backlog if you do not fundamentally understand the nature of the problem”

PAS systems support the automation of patient management across hospitals, allowing them to track patients and manage admissions, ward attendances and appointments and as such are crucial for managing waiting lists. “Tracking and managing patients along complex elective pathways is technically difficult even with one PAS. Today’s NHS needs to manage patients safely across several hospitals in one ICS, making that challenge even bigger,” says Dr Rob Findlay, Director of Strategic Solutions at Insource. MSE has three different PAS systems in use across its acute sites, as well as three different theatre systems.

Insource have begun implementing its data management platform to unify and enhance data visibility across these three hospitals, creating a unified data foundation for system wide recovery, and has now created a unified Patient Tracking List (PTL) across the MSE system. In layman’s terms, the PTL provides a single view for all clinicians and operational managers across the ICS, detailing exactly who is waiting for acute care, for how long, for which specialty and what their clinical priority is – allowing for those with the most urgent needs and those waiting longest to be treated first.

“You can’t address the backlog if you do not fundamentally understand the nature of the problem,” says Barry Frostick, Chief Digital and Information Officer for MSE, who has spearheaded the project alongside Dr Rob Findlay. Reflecting on MSE’s enhanced backlog visibility Rob says, “when the NHS approaches us with a problem, our goal is to help the system clearly think through the challenges and accurately articulate the nature of the challenges they are facing, this way, the potential solutions that could be applied start to become obvious.”


A strategic partnership approach

The size and scope of MSE’s backlog necessitates a truly collaborative approach that develops holistic solutions to reflect the needs of all stakeholders and voices. “The project so far has benefitted from a clear alignment between the provider and supplier. This relationship is far more of a partnership than your typical supplier-provider relationship,” says Barry.

“There is a rich level of intellectual engagement and respect for these challenges across MSE”

From an Insource perspective, this type of relationship allows for a much richer dialogue between provider and supplier – necessary to deal with complex data issues. As Rob explains, “from talking to consultants, medical staff, and managers, it is clear that there is a rich level of intellectual engagement and respect for these challenges across MSE – this engagement has been a hugely enjoyable and rewarding part of this project and has been central to its success so far.”

While Insource have decades of experience in unifying operational data, a system wide, automated PTL is new to the NHS and the fact that MSE have managed to implement such a solution after only being in official existence for a few months is a remarkable achievement. However, despite the initial success, neither Barry nor Rob are getting ahead of themselves – both insist that this is not “miracle working”, but rather harnessing the new ICS structure and laying strong groundwork though effective leadership to create a fruitful partnership.


How has the ICS enabled this change?

‘Partnership’ has become an oft-repeated term in the context of integrated care, so much so that it can at times become an abstract concept. But the relationship between MSE and Insource has already borne tangible, significant fruit in the form of a PTL that now acts as a “single source of truth” on waiting lists across the system. Progress has been down in part to the renewed ICS focus on collaboration over competition (the latter defined much of the approach taken by former CCGs toward industry partners).

“There’s a higher level of involvement and a much higher level of accountability than the commissioner function used to have”

The partnership ethos visible here is in part down to the new ICS structures. Previous provider/supplier relationships under the CCG structure were simply based on providing a service, “whereas today,” says Barry, “the ICS has allowed us to stand shoulder-to-shoulder with our industry partners.”

For this project, the new ICS structure for MSE has allowed system leaders to take a step back from the day-to-day operational grind of service delivery. “The ICS acts as a critical friend to NHS services on the ground, making more impartial decisions, taking a step back and seeing the impact that a potential solution would have across the system” explains Barry.

Rob argues that the ICS is much closer to the frontline than the old commissioners were within CCGs, giving them “more skin in the game”. He says, “there’s a higher level of involvement and a much higher level of accountability than the commissioner function used to have. This allows us to harness the huge potential that the ICB has to intelligently bring together the different sectors, including the mental health, social, community and primary care sectors, as well as the acute sector, which tends to get the attention and is the initial focus”

Ultimately, the initial success of this project will be judged upon how MSE’s elective care backlog figures change over the coming months and years. However, with the new sense of visibility offered by the PTL – few could argue that its impact will be anything but positive. In fact, those closely involved in the project are already looking ahead. There is serious expectation that this new bank of centralised data, accessible system wide, will enable revolutionary improvements across the MSE system.

 

 

Digital Implementation

How ICSs can help uproot risk aversion and progress innovation

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Kathy Scott, Chief Operating Officer and Deputy Chief Executive of the Yorkshire & Humber Academic Health Science Network (AHSN) and Aejaz Zahid, Yorkshire & Humber AHSN’s Director for the South Yorkshire ICS Innovation Hub, spoke with Integrated Care Journal on how the implementation of a dedicated innovation hub within ICS frameworks has helped to streamline innovation and improve patient care.   


Integration and innovation are two increasingly prominent principles that are, in part, designed to address the growing problems of unmet health needs. Each is intended to supplement and support the development of the other.

Integrated care systems (ICSs) offer new frameworks through which innovation can be adopted at scale, streamlining past previous bureaucratic and individualistic barriers to change and adopting a transformation led approach. Innovation is crucial to turning the core aspirations of integrated care into tangible realties, to use technology and sophisticated approaches to data to help address the root causes of ill-health and expand health service offerings.

“There is a vast range of unmet need across the whole health and care sector”

The above outlines the core principles of integration and innovation, which can be found reiterated from a wealth of sources if one is to engage in the sector for even a few days. Integrated care is not a new concept and neither is innovation, so how are these two principles coming together to improve patient outcomes in reality?

“There is a vast range of unmet need across the whole health and care sector,” says Aejaz Zahid, Yorkshire & Humber AHSN’s Director for the ICS Innovation Hub at South Yorkshire & Bassetlaw Integrated Care System (SYB ICS). “Much of this is of course clinical, but a huge part of this more operational, system level needs.

“The ICS needs intelligence on all of this, but then must ascertain how it can use innovation to leverage economies of scale in terms of investing and finding solutions to those problems and challenges. What we are trying to do within the innovation hub is create straightforward and easily accessible processes which enable busy staff working on the ground to regularly bring those challenges and problems to our attention, while enabling ICS leadership to ascertain and prioritize needs that could benefit from a systemwide innovative solution.”

The ICS Innovation Hub is a single point of contact for health and care innovators in the SYB region. The hub works, via the AHSN, to identify and validate market ready innovations and help drive improved health outcomes, clinical processes and patient experience across the SYB health economy. The idea to set up a dedicated innovation hub within an ICS was developed by the Yorkshire & Humber Academic Health Science Network (Yorkshire & Humber AHSN) and has proved a successful model to help spread and adopt innovations at pace and scale. Yorkshire & Humber AHSN also provides innovation support to three different ICSs in the region.


Fostering a culture of innovation

Explaining how the Hub and by extension Yorkshire & Humber AHSN are working to cultivate innovation in the region, its Chief Operating Officer and Deputy CEO, Kathy Scott says “it is as much about identifying good practice as it is implementing the ‘shiny stuff’.

“We can push out new ideas and innovations as much as we like, but if you don’t embed a culture of innovation and improvement, it’s not going to stick”

“As an AHSN we also have sight of a lot of potential solutions that can address those needs often identified by the innovation hub. So we are able to nudge the ICS leadership towards potential solutions.

“It’s about growing the capability and capacity for change within a locality and for improvement techniques and innovation adaptive solutions to be implemented. Not simply implementing new technology and essentially running away.

“We can push out new ideas and innovations as much as we like,” continues Kathy, “but if you don’t embed a culture of innovation and improvement, it’s not going to stick.”

The ICS’s digital focus has also enabled significant work on pre-emptive care. For example, through the Yorkshire & Humber AHSN’s digital accelerator programme Propel@YH, the AHSN has worked with innovator DigiBete to support the adoption of their ‘one stop shop’ app to help young people living with diabetes manage their treatment.

The app was clinically approved during the height of the pandemic with extra funding provided from NHS England and is now being used in 600 services across England. “This is an excellent example of how we can pre-emptively assess unmet need and streamline innovation into the system,” says Kathy.


Innovation as an antidote to health inequality

“Health inequalities is part of our design thinking from the get-go in any project,” says Aejaz, who points to the recent implementation of SkinVision, a tele dermatology app, as an example.

“The app was originally developed in the Netherlands, where predominantly you would have Caucasian skin that the AI would have been trained on,” he explains, “so, from the beginning, we have been mindful to capture more data on how well the app works on other skin types and feed that back to the company to improve their AI algorithms for wider populations.”

The Innovation Hub also works to ensure that implementing digital technology does not exacerbate inequality for less digitally mature users. “If somebody, for example, doesn’t have a smartphone that is able to run that app, there is always the non-digital pathway in parallel. So, it’s never either or.”


Risk appetite

“There is always a level of risk aversion when it comes to adopting something new in healthcare,” says Aejaz, “even with evidence backed solutions, we find there’s sometimes a level of reluctance. Staff want to know whether it’s going to work in their local context or not and whether introducing innovation would entail a significant ‘adoption’ curve. Overcoming hesitancy to innovation is, therefore, central to the role of organisations such as the AHSN and by extension ICS innovation hubs.

“We need to create systems which provide innovators with the necessary psychological safety that allows them to experiment”

“Building a culture of innovation is fundamentally about building a culture of increased risk appetite, where failure is most certainly an option. We need to create systems which provide innovators with the necessary psychological safety that allows them to experiment.”

To help shift the mindset of NHS staff in favour of innovation, the Innovation Hub established a series of ‘exemplar projects’, designed to erode the fear of failure and capture learnings in the process. For example, for Population Health Management exemplars, one of the priority themes for the ICS, the hub called for providers to submit ideas to the Hub, all framed under high priority population health challenges such as cardiovascular health. Successful applicants with promising ideas received funding in the region of £25,000 as well as co-ordination support from the Hub towards their project.

The programme has enabled frontline innovators and has led to the development of a host of new services incorporating novel technologies such as virtual wards and remote rehabilitation. The Hub is also working to transform dermatology pathways throughout the SYB region by introducing an app that allows patients to upload images of skin conditions and be processed more efficiently through the system. Funded by an NHSX Digital Partnerships award, this pilot project with Dermatology services in the Barnsley region will test out the use of this AI enabled app to ascertain how well it can successfully identify low risk skin lesions which can be addressed in primary care. Thereby reducing demand on secondary care and speeding up access for higher risk patients. Each of these projects demonstrates the capacity for transformation when on the ground staff are given the freedom to innovate.

“Introducing solutions outside of traditional domains will enable a culture of innovation and improvement”

Interestingly, many of the ideas that the Hub works with are non-tech solutions. For example, primary care providers working with local football teams via a 12 week health coaching programme to engage with fans who may be at risk of cardiovascular disease, or introducing Cognitive Behaviour Therapy techniques to patients with severe respiratory conditions to help reduce anxiety when experiencing an episode of breathlessness.  To nurture a mentality more open to change, the Innovation Hub and AHSN teams have been reaching out to key leads from each of the provider organisations who are involved in innovation, improvement or research and invited them to become innovation ambassadors. “These ambassadors have become our eyes and ears on the ground across health providers, where they can start to introduce what we do and also help capture unmet needs from colleagues in their respective organisations.”

Following in the footsteps of the first innovation hub established by the Yorkshire & Humber AHSN in South Yorkshire, other AHSNs across the country are now looking at setting up innovation hubs within their ICS by bringing leadership together, getting them out of their ‘comfort zone’ and giving them the space to innovate, and hoping to chip away at risk aversion and fear of experimentation. Introducing solutions outside of traditional domains will enable a culture of innovation and improvement. To streamline past bureaucratic and individualistic hurdles, ICS frameworks are key to facilitating transformational change in every region of the country.

If you would like to find out more about the Yorkshire & Humber AHSN please contact info@yhahsn.com.

Building sustainable ICS staffing to weather the workforce crisis

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collaborative

The advent of integrated care systems (ICSs) across the NHS marks an invaluable opportunity to facilitate greater collaboration, efficiency and more joined-up care for patients.


To be successful, this period of transformation needs to be underpinned by a strong, comprehensive workforce strategy that enables staff to be flexibly and safely deployed in line with fluctuating demand.

Amid present staff shortages and rising waiting lists, and with pressures set to grow over winter, this is, unsurprisingly, no easy task for organisations. As managers rightly address these immediate challenges, it’s understandable that little time or capacity is left to support broader workforce transformation. Yet the benefits of a transition to more collaborative ICS-wide staffing have the power to tackle these same challenges in the long-term.

While it may seem like another hurdle for teams who are already facing extreme pressure, there are a number of ways that ICSs can reap these benefits, without compounding workloads or piling additional pressure on staff. Throughout my time working closely with NHS organisations to tackle various workforce challenges, I have found the following steps essential to successfully enabling truly collaborative staffing. I believe they are also the key to unlocking a more sustainable, long-term workforce strategy.


Harnessing the power of collaborative temporary staffing

Temporary staff are crucial to the successful running of an ICS, helping to plug any gaps in rotas across the region. However, currently, when organisations are unable to source clinicians from their own internal staff bank, they must often turn to more costly external agencies to fill vacant shifts. Instead, by building a collaborative network of approved temporary clinicians, organisations can seamlessly tap into a much larger and more flexible contingent workforce from which to reliably fill shifts.

The key to effectively leveraging a collaborative staff bank is enabling compliant digital passporting for all participating clinicians. This means approved workers can passport their credentials across different participating organisations, without having to repeat compliance or background checks. As a result, they can more easily work across a number of different sites and locations and be deployed effectively in line with demand throughout the ICS.


Increasing data oversight

In order to reliably plan ahead, identify staffing gaps and deploy staff where most needed, access to comprehensive data insights is crucial. This means not only enabling managers to view data from within their own organisation, but granting access to pan-regional workforce data from across the entire ICS.

Dynamic data reporting, which provides timely, granular insights into organisational performance, can help measure the success of workforce planning, enable targets to be reliably met and pinpoint areas where improvements can be made. Individual organisations should be able to assess their own performance data and compare this with others in their region. With clear visibility over regional shift fill rates, workforce spend and staffing trends, it becomes easier to identify areas for improvement, while harmonising pay rates and maintaining safe staffing levels in a truly collaborative manner.


Introducing more flexible rostering

When it comes to rostering, the current systems at managers’ disposal are often slow, outdated and require large amounts of manual input. Introducing more streamlined, digital systems which can safely provide staff with greater flexibility and predictability, while reducing the admin burden on managers, can help open the door to more effective ICS-wide rostering in the future.

Rostering clinicians based on skillset rather than title or grade will allow managers to deploy staff more effectively, in line with patient need. This will also give staff the flexibility to safely work in a wider range of roles, in different locations across the ICS, and to access wider professional development opportunities. These are all essential to helping boost retention.

Meanwhile, multi-organisational rostering could begin to allow more efficient deployment of staff to areas of highest need across the ICS. This makes it easier for managers to reliably plan ahead and gives staff greater control over where they work, in line with their personal and other professional commitments.


Prioritising system integration

System integration is a fundamental prerequisite to the success of every single one of these steps. If the systems being used to organise staffing within different organisations are unable to communicate or share data with each other, genuine collaboration will remain out of reach.

When introducing new workforce management systems, organisations should prioritise those which are fully integrated or interoperable, enabling managers to directly share workforce data, rota planning and temporary staffing networks with other organisations throughout the ICS. This reduces the need for manual data input, minimising admin for managers and speeding up the transfer of vital data and information.

As a result, organisations will be able to collaborate in real-time and deploy staff to the most appropriate services in line with evolving ICS-wide demand.

To reap the full rewards of ICS working, facilitating a collaborative, flexible workforce is vital. This transition does not have to be costly, nor add additional burden to managers or organisations. By working together and implementing these four key areas of change, we can lay the foundations for strong, collaborative ICS-wide working, built to weather the challenges which lie ahead.

Digital Implementation, Ethicon, News

Ethicon showcases product portfolio in UK & Ireland hospital tour

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digital transformation

Ethicon, the Surgical Technologies Company of Johnson & Johnson MedTech, has launched its first-ever roadshow across the UK & Ireland, including a showcase that demonstrates the role of digital innovation in supporting the NHS to tackle the backlog of patients waiting for treatment.


Ethicon is committed in its mission to support healthcare systems to treat more patients and provide better experiences and outcomes, especially as recent announcements from the Department for Health and Social Care show how important digital transformation of the healthcare system is, with £2 billion earmarked from the spending review to help digitise the NHS and social care sector.

The Ethicon roadshow began in September and runs until early December. It is a unique opportunity for clinical and non-clinical healthcare professionals to speak to representatives and industry experts about how driving digital transformation is pivotal in this mission, outlining the importance of Ethicon’s Surgical Simulation Strategy and Services & Solutions offering which gives surgeons additional information to support their clinical decision-making.

The products being showcased on the tour bus cover specialties including Colorectal, Gynaecology, Thoracic, and Bariatric. Ethicon’s digital offering has the potential to drive the next surgical revolution, bringing together the value of Next Generation Robotics and Instrumentation, Advanced Imaging, and AI-powered Digital Solutions.

Learn more about Ethicon and its product portfolio here.

“We’re focused on creating a differentiated digital ecosystem including working in partnership with our dedicated account management team to support a successful implementation, data insights, and best practice sharing,” said Jenny Nagy, Ethicon’s General Manager in Great Britain. She continued to highlight the value the company sees in this collaboration:

“Our Ethicon roadshow will give customers the opportunity to discuss innovation in healthcare and witness our innovations first-hand with our product demos hosted on the bus. Our mission may have been accelerated by the pandemic, but we’re keen to connect with our customers in-person to demonstrate the value we place on working together to advance the use of technology in tackling the biggest healthcare challenges.”

The Ethicon tour bus is also hosting:

  • Science of Energy Training
  • Surgical Simulation Suite
  • Product Training Innovation Workshops
  • New Product Innovations

Clinical and non-clinical healthcare professionals can register their interest in attending and booking a slot at their chosen hospital location here.


This is a sponsored article.

Digital Implementation, News

MIRACL announces new partnership with Birmingham Women’s and Children’s NHS Foundation Trust

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multi-factor authentication

MIRACL – the world’s only single-step multi-factor authentication provider – announces their new partnership with Birmingham Women’s and Children’s NHS Foundation Trust.


With a new directive from NHS Digital to ensure multi-factor authentication (MFA) across IT services within the NHS, MIRACL was perfectly placed to deploy their single-step MFA system in these world- renowned hospitals.

Time is of the essence for all those working in the NHS, so finding a MFA solution that was efficient yet provided the additional layer of security that was now required and, at a cost that met the tight NHS budget, was a challenge. Medical records are highly sought by cyber criminals so any data held by the hospital is always incredibly vulnerable and must be well protected on every level.

MIRACL was able to integrate their single-step MFA codelessly, in just fifteen minutes – minimising disruption to services during the implementation phase, yet providing an added layer of IT security across the organisation. With thousands of users within the Trust accessing IT services on a daily basis, the transfer happened seamlessly and without any unwanted hiccups.

Furthermore, as a passwordless solution, staff weren’t tasked with having to remember yet another password or have to share biometric data. A simple four-digit PIN is all that is required – the patented tech does the rest.

David Marshall, Head of ICT at Birmingham Women’s and Children’s NHS Foundation Trust, added, “numerous staff throughout our sites are having to access NHS IT on a daily basis, but time is always of the essence and it is essential that not only is all data kept safe and private, but staff who need to access information can do so instantly and securely. It was no surprise when we were required to add multi-factor authentication to our systems but finding a solution that would fit our needs was a challenge. MIRACL has provided a single-step MFA that does not require a password and has integrated into our systems seamlessly.”

Rob Griffin, CEO at MIRACL commented, “when we were advised that NHS Digital were directing hospitals to install MFA, we knew our solution was perfect. MIRACL provides MFA, yet requiring just a single-step to use, means that staff can access the IT services as they were before and without the need to remember another password or have a second device at hand to authenticate by SMS. We all know that staff are often working at a high pace across the NHS, so sourcing a solution that did not waste precious time authenticating was really important.” 

Since deployment of the service in mid-April, there have been a total of 150,000 authentications and only 283 failures or a failure rate of only 0.18%.  

MIRACL is the world’s only single-step multi-factor authentication provider. It can easily be integrated into current company and NHS platforms and is a low cost verification option but with banking level security. It boasts clients such as Experian, Domino’s and Cashfac and has been licensed by big tech names such as Google and Microsoft. 

 


For further press information, interviews or photography please contact the MIRACL press office: sarah.sawrey-cookson@miracl.com   |  07765 110438

Digital Implementation, News

GHM Care messaging app integrates with digital care management platform Nourish Care

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messaging

Advancements in nurse call technology unearths a wealth of valuable data for care homes when surfaced alongside daily care records.


GHM Care has announced their flagship nurse call messaging and reporting tool Nexus will now integrate with Nourish Care’s digital care management platform. The ability to integrate personal care records with a nurse call system is a huge step towards a joined-up care environment.

Nexus is a messaging platform that delivers nurse call alerts directly to the smartphones of carers, improving staff efficiencies and response times.

The integration with Nourish will allow Nexus users to link nurse call activity against a resident’s personal care records, driving a greater resident experience through interoperability. Care teams will have complete transparency of the time of the day calls are being made, time of acceptance, reason for the call and the resolution times. This information surfaced alongside daily care records offers contextual oversight, further promoting better care decisions and outcomes. In addition, the integration will enable care teams to run detailed reports and populate care plans within Nourish.

Care homes will benefit from a more comprehensive picture of the personal care provided through more powerful data.

Neil McManus, Managing Director of GHM Care stated: “It’s been great working with Nourish on this project and now we can deliver exactly what our joint customers have asked for. The new functionality has been launched in response to the needs of care homes who previously would not have the time or capacity to record every nurse call alert in a resident’s personal care records. As a result, there is often a disconnect between care records and nurse call activity. The new integration overcomes this by automatically updating Nourish personal care records with any associated nurse call activity.”

Steve Lawrence, Head of Proposition and Partnerships from Nourish Care added: “We are thrilled to be partnering with GHM Care, their leading nurse call solution will open the door to new and exciting data insights when surfaced alongside daily care records housed in Nourish. I look forward to seeing the positive impact this delivers for care teams and those they support.”

Training & Development Lead, Luke Annetts, from Blackadder Corporation said: “I think the integration between Nexus and Nourish has worked well, the information transfers quickly from the Nexus cloud onto Nourish. I think that this information will be really helpful for reporting purposes, especially when we look at accidents/incidents and response times”.

Nourish Care is an app-based care management platform that allows care services to record at the point of care, streamline administrative processes and equip teams with the tools to provide more person-centred care and improve outcomes for the people they support. Nourish works with more than 2,500 care services in the UK and overseas within residential homes, nursing homes, learning disability services, mental health services, and other care settings. Nourish was one of the first recognised as a NHS Transformation Directorate Assured Supplier for the Digital Social Care Records (DSCR) DPS at launch and were also the first accredited by the PRSB as a Quality Partner, working to promote best practice standards for care.


To find out more about how Nourish can help your care service, visit their website www.nourishcare.co.uk to book your free demo today.

To find out more about Nexus by GHM Care, visit www.ghmcare.co.uk.

A person-centred, digital first approach to recovery

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digital first

Ensuring that patient pathways are digitally enabled and person-centred is critical to tackling the elective backlog, writes Patricia Wynn, Director and Sales Leader, International Public Sector Health, Cerner Corporation


NHSE guidance states that “our ambition is to improve core digital and data services in hospitals to ensure we have the basics right.” A leading EPR provider in the UK and globally, Cerner supports systems to reach the minimum digital foundation and strive for HIMSS Stage 7 and beyond.

Cerner work across provider collaboratives to enable shared instances of the EPR. ICS-level collaboration reduces total cost of ownership and enables sharing of resources, such as PMO, training, back office and support. For example, a shared instance of Cerner accelerated provider collaboration across North West London ICS.

Imperial and ChelWest began sharing a domain in 2019 and now London North West and Hillingdon are set to join. According to Kevin Jarrold, ICS data and digital lead, “we have a growing agenda around collaboration across care pathways and the shared domain is absolutely fundamental.”

A shared domain has enabled NWL to gain efficiencies and generate much-needed capacity. Leaders can see across the system and transfer patients more effectively from one site to another. Virtual ward capacity is also managed centrally and embedded into the core EPR. Remote patient monitoring is leveraged from a variety of vendors, with all data feeding centrally into virtual wards created within the core EPR, enabling more efficient workflows and the sharing of virtual care staff.


Prioritising care

The national guidance outlines care must be prioritised based on clinical urgency, the impact of waiting on individuals and potential inequalities. To achieve this, North Central London (NCL) ICS uses Cerner HealtheIntent®, a data and analytics platform that provides a single longitudinal record for every citizen, comprising data from all health and care organisations across the ICS.

According to Amy Bowen, director of system improvement, “[We built] an elective waiting list dashboard in HealtheIntent. Now we can show GPs for the first time ever what their waiting list looks like. We can cut that data by all the demographic factors, e.g. how many people have long-term conditions and how many? We can look and see by ethnicity, by deprivation – we can combine several factors. And we can actually understand that population at a practice level, at primary care network (PCN) level; by specialty, by borough.”


Transforming care

NHS guidance outlines transformation should focus on flexibility, ease of access and citizen control. Re-envisioning patient pathways – and ensuring they are digitally enabled and person-centred – will be critical. Royal Free London (RFL) has standardised and digitised 40 pathways.

Cerner experts are involved from the beginning of pathway design. Dr John Connolly, CEO of the Royal Free Hospital and group director of clinical pathways shares, “The goal of this ambitious programme is to ensure every patient can get the same high-quality treatment in any of the Trust’s three hospitals… and to create value for the entire healthcare system in the locality – not just our hospitals, but also primary care and public health services in an area that has high levels of deprivation.”


Supporting patients

Ultimately, a person-centred, digital first approach must include the person at the centre. Cerner Patient Portal UK, delivered in collaboration with Induction Healthcare, enables interaction and engagement between caregivers and their populations. A prostate cancer survivor in the Wirral explained, “I cannot emphasise how much the patient portal has improved the quality of my life. Those two weeks of waiting – the stress of revisiting the room where I was given my diagnosis – all that is gone now.”

NHSE’s operating priorities will not be achieved by overworking caregivers and staff, but by enabling them to work smarter and more collaboratively. Contact Cerner Corporation if you share a belief in the power of technology-enabled transformation and want to discuss how Cerner can support your system as in tackling the unprecedented backlog of demand.

Digital Implementation, News

Digital revolution – the benefits of paperless

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digital revolution

The digital revolution is well underway, and the innovative new technologies utilised by start-ups have completely transformed business operations. However, there is still a significant number of SMEs and larger corporations that are completely reliant on paper. 41 per cent of businesses agree that moving to digital would cut operational costs significantly. However, the heavy initial investment and potential skills gap is presenting a tough hurdle for many organisations.


According to a study by Xerox, 55 per cent of businesses across western Europe and North America are still completely reliant on paper. A similar study found that 70 per cent of these businesses admit that they would fail within just three weeks should key documents go missing. With all this in mind, we look at the key benefits of going digital.

Why risk it?

Words like ‘audit’, ‘security breach’ and ‘compromised data’ are enough to raise the hairs on any businesses neck. Physical documents pose a multitude of problems when it comes to security, there is a huge reduction in the level of control the business has over them. Paper documents can be scanned, shared, and viewed indefinitely by anyone at all.

Research by AIIM reported that up to 50 per cent of businesses surveyed were unsure whether they had ever suffered a security breach due to a complete lack of visibility. Moreover, 31 per cent stated they had encountered poor record keeping to the extent that it would negatively impact regulation checks and audits.

Smarter, faster, stronger

Productivity is a key priority on any business’s agenda, to get the most from their employees a business should endeavour to establish streamlined processes, efficient operations and transparency. Utilising digital document management reduces the amount of time spent looking for required information dramatically.

Digitally stored data is easier to find, and the quality of data collected is improved; through digital templates and pre-agreed parameters companies can maintain consistent data standards universally. Lengthy approval processes and over complicated workflows are also a thing of the past, digital signatures make authorisation and communication much more efficient. The ability to access documents anywhere at any time through a centralised digital solution will reduce the risk of missed deadlines when employees need to work remotely.

Going digital provides a centralised view of all documents. Access can be controlled, allowing only the necessary and authorised employees to view confidential data. Clear trails can be established to monitor the progression and movement of key information and backups are easily created to avoid the heart-stopping loss of key business information.

Cutting the cost

The reason behind most business activity is to protect and improve profitability; going digital also has a compelling impact on a company’s operational costs. US research from The EPA found that companies choosing to go digital could save as much as $80 per employee in printing resources and the efficiencies that come with streamlining manual processes. For a business of 400 employees this is a sizeable saving of $32,000 per year.

Small businesses can benefit too. For smaller, less established businesses the transition to digital is likely to be much easier as there is less physical documentation to convert. This could mean the ROI is visible much sooner. Digitalisation will make the business considerably more agile and responsive, where competition is fierce the need to respond quickly and accurately to customer enquiries, competitor activity and market demand is essential – this is made much easier with visibility and strict organisation.

Going green – not to be barked at

Although this could quite easily be tied into an organisation’s profitability, reducing carbon footprint often comes with more benefits than just lower operational costs. Corporate social responsibility is a hot topic globally and is only set to get hotter. Recent data in the US showed that the average employee uses a staggering 10,000 sheets of paper a year, the equivalent of a 100ft fir tree.

In many cases, a company’s activity surrounding CSR has become an integral part of a prospects decision-making process. For those in B2B, many businesses with strong CSR values will actively seek out equally responsible organisations to purchase from.

Digital revolution requires effective physical device management solutions

As part of the digital revolution, businesses will be investing heavily in the devices that enable the process. The increasing number of physical devices in the workplace such as laptops, Chromebooks, tablets, smartphones, and other media devices means it has become necessary to implement effective physical device management solutions, protecting the longevity of the initial investment.

To find out why LapCabby provides the perfect storage, charging and syncing solutions for your new tech please visit our website: www.lapcabby.com.

Digital Implementation

North Lincs and Goole replace data warehouse in preparation for shared digital services across region

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data warehouse

NLaG chose Insource as strategic data management partner – initially as unified data foundation across three hospitals and community services.


Insource has been chosen by Northern Lincolnshire and Goole NHS Foundation Trust (NLaG) as its foundational data management platform and ultimately as a joint strategic solution in its move towards shared digital services with partner trust, Hull University Teaching Hospitals NHS Trust.

The partnership falls under the NHS Digital Aspirant programme, which is providing funds to nearly 60 NHS trusts to facilitate digitisation and help deliver a set of core digital capabilities. It is hoped that Insource’s platform, Health Data Enterprise, will see a significant upgrade to NLaG’s ageing data infrastructure system.

Christopher Evans, Associate Director of Information Systems, for NLaG commented, “whilst this is initially about replacing our ageing data warehouse, the core decision is primarily to ensure strategic alignment and collaboration between our two organisations. We already have a shared vision between NLaG and HUTH and we will be merging onto a single platform across both organisations within the next couple of years. What Insource gives us is data consistency and continuity of reporting across the wider regional footprint while we redesign clinical services and pathways to meet our integrated care goals.”

Northern Lincolnshire and Goole NHS Foundation Trust (NLaG) serves a population of more than 450,000 people covering North Lincolnshire, North East Lincolnshire and East Riding of Yorkshire. The Trust runs three hospitals: Diana, Princess of Wales in Grimsby, Scunthorpe General Hospital, Goole and District Hospital and also provides a range of community services across North and North East Lincolnshire.

Emil Peters discusses the next steps for the health and care technology sector

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Emil Peters speaks to Integrated Care Journal

Recently appointed CEO of Tunstall Healthcare, Emil Peters speaks to ICJ about the future of telecare and telehealth and the impact of a seismic era of system transformation for UK health and care.  


“Great advances in medicine have been made during periods of immense stress and strain,” says Emil Peters, recently appointed Tunstall CEO. Peters finds himself at the helm of the largest social care technology provider in the country during a period of critical reform for the health sector.  “A lot of our early medicinal advances originated from battlefields and war injuries,” explains Peters and the pandemic, he insists, has been the latest catalyst for change in the health sector – but the reform has not come from new antibiotics or medicines, but a newfound acceptance of the value of medical technologies, such as telehealth. 

Tunstall today has become an integral part of a constantly evolving definition of health and care

Peters, who moved to Tunstall after 25 years at health technology giant Cerner (the last five of which were spent as President of the International markets), is no stranger to major upheaval in health reform – but even he would admit that the current period of turbulence is unlike any other the sector has faced. He enters his new role as the UK government releases a slew of policy reforms, with the intention of turbo charging a digital and data led transformation of the health and care sector. The latest paper Digital revolution to bust COVID backlogs and deliver more tailored care for patients, places telehealth as a central priority of the government’s digital transformation of the sector.  

Peters likens Covid-19 to a dark cloud with a silver lining, “the pandemic has given us lived experience of technology, forcing our lives to be lived through screens whether they be your phone or whether they be your computer or your television.” Interestingly, Tunstall began as a Yorkshire based television repair company but has since grow to over five million users globally and almost two million in the UK alone, becoming one of the biggest players in telecare in the process. Now, Peters hopes to use this position of strengths to take on a newfound leadership position within the sector, helping to drive technology based transformational change, enhancing access to health care to disenfranchised communities and reducing rampant health inequality across the country. 

At one point, the health tech industry was still arguing with hospitals as to the benefits of using digital over paper-based methods. Today it is widely accepted that telehealth is now central to the evolution of the concepts of health and care. “Through being able to connect patients and carers in the broadest possible terms, Tunstall today has become an integral part of a constantly evolving definition of health and care,” affirms Peters. 


Evolving telehealth in an ICS context 

If Covid was the “slap in the face” as to the value and potential of health and care technologies, then the prospect of integrated care in the UK could prove to be the mechanism which permanently embeds technology like telecare and telehealth into care pathways. 

Each integrated care system (ICS) has placed preventative and personalised care, defined through population health management approaches, as central priorities to care delivery. In many ways, telecare and telehealth could be the glue that connects ICS wellness strategy, via enhanced access to care and reduced strain on healthcare services. 

“The pandemic reminded all of us of the value of working together”

Previous barriers to technology adoption are being eroded in favour of holistically implemented transformational change and the rapid growth of the telehealth sector is helping to shift discourse away from simply reducing acute sector pressures. Priorities are now shifting towards maintaining good health for people as long as possible, keeping people healthy and supporting them in the best version of their life as they define it. 

“Among many other things, the pandemic reminded all of us of the value of working together. Previous hesitations to collaboration have held the sector back – but these barriers are gradually being eroded and this collaborative momentum has manifested itself in the integrated care agenda. 

“In the same vein that we used technology for our supply and demand calculations for the testing of PPE, we now need to think about that in terms of cancer, orthopaedics, neurology, all the other things that we need to be bringing to people because frankly, we kind of went away with that.” 


A new era for health and care technology?  

Peters considers the current moment a once in a generation opportunity to shift norms. “Historically the system has found ways of preserving itself.  We were constantly training for trying to find ways to preserve what we have. Business as usual is no longer an option.” 

I’ve seen a lot of ‘tech for tech’s sake’, and those endeavours tend to be like shooting stars. They burn bright and they fade away

“Telehealth can enable clinicians to see the people they need to see. It allows people within the clinical space to operate to the top of their licence. And it allows me as a son and as a neighbour to operate to the top of my licence when caring for loved ones. Technology like telecare can  help me check in on my elderly neighbour, to check in on my mother, who lives in San Antonio, Texas, thousands of miles away.” 

Peters’ bread and butter is facilitating health and care innovation but his focus with Tunstall will be less on the outright ‘technical innovation’. Rather, Peters is interested in innovating the constructs of how they apply technology. “Our focus is much more centred on value. What is the value of what we’re about to go do? Is it just tech for tech’s sake? Or is there a clearly defined purpose in mind?” 

Peters wants to move the  sector from a ‘thousand flowers blooming at once’ mentality to innovation, and towards a focused approach built upon consistent standards. “I’ve seen a lot of ‘tech for tech’s sake’, and those endeavours tend to be like shooting stars. They burn bright and they fade away. But the innovations that really produce value for the provider, for the person, for the family, those are the things that that will truly be lasting.” 

“It’s up to us, how much we harness this moment,” insists Peters, who warns that a complacent approach to innovation risks returning to a ‘business as normal scenario’. “Are we going to try to fight to go back to the way that we did and run our outpatient clinics the way that we had? Or has this given us a new view on how things can happen? Clinicians want and need to spend time with the people that truly need attention from someone of their levels of qualifications and who can truly have an impact.” 

In Peters’ mind, the impact that is needed with technology cannot be understated insisting that, “it must become this century’s version of a clean water supply for the health and care sector.” 


In September 2022, Tunstall will be joining ICJ and PPP for the ICS Roadhshow, a series of regional conferences to discuss the progress of integrated care at a localised level. To find out how to get involved, please visit our ICS Roadshow homepage.