Royal Surrey NHS Foundation Trust has launched a new digital tool for pre-op assessments, which will enable two-way file sharing between the trust and the patient. 

The LifeBox tool builds an interactive patient summary and allows the secure sharing of information such as test results, medications, advice on fasting and other useful information ahead of planned procedures. It has been created by Definition Health, medical consultants and digital experts.

Patients are able to complete part of the pre-op assessment at home through a healthcare questionnaire. This is reviewed by a pre-op assessment team, who will arrange a phone call if further discussion is required. They can also request tests or checks for the patient at the pre-assessment department.

For patients, being able to complete some of the pre-op assessment at home helps to reduce some of the stress over their forthcoming procedure. It also enables friends and family to be involved and support them through the process.

Consultant anaesthetist at the trust, Dr Harsh Saxena, said: “The benefits of using LifeBox are many and include being able to empower patients and engage them more fully in their own care, educating them about their surgical procedure and facilitating smooth admission. It also allows us to improve standardisation of patient care and reduce unnecessary hospital visits.”

In addition to the tool enabling digital pre-op assessments it also hosts a selection of resources for patients. Information videos can be accessed which explain procedures and provide information to help manage patient expectations. This can help identify individual needs sooner, optimising patient care and safety.

The trust is following in the footsteps of Hampshire Hospitals NHS Foundation trust who announced the launch of Synopsis Home and Synopsis iQ at three hospital sites – digital platforms to manage pre-op assessments.

Turning to technology to treat bowel cancer

The trust has also turned to technology to help improve the experience of bowel cancer patients in the future. Royal Surrey is trialling the use of online surveys to collect accurate details of patients’ symptoms before and after treatment for bowel cancer.

The CITRuS study will then use the data collected to inform what potential symptoms new patients may experience. It will also help doctors spot where patients need extra support through their treatment journey.

Responses to the online surveys will create a regularly-updated record of patients’ experiences. Patients enrolled in the study will respond to the online health questionnaire each month over a two-year timeframe.

Study chief investigator, Dr Alex Stewart said: “It’s recognised that patient-reported symptoms often differ from doctor-documented symptoms, and over time, this leads to inaccuracies in doctors’ descriptions of the effects of cancer or cancer treatment to patients.”

He continued: “We expect this study will also give us a more accurate and timely picture of the patient experience, which in turn will help our doctors communicate with patients more effectively, and ensure that patients are given the clearest possible information before undergoing treatment.”

The CITRuS study is jointly funded by the local charities BRIGHT and GUTS and supported by the Royal Surrey Hospital. Over the next six months there are plans to open up the study at four more UK sites.

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Mid and South Essex Care Partnership Integrated Care System (ICS) has deployed a platform which has helped create a single, system-wide patient tracking list in order to support its elective recovery programme.

The single wait list is hosted on Insource Ltd’s data management platform and covers all specialties across all the acute sites within the ICS, from referral through to treatment or discharge.

Mid and South Essex hope that it will create the data foundation needed to support staff in tackling the backlog in elective care. The new resource will also help minimise long waits, as well as ensure fair patient scheduling and maximise bed and theatre capacity site-wide.

The fully-linked patient tracking list (PTL) delivers end-to-end Referral to Treatment (RTT) waiting lists and is aggregated to ICS level. Automatically refreshed daily, it will provide a single source of information across the ICS for patient pathway planning.

Barry Frostick, chief digital and information officer for Mid and South Essex Integrated Care Board, said: “At Mid and South Essex we were particularly hard hit by a couple of covid waves resulting in significant elective care backlogs, with some specialties waiting much longer than we would want.

“We see our strategic partnership with Insource on the elective recovery programme as a real opportunity to prioritise patients according to clinical need and length of wait, to standardise clinical processes across our multiple sites and to maximise our system-wide waiting list capacity. Having a single, robust, fully validated PTL for all clinicians to refer to is a massive first step.”

Mid and South Essex’s elective care programme is underpinned by the Insource elective recovery suite. This includes system-wide waiting list management and statutory reporting, agile capacity and bed occupancy planning, clinical and theatre scheduling and patient journey analytics. The data drawn from this will help to improve processes across the ICS and streamline care pathways.

Naresh Chenani, director of planning and performance, Mid and South Essex NHS Foundation Trust, said: “In line with the NHS Data Saves Lives policy, one of our strategic objectives is to become a data driven organisation. We are now in the enviable position of having all the data in one place – a single source of the truth – for informed decision-making across the ICS.

“We have a consolidated view of the waiting list position, so we can ensure patients are treated against clinical priority and date order. And, our clinicians and operational staff will shortly have visibility of the unified PTL so we can see how best to allocate staff, theatre and bed resources to boost productivity and drive waiting times down.”

The programme is run on a hybrid-cloud strategy which means back-ups are made both on-premise and on Azure cloud to ensure seamless disaster recovery.

Sam Elliot, CEO, Insource, said: “Building a single, fully validated, automated PTL across an ICS may be our bread and butter, but it is also providing the data foundation for a wide range of planning, performance, clinical and process improvement initiatives that could revolutionise care delivery going forward.”

The Insource tool is now ensuring that data is being collected and the next step for the trust is to involve clinicians and operational staff. An operational go-live is planned for early May.

Earlier this month Mid and South Essex NHS Foundation Trust has teamed up with eConsult to deliver a patient management system designed to reduce the waiting list backlog.

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Professor Ben Goldacre has told the Science and Technology Committee that Trusted Research Environments (TREs) will mitigate data risks and “earn public trust”.

Professor Goldacre, who is a Bennett professor of evidence-base medicine at the University of Oxford, was answering questions from the committee on his review, which he was tasked with leading in February 2021.

The review aimed to look into how health data for research and analysis can be used efficiently and safely. Prof Goldacre described data to the committee as “like nuclear material” that after being refined and processed, “becomes tremendously powerful” and “rather dangerous”.

Speaking to the committee on May 11 2022, Prof Goldacre said: “Once it’s leaked, it can’t be unleaked, and you have to work very carefully with it in order to do good with it, whilst minimising harms.”

In his review, one of the recommendations Prof Goldacre makes is for TREs to become “the norm” and he spoke about the benefits to the committee of MPs.

“Future efforts to share NHS data with private industry should take place in Trusted Research Environments,” he said.

“I’m confident that by doing that, not only can you mitigate risks, but you can also begin to earn public trust.”

TREs would enable data to be made accessible in a secure way to legitimate users without the risk of it leaking and becoming the “nuclear material” that Prof Goldacre describes it as.

Interestingly, Prof Goldacre revealed that he personally opted out of the aborted plan to share GP Health Data last year, describing the risks as “very salient” to him.

He suggested that the government should consider prison sentences for those who do misuse sensitive data.

He told the committee: “You need to block misusing data, you need to ensure that you detect it when they do, and you need to make sure that the penalties are so high that people are afraid to do it.”

As well as ensuring TREs become “the norm,” other recommendations in the review include improving opportunities for data analysts within the NHS and encouraging open working for all NHS data analysis.

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Imperial College London is to collaborate with rostering software provider, Allocate, to create a number of tools designed to help manage staffing levels and ensure that patient care is not compromised. 

Allocate’s SafeCare is designed to increase patient safety while maintaining efficiency and is used by management for informed decision making on staffing levels.

Imperial College London will be licensing a suite of methodologies to the software, which works by matching the available daily staffing level to patient acuity – the level of care required by patients in hospital.

The methodologies being licensed include the NICE-endorsed Adult Inpatient Ward Safer Nursing Care Tool (SNCT) and the Mental Health Optimal Staffing Tool (MHOST). Incorporated into SafeCare, they will help create a comprehensive solution for making evidence-based staffing decisions.

Manish Patel, head of NHS technology transfer at Imperial College London said: “This is an excellent deal for the NHS and Allocate, allowing for web-based modules of SNCTs and MHOST in SafeCare. The aim for all parties in this venture is to help improve services in healthcare organisations.”

The methodology tools are already currently supplied by Imperial College Innovations Ltd, a commercial subsidiary of the college. Going forwards, NHS customers will have the choice of using the tools through SafeCare or continuing to use them as provided through Imperial.

Paul Scandrett, director of healthcare at Allocate, added: “Individually SafeCare and SNCT have become critical tools to help trusts managing safer staffing, particularly key as organisations face staffing gaps. We look forward to working together with Imperial College Innovations to help deliver the very best solutions to our customers”.

In support of the licensing deal, the team at Imperial College London are working with Allocate, who was acquired by RLDatix last year,  on an independent basis through Imperial Consultants – to conduct quality assurance in ensuring the SNCT and MHOST methodologies area accurately incorporated into the SafeCare software.

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The integrated care system (ICS) which covers Dorset has announced Stephen Slough will be its new chief digital officer.

Slough, who is a certified healthcare CIO with CHIME, has worked within the NHS since 2016, where he has held a number of CIO roles within the organisations that make up NHS Dorset. These include Dorset Clinical Commissioning Group, Dorset Healthcare and Dorset County Hospital.

It was a result of receiving treatment for chronic deep vein thrombosis from NHS organisations in Dorset, that prompted Slough’s initial move to work within the NHS.

The new chief digital information officer said he is keen to continue his work on raising the standards of NHS Dorset’s security and foundation services, to help with the implementation of more advanced technologies in the future.

Slough added: “This foundation will allow us to continue to lead the way with our award-winning approach to analytics and intelligence, how we integrate innovative smart technologies used by patients to support their lives, ultimately using data to provide insights and wisdom that empower the Dorset approach to population health improvement and the reduction of inequalities and inequities.”

Second board appointment

Joining Slough at NHS Dorset is David Freeman, who will be taking on the role of chief commissioning officer. He brings with him over 21 years of experience within the NHS at a variety of provider and commissioning roles at national, regional and local level.

In previous roles he has been responsible for implementing a number of improvement and transformation programmes across a broad spectrum of areas.

NHS Dorset Integrated Care Board (ICB) is set to come into being on 1 July this year in line with the Health and Care Bill. Its introduction is something that Freeman notes will impact on his new role positively.

He said of his new position: “becoming Dorset’s new chief commissioning officer is both a great privilege and a fantastic way to maximise the benefits of the forthcoming Integrated Care System legislation.

“This is our chance to rapidly accelerate plans for improving outcomes and to help make a major difference to health and wellbeing across all our communities. I am really looking forward to working closely with my new team and all our integrated care partners especially our voluntary sector, our GPs, our local authorities and most importantly, with the people of Dorset.”

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The chief digital officer at Royal Free London NHS Foundation Trust has said that the trust has treated a recent HIMSS Level 7 accreditation as “not a badge for IT” but rather a “proxy for better care”.

In March 2022, Chase Farm Hospital was awarded EMRAM Stage 7 from the Healthcare Information and Management Systems Society (HIMSS).

Speaking to Digital Health News, the trust’s chief digital officer, Glenn Winteringham, said that in order to help engage staff with digital, the trust made sure the changes were marketed in the right way.

“HIMSS doesn’t necessarily mean much to clinicians, but it is a global standard for measuring digital maturity,” he said.

“We’ve adopted it [HIMSS] as a proxy for better care, for higher quality care and safety and we don’t see it as a badge for IT.

“What we convey is that if you achieve these high levels of digital maturity, you’re scanning your patients, you’re scanning your prescriptions, you’re checking your medication, you’ve got good cyber security – all of that means you are going to deliver better, safer, faster care.”

Investing to digital leadership

Achieving HIMSS Levels 6 and 7 formed part of the Royal Free London’s programme of being a Global Digital Exemplar (GDE). The programme aimed to a create a “cohort of digitally advanced exemplar provider organisations” which were then expected to pass their learnings to “less digitally-mature ‘fast follower’ provider organisations (FFs)” in a bid to enable large-scale digital transformation across the NHS in England.

Part of the Royal Free London’s GDE funding has helped the trust invest in digital leadership, which Winteringham believes has supported their HIMSS accreditation. This included chief medical officers, a chief nursing information officer and allied health professionals.

“The clinical informatics team has been absolutely fundamental because they are frontline clinicians who are using the same solutions, so they are a bridge between the digital team, the management programme and the end user experience,” Winteringham said.

“They became absolutely key – front, line and centre – explaining why we were doing this and the benefits.”

As well as investing in leadership, Winteringham added that having support from all levels of the organisations played an important role.

“You need amazing leadership in your organisation, you’ve got to have chief execs and the whole of the executive team interested because it is a change programme, not an IT programme,” he said.

Winteringham added that having support from the executive teams is important because it shows commitment “from the top”.

Changing the culture

Another aspect of the Royal Free London’s digital programme has been altering the culture of the trust, Winteringham explained, adding that being open played a big part.

“We had some really important phrases from the project and one of them was ‘being open and transparent with each other’ and setting certain expectations,” he said.

“If things weren’t going well, be open and admit that failure is okay.

“We also wanted to be open and transparent with our supplier and treat them as a partner rather than a vendor. It’s all great when things are going well but when things aren’t going well, don’t pull the contract out as a first resort, try and resolve collaboratively as it’s a very long partnership.”

“Things will always go wrong on a big change programme but don’t blame people, focus on the problem.”

Next steps

Looking ahead, Winteringham said priorities for the trust include further enhancements to their Integrated Care System (ICS) wide information shared record and, population health management solutions, as well as developing the trust’s patient portal.

Finally, Royal Free London is planning for their two other hospitals, Barnet Hospital and the Royal Free Hospital to attain HIMSS EMRAM Level 6 in 2023/24.

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Sweatcoin, an app that rewards users with products and services if physical activity goals are met, are the focus of our latest profile on this year’s Rewired Pitchfest finalists. Here, Sara Balafrej, whose work within the company is on partnerships, answers some burning questions on Sweatcoin’s journey so far and a future filled with optimism and promise.

What does Sweatcoin do?

Our product is an app on a smartphone that incentivises physical activity through rewarding users with products and services for achieving agreed targets. It’s like a supermarket loyalty card meets a step count. You get points, essentially prizes, for achieving physical activity targets that are monitored via your phone. Our objective is simple; to influence behaviour change in an engaging way.

What gave you the idea for Sweatcoin?

Our founders were always passionate about health and fitness, but it was personal experiences that drove them to create Sweatcoin. Whilst they never found it difficult going to the gym and working out, eventually, they found that they were losing their true motivations.

It got them thinking, what motivates us to stay fit? What drives us to exercise? Imagine if each person had a generator attached to them, showing them the value of their movement and their energy output. We obviously know that physical movement has value, but what exactly is it and how much is it?

For our founders, it was the mix of the two — lacking their own motivation and observing individuals around them that led to the idea of Sweatcoin. As an app, Sweatcoin tackles both issues — it motivates you to move more, while also incentivising you by placing value on movement.

How will Sweatcoin change the way the NHS works?

There are currently five million people in England at high risk of developing Type 2 diabetes, which is largely preventable through lifestyle changes. About 10% of the entire NHS budget is spent treating complications from diabetes, or £10billion a year.

The current National Diabetes Prevention Programme achieves only a 20% completion rate, and so an engaging alternative is much needed. Sweatcoin directly addresses this issue, creating an accessible, gamified experience and having a significant impact on people’s well-being and on resources.

Although our programmes are not only limited to pre-diabetic patients, we could certainly create programmes to help individuals who are suffering from a range of diseases, whether that’s mental health or obesity. Our objective is to help millions of people across the NHS.

What gap in the market does Sweatcoin address?

The UK is currently in a physical activity epidemic and one of the most common causes of a number of long-term ailments (diabetes, cardiovascular disease, obesity) is the lack of physical activity. Whilst there are many programmes that do work, they suffer from low completion and engagement rates.

For instance, the NHS Diabetes Prevention Programme, whilst it works well for those who complete the programme, unfortunately only 25% of those who start manage to finish. Our product delivers sustained behaviour changes, but more importantly it has market leading completion rates, with an average of 96% of users completing our programme.

How have you got to where you are now?

We have delivered an engaging product experience – evidenced by our high app store rankings (being the number one app overall in over 30 countries) and further reinforced through the high completion rates of our healthy incentive programme (an average of 96% completion).

Why did you decide to enter the health tech start-up space?

Part of our long-term vision is to reduce the inequalities in healthcare. Our app has already proved that individuals who regularly use Sweatcoin are 20% more active but we understood that this could be a significant product for healthcare providers.

With over 60 million users, our consumer facing app has shown that we have created a successful product. We knew that this could be easily scalable and accessible for healthcare providers, and that we could help millions of people improve their health across the UK.

Have you faced many barriers in getting Sweatcoin off the ground?

Fortunately, we have been able to be part of many helpful accelerator programmes. We were chosen to be part of the prestigious DigitalHealth.London accelerator programme, which gives us the opportunity to develop our product with the help of public health experts.

The main difficulty has been ensuring we focus on narrow problems, given that our product has so many widespread applications.

Why did you decide to enter Pitchfest?

Having previously been involved in the NHS accelerator programme, we understood the importance of networking and getting guidance from key industry professionals, their support has been instrumental in our growth within the industry.

We saw the opportunities that many of the finalists from the previous year were able to attain through being involved with Pitchfest. We also knew it would be a fantastic moment for us to highlight some of the incredible work we’ve completed with the NHS in front of a digital health audience.

How did you find the experience?

It was fantastic! From the initial entry submission through to the live finals, the process was extremely well structured and professional. Pitching in front of the specialist judges and a digital health audience created a competitive environment and only having three minutes to sell our pitch was difficult but equally very enjoyable.

The whole experience was incredibly rewarding and has given us the right platform to bring awareness to our projects.

Looking to the future, what do you hope Sweatcoin will achieve and what’s the next step in achieving that goal?

We want to be committed to working with national and local governments in helping them achieve their goals of making their citizens/residents more physically active. It could become a universal movement, backed by governments across the world to encourage entire populations to move more and become healthier.

Our big picture use case for Sweatcoin is paying at least some part of your personal tax with Sweatcoins!

What advice do you have for others looking to enter the health tech start-up scene?

Perseverance is the key. It is important to keep going, despite any hardships.

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Digital Health is pleased to announce that we have launched three more bursary programmes for Summer Schools 2022.

Now in it’s ninth-year, Digital Health’s Summer Schools 2022 is a two-day residential event dedicated to local NHS IT leaders. The event will explore the evolving challenges of being an effective digital leader in the NHS and the different dimensions of leadership roles. The event will focus on the networks, future leaders, nursing, diversity and equality and emerging leadership in the ICS space.

This week we have launched three bursary programmes for the event.

First up we have the NHS Digital and Shuri Network Bursary Programme which aims to encourage and facilitate diverse representation and attendance at the Digital Health Summer School 2022. NHS Digital will provide 20 women from minority ethnic groups who are members of the Networks with a bursary to cover the cost of attending the Summer School.

We also have the Digital Nursing and Midwifery Bursary Programme, which is open to UK-wide nurses and midwives. The programme has been created to help identify, promote and support future digital nursing and midwifery leaders and future talent in the UK health informatics and digital health sector.

Finally, there is the Digital Allied Health Professional and Pharmacy Bursary Programme, which is open to UK-wide AHPs, pharmacists and pharmacy technicians. Again, the aim is to identify, promote and support future digital leaders in the sector.

You have until 27 May to get your nominations in for all three bursary programmes.

Still time to get your nominations in for the Digital Health Awards

There is also still plenty of time to get your nominations in for the 2022 Digital Health Awards – which celebrate the digital achievements of NHS IT leaders. They are also the only health IT awards in which all 7,000 plus members of Digital Health Networks are invited to vote online for the winners.

The award categories are:

• Digital Health Networks CCIO of the Year
• Digital Health Networks CNIO of the Year
• Digital Health Networks CIO of the Year
• Future Digital Leader of the Year
• Rising Star in Digital Nursing
• Digital NHS CEO of the Year

The winners will be announced during a gala dinner on Thursday 14 July, which is the middle night of Digital Health’s Summer Schools.

The Digital Health Awards are open to anyone currently working in a UK-based NHS or private healthcare provider environment. You can put yourself forward for an award or you can nominate a colleague (with their permission).

Nominations are now open and will close on Monday 6 June at 5pm.

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Dartford and Gravesham NHS Trust is due to deploy an anaesthesia solution and emergency EPR module to ease pressure on emergency department staff, theatres and recovery.

The A&E department at the trust’s Darent Valley Hospital will use Miya Emergency, an additional module of Alcidion’s open standards Modular EPR, Miya Precision, which is already in use across the trust.

Miya Emergency will extend benefits from the EPR to the trust’s emergency department, such as e-noting and clinical decision support functionality, which will proactively suggest appropriate routine tasks for clinical teams under pressure.

The module will be deployed to respond directly to the department’s clinical priorities. Functionality will support efficient patient registration and triage and will also integrate requests and results from diagnostics.

It will contribute directly to streamlined patient flow through emergency and onto the next care destination, as appropriate. Staff will also use the system to address monitoring and reporting requirements, including providing data for the national Emergency Care Data Set.

The trust has also signed a five-year deal with a new entrant to Alcidion’s partner network, Provation, to implement a digital anaesthesia documentation solution.

Provation iPro is an anaesthesia information management system (AIMS) which will integrate with the trust’s existing solutions including the EPR and will allow the trust to move away from paper-based anaesthesia records.

The system will be rolled-out across the trust’s pre-operative, peri-operative and post-operative locations across Dartford and Queen Mary’s Hospital in Sidcup.

Provation iPro, the world’s first mobile AIMS, will automate and simplify anaesthesia documentation and assist staff in efficiently capturing and managing patient information as they create a complete anaesthesia record. The system is expected to help the trust manage compliance and improve patient safety.

Neil Perry, director of digital transformation at Dartford and Gravesham NHS Trust, said: “From day one, our digital transformation has been focussed on delivering what our clinicians need.

“Clinicians working in areas like our A&E and theatres are under continual pressure. Deploying technologies that can alleviate clinical burden and make data more useful, is an important step on our journey.

“I look forward to seeing Miya Emergency and Provation iPro in action and helping our clinical teams respond to the demands they face.”

Alcidion’s Miya Precision is not their only technology being implemented in hospitals and trusts across the NHS. In recent weeks, East Lancashire Hospitals NHS Trust announced they will deploy Miya Flow, as did Herefordshire and Worcestershire Health and Care NHS Trust, becoming the first community trust to do so.

Kate Quirke, CEO at Alcidion, said: “It is always rewarding to see our technology applied to helping the NHS, and in this case highly regarded technology of one our partners.

“NHS organisations continue to show a real appetite for genuinely helpful technology, none more so than Dartford and Gravesham NHS Trust. I look forward to seeing the benefits emerge for healthcare professionals from this latest development.”

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Hampshire Hospitals NHS Foundation Trust has signed a 10-year agreement with GE Healthcare with the aim of transforming radiology services and improving patient care.

The Radiology Managed Service (RMS) agreement covers 120 pieces of radiology equipment, a command centre and an oncology cockpit. It will see GE Healthcare manage the installation and maintenance services of radiology equipment.

It is hoped the long-term agreement will support Hampshire Hospitals to speed up the diagnosis for patients, thanks to the inclusion of an oncology cockpit and the command centre. The former will help staff to identify potential delays in the cancer pathway by mapping diagnostic demand and capacity constraints. Not only will it improve how quickly patients receive a diagnosis but it will also simplify patient workflow and reduce waste.

The command centre will make use of advanced analytics so that staff have a system that is in near real-time, as well as a patient overview that covers radiology, outpatients and inpatient care.

Alex Whitfield, chief executive of the Hampshire Hospitals NHS Foundation Trust, said: “Our vision is to provide outstanding care for every patient. To do that we need to bring innovation and investment into our hospitals and our clinical teams.

“This partnership will not only give us access to advanced radiology equipment, but it will also enable faster, more accurate diagnosis and reduce waiting times for patients.”

It’s not the first time that Hampshire Hospitals and GE Healthcare have worked together. During the height of the Covid pandemic, GE Healthcare was able to provide ventilators and monitoring support to the emergency departments in Hampshire.

In September last year the Hampshire trust announced it would be rolling out a new digital platform to manage pre-op assessments, Synopsis Home and Synopsis iQ.

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