ChallengeHere are some examples of projects that the team have either recently completed or are currently working on.
Case study: Humber, Coast and Vale Digital Maternity Project – Business Change and Benefits Support
Maternity systems currently straddle primary care, acute care, community care and segue into health visiting supported by the local councils. None of these services are integrated and this can lead to multiple delays, gaps in records and disjointed care.
In late 2019/early 2020, Humber, Coast and Vale Local Maternity System (LMS) reviewed how clinical activity and financial information was shared between provider units, with a view to being able to achieve the requirements of the Better Births report and NHS Long Term Plan as efficiently as possible. The vision for the LMS is to: ‘Deliver personalised maternity care alongside high quality and integrated services, ensuring that women and their families receive the best possible experience and outcomes.’
The aim of this project is to support that vision by capturing, tracking, and monitoring the benefits of procuring the most suitable IT system for maternity services across the Humber, Coast and Vale area. The chosen IT system will enhance the digitisation of maternity records and services, providing opportunity for far greater interoperability with other Health IT systems. The project commenced in April 2021 and is expected to conclude by July 2022, with further Benefits management and realisation completed by April 2023.
The benefits of this project are:
- Women in the region will benefit from having access to information to enable them to make decisions about their care as part of a safer, more personalised, kinder, more professional and family-friendly service.
- To improve choice, safety and the overall care of women and families
- Place quality and safety at the core of Maternity service delivery·
- Reducing health inequalities by using digital technologies to drive innovation across services
- Embed collaborative and multi-professional working through provision of interoperability throughout our system.
- Improve timely and accurate data reporting
Case study: Digital Consultations in Primary Care – Project Management, Business Analysis, Training and Benefits Support
Our focus was to establish best practice and define new ways of working so that the potential value of utilising video consultations in primary care can be realised and to make recommendations that support an informed and co-ordinated future deployment of video consultation capability across the North East and North Cumbria (NENC) region. This was to ensure GP practices continue to be well positioned to deliver video consultations and are informed to make future procurement decisions.
Initially the project delivery was focused on the COVID-19 response, ensuring and demonstrating that all NENC practices had a video consultation solution enabled ahead of the Secretary of State deadline. Focus then moved to tracking and supporting the utilisation of video consultation solutions and a bespoke dashboard was created to track activity at regional, CCG and practice levels.
During the practice engagement phase, lessons and experiences were collated from practices and this is also the phase that the Landscape Analysis and Benefit Milestone Report deliverables were produced.
Finally, project delivery focused on supporting future procurements, collating and prioritising requirements and liaising with the Procurement Hub to secure SMS bridging arrangements.
Productive and beneficial relationships were established with a range of suppliers in preparation for future procurements and potential support to assist with embedding new ways of working.
Case study: Digital Consultations in Secondary Care – Project Management Support
In 2019 when the COVID-19 pandemic took hold of the UK, our secondary care services were impacted immediately. As a result, NHSEI commissioned a project to provide a rapid rollout of video consultations in acute, community, mental health NHS Trusts and Foundation Trusts in England and Wales, enabling them to provide care to patients remotely in the event that patients were advised not to, or were unable to, attend hospital for planned care appointments.
A video consultation is a secure way to remotely triage, evaluate, monitor, treat and/or deliver therapy to patients and service users. The patient/service user and the clinician can hear and see each other during the consultation. Additional remote participants, such as a carer, interpreter or another healthcare professional can also be added to the video consultation.
The Virtual Consultations project forms part of the wider Outpatient Transformation Programme that has seen LTP commitments to reduce the number of outpatient visits in 5 years by 30 million, and to offer all patients the option of a virtual consultation where appropriate – playing a part in reducing the NHS’ CO2 impact.
NHSEI requested Project Manager support from NECS with a hybrid skillset, providing service management to a newly formed dedicated VC Helpdesk, overall project governance links between the board and the Service Leads within the programme and technical hardware support for the regions involved in the mobile hardware solutions that were deployed through the project.
Case study: HealthCall – Project Management Support
NECS have provided HealthCall with Project Management support for a range of current pathway developments.
Case study: Comprehensive Geriatric Assessment/Comprehensive Holistic Assessment (CGA/CHA)
Working with the Regional Frailty Network to design, develop and implement an assessment tool in which multi-disciplinary teams can contribute to the collation of information for a specific individual who has been identified as frail. Initially the tool was aimed at older people with frailty, though potential has been identified to expand utilisation for younger people who are identified as frail, for example, those who may have Long Covid related frailty. Liaising with AHSN around pre-evaluation work.
Case study: South Tyneside Care Homes
Facilitating the development of a pathway in which care homes can send information directly to community teams should a referral or further advice need to be sought for a current resident utilising up-to-date information and/or clinical measurements where appropriate (e.g SBAR & NEWS2). Working with care homes and community teams within each area to modify the pathway and process to align with current ways of working and links with clinical systems.
Northern Cancer Alliance Remote Monitoring
Development and implementation of a remote monitoring programme for patients who have completed treatment within a breast cancer pathway for Gateshead NHS Foundation Trust. Additional pathways are planned for colorectal and prostate remote monitoring. To be rolled out across trusts within the region.
All projects involve collaboration with the Health Call Senior Programme Manager, Business Analyst, Development Team, Clinical Safety Officer and Clinical Leads as well as Subject Matter Experts and colleagues from partner organisations (clinical and technical).
Case study: Lloyd George Digitisation – Project Management Support
A typical GP practice, with 7,100 patients will house approx. 500,000 pages in Lloyd George (LG) Envelopes containing crucial historical medical records for every patient. Whilst primary care provides a predominantly digital service today with practices using electronic patient record systems, historical records are largely still paper-based.
The detailed personal information stored inside means that security and accuracy are paramount, yet many paper records are over 60 years old, in a state of decay and becoming unreadable – this is both clinically and legally unsafe. Practices are also required by law to retain and store the LG envelope and their contents. For the most part, they can be very paper heavy and take up storage space on a practice site or in secondary storage areas at a significant cost to practices.
NHS England and NHS Improvement are developing national guidance to support the Lloyd George digitisation process. Approval to destroy the Lloyd George envelope will hopefully be given soon. Until then, practices legally need to retain the empty Lloyd George envelope.
Organisations across the National Health Service (NHS) are working towards meeting national targets of being paperless at the point of care by 2020/21 with the aim of using digital technology more effectively to benefit patients, clinicians and the public. The digitisation of patient records throughout both primary and secondary care is a key enabler to achieving the paperless vision. In January 2021 the production and distribution of new paper Lloyd George envelopes stopped, helping us become one step closer to a digital NHS.
The benefits identified to date are:
- Maintaining access to historical medical information
- Enhanced security and audit
- Improved disaster recovery
- Better use of resources (clinical space, time to recover paper records and money)
- Improved transfer of information
- Supports the NHS long-term plan, General Practice Forward View (GPFV), Five Year Forward View (FYFV), the Personalised Health and Care 2020 (Paperless 2020) and Five Year Framework for GP Reform which are the main drivers for digital change in the NHS.
Case study: ICS Primary Care Digital Workstreams – Project Support
NECS is currently providing Project Support to the ICS Workstreams. The dedicated Project Support Office assists with the development of governance arrangements, meeting structures and reporting as well as managing the complexities of working with multiple partnerships, stakeholders and key customers within the ICS while assuring aspects of the ICS Primary Care Digital Workstreams.
The team navigate a broad range of services which has seen even more challenges due to the impact of the coronavirus whilst still achieving performance and upholding NECS standards, providing an audit and control function including co-ordinated governance and assurance for all projects and workstreams ensuring customers receive high quality project implementation. The PMO is a source of documentation, guidance combined with governance and data quality assurance.
Tees Valley CCG Practice Manager I think the project was deployed very well. The last few days were very stressful but that is to be expected. The staff where surprised by how much they had learned and in fact the switch over was relatively painless. I cannot thank the project team enough as they worked very hard and kept us on track through a very complicated process. Laura was just amazing, and we felt Paul Cawgill went above and beyond for us. Together the whole team delivered the project on time and with very few hiccups.