Digital checks that can prevent dementia and falls in older people, and save lives through diagnosis of sepsis, are among a range of tools being made available in hospitals across the country, as part of the NHS Long Term Plan.
One in eight hospital patients is affected by delirium, which can make people unsteady on their feet, increases the risk of developing dementia and can result in longer hospital stays or admission to a care home.
However, these problems can be avoided through timely and effective care, with a scheme in Salford increasing the number of patients correctly diagnosed with delirium by 34%, through the introduction of screening for all over-65s who are admitted to hospital.
Doctors and nurses run through a symptoms checklist on a mobile computer or handheld device.
The scheme is just one of a series that is being rolled out across the country through the adoption of toolkits, known as blueprints, that allow any NHS hospital to implement improvements quicker and more easily to transform care and improve services for patients and staff.
Up to 200 lives a year are being saved at one hospital trust thanks to early recognition and treatment of sepsis using digital technology.
Screening for sepsis at Royal Liverpool and Broadgreen University Hospitals’ emergency department is now at 100% and antibiotic administration for patients with sepsis within an hour has increased to 90% in the emergency department.
The use of police powers to detain people under the mental health act has fallen by 78% in the North East thanks to street triage teams, made up of NHS staff and police, equipped with mobile devices and remote access to a hospital’s electronic record system.
With full access to records, the street triage teams are able to look after patients and determine the most appropriate response based on both current circumstances and historic information.
The first batch of blueprints includes Salford’s assessment tool for delirium, Northumberland’s remote access and mobile working project and Liverpool’s E-sepsis tool.
Matthew Swindells, deputy chief executive of NHS England, said: “Using straightforward technology to its fullest in the NHS will not only improve patient care and safety, but can also free up staff time.
“Some NHS hospitals are already making a huge difference to the care they offer through digital tools, and with these new blueprints it will now be easier than ever for other NHS organisations to learn from the best we have and improve care for their patients faster.”
The blueprints have been created by hospitals on NHS England’s Global Digital Exemplar (GDE) programme, that is providing funding to 43 acute, mental health and ambulance trusts to help them digitise.
Will Smart, chief information officer for Health and Care, said: “The NHS Long Term Plan set out our ambitions for a world class digital NHS using the best available technology.
“Our blueprinting work will help NHS trusts drive their use of digital far more quickly and cost effectively than has been possible in the past, adopting successful technology and projects that have already made an impact elsewhere.”
Health Secretary Matt Hancock said: “I love the NHS – and am determined to do everything I can to make sure it offers the very best service possible to patients. These are fantastic examples of how modern technology has the potential to save lives – and I want to see more of this.
“We have the opportunity to build the most advanced health and care system in the world and harness the full potential of technology to improve the lives of patients and empower people to take greater control of their own healthcare. Innovations like these can help the NHS achieve its bold ambitions in the Long Term Plan to create a preventative, predictive and world-leading health service which is fit for the future.”
The new blueprints include:
At Royal Liverpool and Broadgreen University Hospitals NHS Trust early recognition and treatment of sepsis using digital tools is saving up to 200 lives a year. The Trust introduced E-sepsis, a clinical decision support tool, with screening now at 100% in the ED and on its wards; antibiotic administration for patients with sepsis within an hour has increased to 90% in ED and 60% on wards and septic shock mortality in the under-45s has dropped from 60% to 7.69%.
North East England
Over 4,000 mental health staff at Northumberland, Tyne and Wear NHS Foundation Trust are now able to access electronic patient records securely from anywhere, transforming care delivery. This has supported clinical staff to innovate practice and access systems and information remotely – from care homes to providing street triage services with the police – and supports its ambition to be the ‘work from anywhere Trust’. Implementation of the street triage team has reduced use of police detaining people under Section 136 of the Mental Health Act by 78%.
Salford Royal NHS Foundation Trust’s new electronic assessment tool for delirium has increased screening of over 65-year-olds on admission to hospital and has increased assessment of those who become newly confused when they are in hospital, with the number of identified cases per year having risen by 34% and the length of stay for these patients has reduced by 11%, saving an estimated £1.7m in the first year. Readmissions for delirium patients has also reduced from 15% to 13% saving an estimated £101,000 for the same period.
At Gateshead Health NHS Trust pathology tests – such as blood tests – are now being turned around in 25 minutes since the Trust moved from a paper-based system to an electronic order comms system. This has improved safety and governance around ordering tests and managing results.
Before changing systems in 2010, Gateshead used paper forms filled in by hand to request blood tests and X rays. Results of tests were reported back to clinical teams on paper slips, which were sometimes posted to the location where the request had been made only for the patient to have been moved.
Cambridge University Hospital’s introduction of barcode medication administration (BCMA) has improved patient safety by reducing the overall rate of adverse drug events and decreasing transcription errors. Medication scanning is live across all inpatient areas and the emergency department. On average 168,000 medication administrations are scanned per month.
Staff at the Trust have reported feeling “safer” in administering medication thanks to the clinical decision support and alerts provided through the BCMA process.
Created by NHS Trusts, the GDE blueprints are a guide for hospitals that explain how a particular system or innovation was developed and introduced, and the benefits it has had. They detail all the components needed for sustainable digital transformation such as; organisational leadership and culture, technical and configuration guidance, clinical and staff engagement as well as the people and processes required to successfully deliver the benefits of new technology.
NHS England will publish more blueprints throughout this year.