Aspiring to digital excellence in South Tees

30 April 2021 Ian Willis (Head of Digital Programmes, South Tees Hospitals NHS Foundation Trust)

Ian Willis describes South Tees Hospitals' progress through its first year as a Digital Aspirant. First year investment has laid the groundwork for phase two of the trust’s digital transformation plans - and supported how the trust has adapted to operating during the pandemic.

An integral part of our plan for continually improving the quality of the care we deliver for our patients, and for how we support our staff, is embedding digital technology in the ways we work. Key to this is our participation in the Digital Aspirant programme and our roadmap for ensuring that digital is at the core of how we operate as a trust.

The Digital Aspirant programme offered the trust a means by which we could achieve a real step change in digital maturity. Already, in our first year as a Digital Aspirant, programme funding and support has underpinned change and progress at an accelerated rate as we’ve adapted to the impact of COVID-19 on our ability to continue to deliver care safely and effectively.

At the start of our journey, our digital maturity wasn’t where we aspired to be, and we weren't comparable to our peers in the region. However, we had a clear strategy for where we wanted to be and what we needed to do to get there. The trust’s digital strategy has at its heart the implementation of an electronic patient record (EPR): this will provide clinicians access to integrated patient information from one source, saving time and increasing efficiency. Funding through the Digital Aspirant programme has enabled us to make good progress on this journey, and while the solution that the trust has now implemented through investment of Digital Aspirant funds is not a full EPR, it provides the building blocks required to progress our digital transformation. These include electronic prescribing, electronic noting, alerts and clinical decision support.

One challenge we faced was the age of the equipment used across the organisation. Outdated equipment was leading to inefficiencies through colleagues waiting for equipment to start up, and for information to load and be presented. This meant that colleagues could find themselves waiting for information when time could have been better spent caring for or interacting with patients.

The ability to work remotely was a fundamental part of how the trust adapted during the pandemic, but many staff were office-based and relied on office-based equipment such as desktop computers to perform their duties. New ways of working, including working from home, required more portable equipment such as laptops.

On joining the Digital Aspirant programme, we immediately used our first tranche of onboarding funding to fix a lot of historical issues with our IT infrastructure:

200 new laptops were purchased
The wireless network was upgraded and enabled trust-wide, with 500 additional wireless access points
Every ward in the trust was provided with a trolley and all-in-one computer

We were also able to update a number of our clinical servers with upgraded software and added additional memory.

This initial investment in infrastructure not only laid the groundwork to enable our digital transformation plans going forward, but also put us in a good position to adapt to COVID-19. The new equipment has enabled remote working for staff and is already delivering efficiencies across the trust. On some wards the new computer trolleys have been used to enable colleagues to directly dictate operation notes on the wards, rather than having to return to their offices to dictate or transcribe information. By having quick and immediate access to information via new PCs, colleagues spend less time waiting for a computer and more time caring for patients. This new technology is making a real difference to the delivery of care and the experience of staff on the wards. I have personally had a number of emails from ward managers thanking the team and talking about how it has made their lives so much easier.

This first phase of investment has allowed us to lay the foundations for our roadmap to digital excellence. The trust is now well into phase two of its journey as a Digital Aspirant, with programme funding committed to a digital transformation of existing processes.

In February 2021, we began work on a new e-prescribing system which will go live in October, rolling out trust-wide over the following six months. New electronic observation and vital signs technology is currently being tested and will be rolled out across paediatrics and maternity this summer. A consolidated electronic patient record along with clinical noting technology that utilises Natural Language Processing (NLP) to support clinical documentation will replace paper forms, starting in May this year.

Currently much of this information is collected on paper and can’t be easily shared across teams. Although the trust does currently collect some information electronically, for example observations and vital signs, this information isn’t integrated. These new solutions will provide colleagues with an integrated patient record bringing information together into a single source. This will provide a number of benefits, for example clinicians will have access to a shared e-prescribing record linked to pathology results, patient allergies and vital signs information. All assessments and documentation will be recorded once and will immediately be available to all staff involved in the patient’s care.

Before and during the programme, we’ve worked closely with other organisations to learn lessons and to share knowledge. We’ve reviewed a number of blueprints to help inform us including a number from the Global Digital Exemplars (GDEs). These included a Blueprint on Digital Whiteboards published by Gateshead Health NHS Foundation Trust, and a number of blueprints on ePMA implementations, including from North Tees and Hartlepool NHS Foundation Trust.

As we move into the next phase of our digital transformation, and as a requirement of the Digital Aspirant programme, the trust will provide Blueprints of our own which will be available for other organisations to learn from. Our progress as a Digital Aspirant has not only helped the trust navigate the unprecedented challenges of the last year – it has confirmed our aspirations to ensure digital ways of working are at the heart of how we can continue to deliver safe, high quality care in the best ways possible for our patients and our staff going forward.