NHS England - Transformation Directorate

Digital PODAC Fund

NHS England provided funding of £6 million (£5m capital and £1m revenue) in 2021 to 2022 to unlock the potential of digital technologies to support the delivery of care within the ambulance and community health service sectors.

These projects support the long term vision for staff and patients to no longer experience a disparity in digital services between ambulance and community health service sectors in comparison to the acute sector.

Just over £6 million has been invested to support 17 projects across 16 organisations in 2021 to 2022.

Through these transformation projects, a range of benefits are expected across the 16 organisations. All of the organisations are producing ‘blueprints’ which will be published on the FutureNHS Blueprinting Library. These blueprints will provide further detail on the solutions, challenges, costs and benefits of each of these projects.

Aims

For the community sector the aim was to support projects that met one or more of the following criteria:

  • Optimise and increase the take up of electronic patient record (EPR) systems and scheduling technologies across community services
  • Use technology to increase remote access to EPRs and other relevant applications
  • Increase usability of interfaces to support the electronic capture of clinical activity across community based systems including cloud-based EPR solutions
  • Increase patient access to appointment and booking systems to allow self-management
  • Develop or enhance interfaces for data exchange between community provider systems and local shared care record systems and other platforms

For the ambulance sector the aim was to support projects that met one or more of the following criteria:

  • Align, design and build on existing integrated ambulance data architecture, working with Integrated Care Systems (ICSs) across their geographical footprint
  • Using a service-oriented architecture which translates data and user functionality; or defining interfaces for data exchange between the ambulance architecture and local shared care record systems and other platforms.
  • Integrate future capabilities and solutions, including on-board point of care diagnostics and monitoring tools, bookings and referrals with fleet and control room capabilities
  • Support local ambulance trusts to improve and standardise infrastructure resilience, enabling robust cybersecurity, failover and demand surge management

Benefits

Some of the benefits that the ambulance organisations expect include:

  • Data on contact with emergency services and ambulance journeys will be available to population health management teams, allowing services to be planned with full reference to the use of emergency care
  • Improved patient safety due to improved service resilience
  • Reduction of risk of system downtime
  • Reduction in ambulance crew time spent handing over patients at the Emergency Department (ED) leading to increased availability
  • Improved continuity of care through access to all information on a patient’s emergency contact

Some of the benefits that the community organisations expect include:

  • Improving efficiencies by replacing paper and telephone processes to free staff time to support families
  • Online appointment management to reduce DNA’s (did not attend) and improve engagement with hard to reach families
  • Cost savings
  • Reduced administrative and cognitive burden on staff, improving their experience of work
  • Increased efficiency by making the most of available resources in community services through better planning
  • Improving patient care by having the right people to deliver the right care at the right time and in the right place.
  • Reducing duplication and bureaucracy while increasing clinical autonomy and quality of care
  • Raise the digital maturity of the organisation and increasing opportunities for efficiencies
  • Mileage reduced, time allocating visits reduced, and average visit numbers increased
  • Increased number of records updated at the point of care
  • Improved information sharing and data quality from improved standardisation and streamlining recording of information and reporting of performance
  • Increased access and choice for patients in booking appointments

Project summaries

NHS England - North West

The PRISM programme aggregates patient information from regional shared care records and presents this seamlessly to North West Ambulance Service NHS Trust (NWAS) clinicians in a single view. The architecture also implements a data layer to enable notifications and patient alerts from NWAS to flow across the North West.

NHS England - North West

PODAC funding will be used to deliver a fully operational model for ambulance crews to onward refer patients electronically on scene that do not need to be conveyed to the Emergency Department (ED). The funding will enable a full end to end programme of support and enablement to ensure that there is a very high confidence in programme delivery and success.

Manchester University NHS Foundation Trust

The main purpose of this project is to consolidate the North Manchester Community Services onto the Manchester University NHS Foundation Trust (MFT) EMIS community EPR.

A component of the project is the migration of the Trafford Local Care Organisation (LCO) EMIS instance into the MFT EMIS environment and the deployment of a SMS test reminder service to the North, South and Central community services.

London Ambulance Service NHS Trust

Transfer of Care Pilot - London Ambulance Service NHS Trust (LAS) to St George's University Hospitals NHS Foundation Trust (ED Handover).

The project will develop a means to pass ambulance ePR data directly into the Emergency Department (ED) clinical system to facilitate improved Transfer of Care (ToC) of patients conveyed to the emergency department, allowing clinicians to handover the care of the patient more efficiently.

East Midlands Ambulance Service NHS Trust

Access to Clinical information - East Midland Ambulance Service NHS Trust (EMAS) is implementing a shared care record to maximise the patient information presented to clinicians when treating patients. Having five Integrated Care Systems (ICSs) means our clinicians need to look in lots of places to understand their patients’ care needs. This solution will create a single portal for use across EMAS, supporting delivery of the most appropriate care, first time, every time.

Derbyshire Community Health Services Foundation Trust

There are two distinct projects being undertaken by Derbyshire Community Health Services Foundation Trust (DCHS):

  1. Community nursing and therapy services are benefiting from optimisation of the electronic roster and implementation of electronic job planning giving them access to digital tools and information to ensure more efficient workforce planning. This has positively impacted on the proportion of shifts filled and will also impact on both staff and patient experience (reflecting the aims of the National People Digital Strategy).
  2. DCHS has implemented a clinically-led redesign to optimise documentation and the use of the electronic patient record (EPR). The new documentation supports clinical decision-making and more personalised care and will also improve the accuracy and quality of the record. To realise these benefits a comprehensive, sustainable training and support programme has been developed to provide the wraparound support required.
East of England Ambulance Service NHS Trust

Access to Clinical information - National Records Locator

East of England Ambulance Service NHS Trust (EEAST) wish to enable access to National Records Locator (NRL) by building integrations with two commercial partners, Telefonica and Mastek.

NRL is a national index of over 300,000 pointers to patient records. It will enable an EEAST paramedic on scene or a clinician within the control room with correct authorisation to access a patient’s information to support that patient’s direct care. Currently, EEAST does not have access to this information and will typically convey a patient to an ED setting based on an assessment of the patient’s presentation.

Allied Health Professionals Suffolk CIC

This project had 3 different elements:

  • Integration of the self-referral portal (SRP) with the Microsoft Azure Translations engine to enable patients to refer themselves in their native language
  • Data warehousing implementation to store and process data from the self-referral portal and electronic patient records (EPRs)
  • Integration of the self-referral portal (SRP) with the patient demographic service (PDS) via an NHS Digital API enabling confirmation of the NHS number on all self-referrals
Cambridgeshire Community Services NHS Trust

Cambridge Community Services NHS Trust (CCS) is East of England’s main provider of Integrated Contraception and Sexual Health services.

Delivering these services across such a wide geography offers the opportunity to share best practice and knowledge, explore innovative, accessible and sustainable delivery of sexual health services in our communities. This project involved:

  • Merger of 6 clinical systems into one across the whole service
  • Implementation of an order comms module - linking with an external diagnostics portal enabling the results of tests to be shared back with the clinical system without the need for manual input
  • Implementation of a data feed between the clinical system and asymptomatic STI testing portal automating the recording of test results
  • Implementation of a new module (Lilie Hub) which enables members of the public to discreetly book appointments online without the need to speak to the service directly
Yorkshire Ambulance Service NHS Trust

Data provision to Yorkshire and Humber Shared Care Records

Yorkshire Ambulance Service NHS Trust is sharing information on all patient encounters with 999, 111 and patient transport services with regional health and social care services through the Yorkshire & Humber Care Record, providing a rich history to help inform ongoing patient care.

Yorkshire Ambulance Service NHS Trust

Yorkshire Ambulance Service needs to improve Business Intelligence (BI) systems resilience. Current services are dependent on one server and the new architecture with three new servers over two sites, with data replication, will mitigate the risk and reduce downtime of reporting if there is a service interruption.

Northern Lincolnshire and Goole Hospitals NHS Foundation Trust

Northern Lincolnshire and Goole NHS Foundation Trust will implement Augmented Reality (AR) technology to enable frontline community nursing colleagues to release time from the administrative task of retrospectively documenting visits.

This released capacity will be reinvested into direct patient care, increasing the productivity of the service, improving access, enabling delivery of key performance indicators and ultimately improving patient experience.

York and Scarborough Teaching Hospitals NHS Foundation Trust

Implementation of the Healthy IO wound care management application to test the impact of high quality clinical imagery (photographs) for wounds and pressure ulcers.

This app provides a number of opportunities including:

  • A high quality scan / image that supports standardisation of clinical imagery. This in turn supports continuity of care through standard imagery, virtual review of a wound by a senior clinician ( DN or TVN) an opportunity to explore the use of virtual platforms connecting to the patients coupled with clinical imagery.
  • At a glance database supporting improved planning of wound care support
West Midlands Ambulance Service University NHS Foundation Trust

Multi-project funding allocation:

West Midlands Ambulance Service (WMAS) are working to address four areas of digital maturity for their organisation with the funding that has been allocated including:

  1. Asset and resource optimisation - ensuring high levels of vehicle availability for clinicians by integrating processes and systems across 999 operations, fleet and stock control
  2. Transfers of care - development of registration and handover (transfer of care) processes with hospitals to allow clinicians to handover the care of the patient more efficiently with the use of structured data at handover
  3. Decision support - developing and introducing artificial intelligence based guidance to 999/111 operating centres, promoting safe use of alternative pathways to ensure patients receive the right care in the right location
  4. Records, assessments and plans - development of digital services for patients for use while they are waiting for an ambulance response or clinician contact, reducing the need to call back for further information
Isle of Wight NHS Trust

Purchase of new vehicle defibrillators to increase clinical data sharing/linkage to new electronic patient record (EPR) solution.

The final component is making the equipment compatible with SCAS equipment.

This will save time by automating the collection of vital signs into the EPR. This will save a significant amount of time on calls where this is required.

The current process requires the paramedics to type this into the record from a tablet, but once the defibrillators are integrated with the EPR this is automated.

Provide CIC

The Integrated Care Teams face growing demands on their service as they undertake approximately 200,000 visits to patients’ homes each year to support patients being discharged from hospital and to keep many more in their own homes and out of hospitals.

This project involves implementing three new solutions to help meet this challenge.

DragonOne dictation was implemented for 168 staff. Staff were issued headsets and provided with training, and templates in the electronic patient record (EPR) were streamlined and amended to better support dictation.

AutoPlanner, which is a part of SystmOne, was implemented to enable automated scheduling of patient visits in the most efficient way to consider all required factors and to produce efficient worklists.

Brigid implementation, a new mobile app allowing SystmOne records to be viewed and updated from mobile phones. To support this we issued staff with new smartphones with large screens.

Southern Health NHS Foundation Trust

Implementation of a Parent Information Portal (PiP). The PiP provides a secure, interactive platform linked to children’s records for 90,000 parents in Hampshire, giving access to quality, targeted health information and messages at each stage of their child’s development.

PiP replaces inefficient processes with modern digital services, freeing staff time to support families and providing access to health care quickly and conveniently for families.