Improving care with Technology

The highly impressive life and cost saving outcomes of the NHS North West and BroomWell HealthWatch telemedical electrocardiogram (ECG) pilot study, run over six months across the Lancashire and South Cumbria cardiac network (LSCCN), didn’t only make their mark with the HSJ Awards judging panel.

The potential for reductions in mortality and emergency treatments – the equivalent of as much as£46 million a year off the healthcare bill - has seen the scheme attracting the attention of the NHS National Technology Adoption Hub, with a view to supporting a national roll-out.

"Be clear about the benefits you believe your project delivers in your entry," says Sally Chisholm, director of the LSCCN, "and maintain the focus on what it is you are trying to showcase."

Having successfully demonstrated a positive contribution to the assessment pathway across 15 GP practices and two NHS walk-in centres, and then winning the HSJ Awards Improving care with E-Technology category, the approach of combined pocket-sized ECG device and prompt monitoring centre reporting is already being taken up under contract by a number of PCTs in the North-West.

"Winning the award didn’t just raise the profile of this piece of work," says Ms Chisholm. "As part of this year's local development plan other technology that could improve health across Cumbria and Lancashire is being actively discussed."

Collaboration on the project between such a number of different organisations posed several technical governance challenges. The ability of the team to work through these issues while overcoming cultural and social hurdles to the adoption of technology was another feature that drew praise from the judges.

What judges want

  • Work which reflects the national IT priorities
  • Demonstrable benefits to the patient
  • Mainstreaming IT within the organisation
  • Partnership working between trusts and the private sector
  • Engaging with clinicians
  • Supporting new ways of working

Patient centred Care

The Leeds PCT "Pick and Mix" pharmacy needle exchange scheme has engaged users, staff and community professionals in a simple but highly effective system redesign that effectively reduces the risks posed by the sharing of injecting equipment.

Judges for the Patient Centred Care category applauded the scheme for its work with an often hard-to-reach client group. Service user questionnaires and consultation identified some of the key issues around poor take-up of an earlier pharmacy-based needle exchange scheme. These included poor staff attitudes, a lack of confidentiality and limited choice of equipment.

Service users now indicate what they need on a page from the "What Works" pad. Devised by clients themselves, this contains images of the wide range of needles, syringes, condoms and other items now available. It also allows the PCT to pull together basic data on the gender, postcode and drug use of people accessing the scheme. Payments, renegotiated for participating pharmacists, can also be calculated from the information collected.

Training packages at NVQ levels 1 and 2 were developed and the administrative burden of pharmacy involvement in needle exchange was reduced.

"The award hangs proudly on our office wall," says Caroline Wellings, project manager. "Since winning we have gone on to develop an on-line training package for pharmacy support staff. Set in a virtual pharmacy it has lots of interactive elements and helps staff become more familiar with the principles and practice of needle exchange."

With 16 pharmacies across the PCT now taking part the numbers of ‘Pick and Mix’ visits now runs at roughly 1,800 a month.

What judges want

  • Clearly defined objectives for quality improvement within the project
  • An understandable model for patient-centred care, with clearly described interventions
  • Evidence that patients have been engaged in the project's design, delivery and decision-making
  • Robust data collection and analysis, showing measured improvements in patient care, including clinical outcomes
  • Tangible evidence that the interface between healthcare professionals and their patients had changed
  • The sustainability of the changes observed