The Download: A closer look at the FDP in action

NHS England’s Federated Data Platform has been the hot topic in the health tech world for two years, yet there are still lingering questions about what exactly it is and what the NHS is getting for the £330m that will be spent on it over the next seven years.

Fortunately, The Download was invited to North Tees and Hartlepool Foundation Trust last week to see the FDP in action and hear from those who use it daily.

OPTICA

Pilots of the FDP, which began back in 2021, focused on two “use cases”: Optimised Patient Tracking & Intelligent Choices Application and Improving Elective Care Coordination for Patients.

OPTICA was developed at North Tees and Hartlepool in partnership with the North of England Commissioning Support Unit following an idea from the trust’s head of patient flow services, Vicky Cardona.

The tool itself was built on Palantir’s Foundry platform which was initially provided to the NHS for free at the start of the covid-19 pandemic. It has not yet transitioned onto the FDP itself.

The idea is to bring together disparate data about patients in hospital into one place to make it easier to track what actions were needed to ensure they are discharged promptly.

Everything is then presented to the discharge team in the integrated co-ordination centre. Picture the VAR control room (or, if you are not football-minded, a small air traffic control room) with screens displaying near real-time data about the patients currently in hospital and the actions needed to discharge them.

The data itself is drawn from the trust’s electronic patient record and includes things such as demographic data, covid-19 status and criteria to reside status. It does not contain clinical data.

Stacey Rutter, the trust’s senior clinical professional in patient flow, said it is not necessarily a clinical tool, but a “process management” tool.

Staff on wards can remotely input information into the system about actions required to discharge patients, which can then be coordinated by the discharge team at the integrated coordination centre.

Benefits

The current method of coordinating discharges through OPTICA is a far cry from the previous way of doing things at North Tees.

Neil Atkinson, the trust’s managing director, said it was a “very paper-based system” previously.

He said: “There were lots of spreadsheets, there were sometimes errors made and I think as we’ve moved to an electronic solution, we’ve overcome all of those particular things and what we’re getting is much more timely discharges.”

Ms Rutter said clinical time has been made “much more efficient” thanks to OPTICA, as previously there was “a lot of time that was spent on telephones or via emails or waiting for people to bring information back from the wards”.

She said: “We relied upon people physically going out to the wards, attending the huddles, and bringing that information back. Whereas now, as soon as it’s inputted… then that information is instantly available in the command centre and then from there it’s coordinated.”

She added: “It helps us in terms of real time, identifying where our barriers are, where our delays are and what those challenges are in terms of the community resource so that we can have those live conversations and plan future developments. For example, we’ve used some of the intelligence that we have and worked with our local authority colleagues who have commissioned an overnight care service for people in their own home because that was a barrier.”

The results have been positive. The trust has been recognised as being one of the country’s leading performers in terms of accident and emergency performance (particularly around type 3 admissions, though there is still a way to go with type 1s), receiving £5m of capital funding from NHSE’s capital incentive scheme.

While the trust was already a relatively high performer in this area, Mr Atkinson said OPTICA “allowed that to happen” as the trust needs “the flow across the hospital” to improve performance.

Next steps

OPTICA is just one tool that will be available through the FDP. As more trusts and eventually integrated care boards take up the offer as NHSE hopes, more tools will become available.

NHSE’s current aim is to have 71 trusts live with a local instance of the FDP by the end of 2024, including the 44 pilot sites of which North Tees is one.

Engagement work is ongoing, but there is hope the results will speak for themselves.

North Tees and Hartlepool recently entered into a group model with neighbouring South Tees Hospitals FT, and there is already an appetite to expand OPTICA across the newly formed group.

Mr Atkinson said: “These are the kinds of conversations we really want to get into. At South Tees, we are not at the same point in the journey, but given the success at North Tees, we would expect that to be considered by the group.

“There has been a lot of interest in this particular model, not just across the group here, but at neighbouring trusts as well who are starting to look at it.”

The tool itself is also constantly being tweaked and updated.

Ms Rutter said: “There are plans to have some extraction of information from our local authority systems (provided there are local data sharing agreements in place), in terms of what community services patients are in receipt of currently, or what they’ve had previously, so that we’ve got more intelligence around planning for discharge appropriately and not having to go over old conversations and asking other services to link into their systems. We’ll be able to have that to hand which makes it much more efficient for the patient.”

NHSE is clearly pleased with the progress on OPTICA at North Tees, as it is one of nine case studies used in official communications campaigns for the FDP.

The question now is, will more trusts come forward with the benefits that they have realised through using the platform?