Winner NHS Northwest,LancashireSouth andCumbria

Cardiac Network and Broomwell Healthwatch

Cardiac Telemedicine in Primary Care

An NHS North West 6-month pilot of telemedical ECGs within Cumbria & Lancashire has the potential to slash NHS bills by at least£46M per year.

Translating the success across the 15 GP practices and two NHS walk-in centres participating in the pilot, at the national level the BroomWell Healthwatch hand-held 12-lead ECG machine and specialised cardiac monitoring support centre could save 90,000 A&E visits, 45,000 hospital admissions and hundreds of lives each year inEngland.

The centres in the pilot were recruited with the support of the
Lancashireand South Cumbria Cardiac Network, who also provided evaluation advice.

The pocket-sized ECG devices and the monitoring centre help GPs to make diagnoses in minutes. A nurse, clinician or paramedic uses the ECG machine in the same way as a conventional machine. When complete the trace is transmitted as a sound signal by landline telephone to Broomwell’s monitoring centre.

Experienced clinicians give an immediate verbal interpretation that allows for the necessity of any prompt medical attention. A full written ECG report is also sent to the GP surgery by email or fax.

A referral to A&E or outpatients following the test was only required in 18 per cent of cases. Local diagnosis and early detection of heart problems in this manner can save hundreds of lives each year. The other 82 per cent of patients who had no abnormalities were quickly reassured and relieved of a great deal of stress.

Choosing the Cardiac Telemedicine in Primary Care project as their category winner, the judges praised what they described as a well-governed project and good all round proposition with quality outcomes and cost savings. They further felt that the demonstrable benefits to service delivery and the ECG assessment pathway that overcame cultural and social issues to the uptake of technology were scalable and immediately capable of replication.

Contact - Sally Chisholm, Cardiac Network Programme Director

Highly Commended SalfordRoyalHospitalNHS Foundation Trust

Access, Booking & Choice

Three initiatives utilising the benefits of the Choose and Book (CAB) system with other information technology tools have been put into practice by the Access, Booking and Choice (ABC) team at Salford Royal to improve patient access and meet the challenges of the 18 week target.

The result - a reduction in the trust “did not attend” (DNA) rate, improved Choose and Book access and a more responsive performance monitoring mechanism by which to plan capacity.

In addition technology in the shape of an automated check-in service within main outpatients has improved throughput and queue management and resulted in a far more satisfactory patient experience.

The call reminder service uses an automated voice recognition service to contact patients between 7-10 days prior to their appointment. They can confirm, cancel and/or rebook their appointment. Slots reallocated under this system have saved the trust approximately£20,000 a month and allowed patients access to earlier appointments.

Demand & capacity tools that highlight constraints and forecast requirements are helping departments plan and maximise outpatient capacity with consequent improvements in access. The CAB Demand & Capacity Red, Amber Green Report has been further developed with the strategic authority into a Service Status Report for commissioners.

Position reports are also being used to measure planned and actual performance levels and make more informed proactive adjustments rather than the traditional reactive approach.

The judges commended what they described as the hardwiring of service improvements with a human touch. The use of touch screen technology in an outpatient department to reduce queues and improve the patient experience was singled out as an innovative approach.

Contact - Tracy Brown, General Manager, Access, Booking & Choice

Met Office / Medixine

Automated COPD Health Forecasting inCornwall

A pilot scheme inCornwallacross 9 GP practices used automated telephone calls to alert people with COPD to periods when their risk of illness was elevated. The Health Forecasting Service, provided by the Met Office and Finnish telemedicine company Medixine with funding from Cornwall Social Care and Cornwall Primary Care Trust ran throughout the winter of 2006-07 and involved 447 period with COPD.

The interactive call asked patients two evidence based questions and the system relayed their answers to their GP or Practice Nurse. Practices using the service reduced COPD admission rates by 52 per cent compared with the previous year, while 89 per cent of patients found the calls helpful.

Contact -Patrick Sachon, Health Forecasting Business Manager, Met

Newham PCT / Serco Health

Managing long-term conditions with appropriate information technology

One of the most deprived and diverse boroughs inEngland, Newham is a challenging environment in which to provide healthcare. It is has the highest incidence of diabetes in theUKand the highest rate of deaths from strokes inLondon.

Newham PCT has introduced community matron led case management to tackle some of the problems experienced by patients with long-term conditions. In turn and as the result of a partnership with Serco Health, the matrons are supported by improved information management systems that target vulnerable patients for self-care education. Mobile technology with workflow software and real time updating makes clinical delivery in the community more efficient and also improves patient care and safety.

Contact - Imran Devji, Group Manager Primary Care Services

North YorkshireandYorkPCT

Digital Pen Pilot

A multi-partner pilot scheme examined the feasibility of collecting and uploading single assessment process data using digital pens.North Yorkshireand York PCT, North Yorkshire County Council SSD, Accenture Health, Liquid Logic, The University of Sheffield and Standard Register all contributed to the project.

Practitioners completed digitised pen and paper assessments with the client. Back at the office the pen was docked into the computer the information transferred via a handwriting recognition interface, to the database where it was made available to other staff.

Staff spent more time with clients and less time entering data, the client kept a copy of the assessment could and the information was available to other staff more promptly.

Contact - Gail McCracken Joint Community Strategy Manager, NYYPCT