IMPROVING CARE WITH e-TECHNOLOGY

Further projects have been added at the request of users and stakeholders. Critical care and nursing and residential home systems aim to reduce the time spent looking for vacancies and maximise use of a reducing bedstock. ECMScopyright also provides information about pharmacy, NHS, social services and the voluntary sector. Information about vulnerable adults, those at risk of deterioration, falls, carer collapse and so on, is held centrally as part of an initiative to provide preventive assistance.

Management The system is operated and managed by Surrey Ambulance Service trust on behalf of the East and West Surrey health and social care systems at chief executive and local capacity planning group level. There is a director steering group and regular operational group meetings. At a local level, ECMScopyright is managed by an emergency capacity manager, supported by an assistant manager and call centre supervisor.

Winner: Surrey Ambulance Service trust Project: Emergency capacity management system Contact: Chris Watts, tel: 01737-353333 Innovations and successesECMScopyright GP/999 has equalised pressure across Surrey. Before it was introduced, activity levels varied by as much as 80 per cent - the range is now less than 10 per cent. Since the start of ECMScopyright, none of the local accident and emergency units have closed or diverted ambulance arrivals. The nursing and residential homes database has generated positive feedback. Patients have benefited from earlier discharge or avoidance of admission.

The judges said: ECMScopyright clearly demonstrates innovative thinking, implementation evidence and solution scaleability. The project has been well managed, with mature channels for communication for feedback and excellent promotion to other parts of the country.

Runner-up: Royal Alexandra Hospital trust, Paisley Project: RACHEL - the Royal Alexandra Cardiac Electronic Health Link Contact: Dr Iain Findlay, tel: 0141-580 4422 This computerised clinical record system uses NHSnet to communicate between primary and secondary care. The system enables rapid online referral of patients with chest pain, according to the national service framework for coronary heart disease. An electronic patient record provides online audit data. Discharge letters are provided via a web-browser.

The system is available to staff working in the cardiology department, accident and emergency, pharmacy, coding and 45 general practices serving a population of 200,000.

Management A project manager was appointed. Staff contributing to the project were consulted.

Existing computing facilities were used where possible.

The system uses software developed in a university at no cost to the NHS. GP access is free and the system could be transferred to other parts of the NHS at little cost.

Innovations and successes The major stimulus was the Scottish hospital outcome indicators for myocardial infarction. These showed high mortality at Royal Alexandra Hospital that it could neither refute nor confirm. Data can now be collected from A&E, through CCU to phase 3 cardiac rehabilitation and back to primary care through NHSnet.

The system has brought about faster admission for patients not requiring emergency care.

The judges said: An impressive system of operational electronic records for patients with coronary heart disease, supporting the framework. It has great potential for being rolled out to other diseases.

Runner-up: North Somerset primary care group (formerly Weston-super-Mare PCG) Project: Coronary heart disease secondary prevention service Contact: Dr Peter Smith, tel: 01934-410103 In November 1999, the then Weston-super-Mare primary care group board (now North Somerset PCG) appointed a community specialist nurse to help GPs meet the expected requirements of the national service framework on coronary heart disease. The initiative was backed by the Modernisation Fund and three pharmaceutical companies. The support included software to support clinical decision-making. The software, CVR Profile, features interactive patient consultation tools and a clinical database capable of integration with any clinical system in use in GP practice.

Management The salaried, G-grade community specialist nurse visits all 13 practices weekly to set up and run secondary prevention clinics or audit clinical data from practice nurse-run clinics.

Innovations and successesThe nurse has applied a consistent standard of care and organisation to the disease register within each practice, so performance can be compared. Clinical records have been put in good order in preparation for the arrival of the national PRIMIS system of clinical audit.

The bespoke clinical software has enabled rapid and accurate analysis of the specialist nurse's work. CVR Profile is also a patient education tool.

The judges said: This project showed a collaborative approach to working with the private sector - pharmaceutical companies and high-street chemists - and data protection issues seem to have been addressed effectively. It has the potential to be used in other disease processes.