Patients, passengers, and why a hospital is like an airport

On stage at NHS ConfedExpo earlier this month and in Netcompany’s last HSJ advertorial, I argued that the NHS lacks the ability to coordinate existing capacity quickly enough. This is leading to backlogs in elective surgeries and diagnostic tests, and longer accident and emergency department waits.

I am not alone in discussing the topic. In his keynote at Confed, NHS England chief executive Sir Jim Mackey noted: “We’ve got to change how our patients flow, with primary and secondary care working together to think about how we manage demand differently.”

Coordinating capacity isn’t an issue that’s confined to the NHS, however. The same problem affects airports, transport networks and other environments where many moving parts need to work as one. Thankfully, the same approach used in those industries to improve flow can also be applied to healthcare. That approach is orchestration.

A pervasive problem

The NHS has digitised significantly, but digitisation doesn’t solve the challenge of synchronising staff, patients and data across complex frontline services and trusts. A hospital, for example, comprises tens of overlapping IT systems, each reporting independently, leaving staff to reconcile information instead of acting on it. Simultaneously, patient demand continues to rise. Yet NHS capacity is constrained by limited physical expansion, staffing pressures and the lag between investment and operational delivery.

Therefore, the challenge is to create capacity from efficiency.

Why patients are like passengers

Airports face similar constraints. They have peaks and troughs in demand, limited room to grow, high consequences of failure, and many organisations working within one environment. At Copenhagen airport, for example, 46 organisations and more than 4,000 people collaborate under one roof.

To manage this ecosystem – which was facing inefficient operations and excessive energy consumption – Copenhagen airport and Netcompany co-developed AIRHART, an airport operations orchestration platform (AOOP), to bring more than 100 systems into a single operational environment. The goal was to give staff and partners a single source of truth, so that planning, security, baggage handling, crowd control and traffic management could be coordinated in one place.

The result has been a 33 per cent increase in throughput (30 million to 40 million passengers a year), alongside predictive planning and reduced carbon emissions. In short, data and process orchestration helped move more people through the same infrastructure without physical expansion.

What works there can work here

Orchestration is sector agnostic, so if it works for airports, it can work in healthcare. Across environments, it coordinates data from multiple sources to create a single operational view. This, in turn, improves the management of processes and actions, improving communication, speeding up delivery, and providing a bedrock for predictive modelling.

Our work with Transport for Greater Manchester (TfGM) is another good example. TfGM was dealing with around 60 different applications across its Bee Network control room, and staff were effectively acting as the integration layer, switching between screens, checking data and manually piecing together the picture – before deciding on a plan of action. That manual process made it tough to respond to incidents quickly.

We used PULSE – which shares its DNA with AIRHART – to create a single view of the Bee Network by combining more than 10 datasets, including open-source feeds, CCTV locations, route data and traffic infrastructure information. Operators could then see incidents, affected routes and likely knock-on effects in one interface, with suggested actions built into the workflow. This enabled faster incident handling, smoother operations, and even easier training for staff.

Legacy modernisation without disruption

Orchestration platforms also support legacy modernisation. By sitting above existing systems and connecting them more efficiently, they avoid costly “rip and replace” projects and make change less risky and disruptive than wholesale redevelopment.

Our work in the maritime space illustrates this. By placing PULSE at the centre of a long-term legacy modernisation programme, a client of ours finally switched off an outdated mainframe it’d been reliant on for decades.

Data trust and control

A common concern in healthcare is whether missing or inaccurate data would impact the efficacy of such a system. In practice, data orchestration can be applied to environments with various levels of digital maturity. PULSE can toggle sources on and off, flag potentially problematic data, and improve data quality over time by making it easy for staff to validate or enrich information.

Questions about the ownership of data are unavoidable (and necessary) when discussing the NHS. With PULSE, the data resides in core systems, remaining under the full authority and control of the original owner. Similarly, any third-party solution must respect governance, security and human oversight, and make it easy to set clear rules for who can access what.

Where to start

To see how data and process orchestration can free up capacity, trusts should begin with trials at the pinch points where inefficiency obviously wastes capacity – such as discharge delays, accident and emergency department pressure, and ambulance handovers. Predictive modelling can help identify where pressure is building and where intervention is most likely to work. Regardless of the approach, start small, prove value and then build outward.

This is the journey we’ve recently started with the Netcompany INEOS professional cycling team, which will build PULSE into its operations to improve logistics, coordinate rider and team data, and assist in race strategy.

Much like the NHS, the team already has the data and the operational urgency. What both must focus on now is coordinating that data effectively to improve performance on the ground.