Category: News and case studies

Obesity is a pressing global health challenge, linked to various chronic diseases such as type 2 diabetes, cardiovascular issues, and certain cancers. In response to this growing concern, the NHS launched the Digital Weight Management Programme in April 2021, marking a significant step towards addressing obesity at a national level.

The NHS Digital Weight Management Programme stands out as the first nationally available service of its kind, offering digital interventions to help adults manage their weight effectively. Unlike traditional face-to-face interventions, this program is delivered digitally, allowing for scalability and accessibility across different levels of intensity.

A recent study, co-authored by Priyantha Jayawardane and Neil Davies from the NHS Midlands and Lancashire’s (NHS ML) Digital Innovation Unit, marks the first comprehensive evaluation of this pioneering program. Published in the Obesity: A Research Journal by The Obesity Society, the study provides valuable insights into the early outcomes of referrals to the NHS Digital Weight Management Programme.

The study, conducted between April 2021 and March 2022, analysed data from over 63,000 referrals made from general practices. Of these, 50% opted to participate in the 12-week program, demonstrating a significant uptake. Participants were triaged into three intervention levels based on demographic factors, to optimise completion rates.

Among the key findings, the study revealed that participants who completed the program experienced clinically meaningful weight loss. On average, participants who finished the program shed 3.9 kg, while those who had time to complete but did not finish still saw a weight reduction of 0.74 kg. Importantly, these outcomes compared favourably to both web-based and face-to-face weight management interventions tested in previous trials.

The study highlighted the programme’s potential to bring population-level benefits, provided increased participation. Notably, weight reductions were consistent across participants regardless of individual socioeconomic status, indicating equitable access to the intervention.

The NHS Digital Weight Management Programme represents a significant advancement in the fight against obesity, offering a scalable and effective solution for individuals looking to manage their weight. By incorporating digital delivery into clinical practice, the program has the potential to enhance the overall effectiveness and reach of weight management services, ultimately improving public health outcomes.

For those interested in reading more into the study’s findings, the full article is available at: Early outcomes of referrals to the English National Health Service Digital Weight Management Programme [https://onlinelibrary.wiley.com/doi/10.1002/oby.24024].

This study not only underscores the effectiveness of the NHS Digital Weight Management Programme but also lays the groundwork for further research and innovation in obesity management.

Our Digital Transformation team’s expertise in programme management significantly enhanced an integrated care system’s readiness for the 2023 Integrated Care Board (ICB) transition, establishing a robust programme management office that ensured effective governance, process optimisation, and successful day-to-day project management.

Background

In 2021, to assist a digital team within an integrated care system to prepare for the 2023 ICB transition, NHS Midlands and Lancashire CSU’s Digital Transformation team utilised their expertise in projects, programmes, and portfolio management to establish a digital programme management office for the integrated care system (ICS). The goals were twofold: firstly, to provide a framework for effective assurance and governance of the ICS’s complex mix of digital programmes, projects, and routine activities; and secondly, to ensure the availability of necessary processes, tools, and competencies.

Action
Our Digital Transformation team offered a comprehensive programme management office service, which included a central point of coordination and oversight to match the project requirements through experienced resources. Our approach, grounded in best practice methodology, encompassed three key phases:

– Definition: we established clear goals and objectives, ensuring executive buy-in and facilitating robust communication.

– Design: our team created a tailored delivery service to meet the specific requirements of the project. This step included setting up and establishing the service, providing projects, programmes, and portfolio management and resource management tools.

– Delivery: we executed the projects, programmes, and portfolio management strategy, defining a governance structure (reports, procedures, processes, and tools), and provided the appropriate competence models and resources where required.

Impact

The successful implementation of our programme management office service led to an ongoing role in overseeing day-to-day delivery, reporting, and meeting coordination for the client. Our approach facilitated an efficient and timely management of the project, aligning with the client’s requirements and project complexity.

Feedback

“MLCSU have actively provided an outsourced programme management office service for the digital team helping us to keep a steady rhythm of quality reporting and meetings with a complex and demanding mix of stakeholders. Their ‘can-do’ approach and professionalism helps maintain smooth operation.”

Joe McGuigan | ICB Director of Digital Operations and Assurance | ICB Deputy SIRO & SCR Strategic Lead |
NHS Lancashire and South Cumbria Integrated Care Board

If you would like to find out more about our programme management office services you can do so by visiting our Digital Transformation page.

Our Digital Transformation team’s in-depth review and strategic guidance significantly improved Lancashire and South Cumbria integrated care system’s programme management office, leading to enhanced governance, better resource allocation, and a clear roadmap for future development.

Background

Lancashire and South Cumbria (L&SC) integrated care system asked NHS Midlands and Lancashire CSU’s (MLCSU) Digital Transformation team to undertake a review of their journey in setting up a programme management office and its governance. They had made some progress in setting up and finding tools, but realised they needed more work to become more stable and controlled. L&SC wanted the team to closely look at their current practices across their whole portfolio and suggest ways to reach their goals.

Action

Our Digital Transformation team worked closely with L&SC to explore existing process, controls, and capabilities across six areas; definition, finance and allocation of resource, controls, communication and engagement, change/benefits management and PMO/programme control.

The review process was split into three defined parts:

1. A detailed document review to establish the current project position with source material shared by the L&SC team

2. A series of interviews to ‘deep dive’ into the review areas with L&SC project and programme leads

3. A series of interviews with the senior leadership team to review the areas from a senior perspective.

The outcomes of the review processes informed an assessment of project and programme management capacity and capability. MLCSU’s assessment provided a current baseline for each of the projects and programmes within scope and identified opportunities for improvement to support the development of the programme management office along with identification of key areas to be prioritised. Following the assessment, the L&SC requested further support with implementing the findings and next steps with their project teams.

The MLCSU team designed and facilitated a two day workshop to provide this feedback and further develop the next steps with key input from the L&SC project teams.

Impact

MLCSU’s Digital Transformation team offered valuable insight into the L&SC programme management office’s current state, along with advice and guidance on how to develop their programme management office into a controlled, stable state.

This included the identification of key areas requiring the development of tools and templates, as well as recommendations for improvements to governance, links to strategy and ownership of budgets. Furthermore, our Digital Transformation team prioritised these recommendations for L&SC and built on them with the engagement of the L&SC project teams to initiate the development of the tools, templates and improvement activities, giving them the confidence to own their plan and actions to get to their future state.

The result of this collaborative approach provided L&SC with a clear roadmap for the development of their programme management office, with clear actions and owners against this roadmap and extremely positive feedback from both the project team and senior leadership team in terms of the approach to this work as well as the output. Subsequently, MLCSU’s Digital Transformation team have been engaged to further support L&SC with an outsourced programme management office service.

Feedback

“I wanted to feedback to you on the positive partnership that we had with Gurpreet, Steve, and Lizzie. The work was well managed and undertaken in a true spirit of partnership, support, and guidance. The whole digital staff team reported a really positive experience and valued the input from Steve and Lizzie in the one-to-one interviews. We have a clear roadmap now of where we need to utilise our limited resources and priorities. I wanted to personally acknowledge the hard work that Lizzie put into the process and the workshop, she is a real asset to your team.”

Janet Davies | Programme Lead Digital PMO | Lancashire and South Cumbria ICS

Recorded live at the Digital Healthcare Show 2023, host Andy Downton engages in a captivating conversation with Priyantha Jayawardane, Deputy Director of the Digital Innovation Unit at NHS Midlands and Lancashire CSU.

Listen to “Inside MLCSU” online, or download via Spotify, Apple Podcasts and Amazon Music.

New episode: How automated innovations are helping to reduce hospital waiting times.

In this episode, Priyantha sheds light on how digital advancements are revolutionising productivity within the NHS, particularly at a critical time when waiting lists are at an all-time high. Discover how the implementation of remote monitoring, digital pathways for remote treatment, and robotic process automation are making a significant impact. These technologies are not just reducing hospital admissions but are also enabling skilled NHS staff to focus on high-value tasks, ultimately enhancing patient care.

A must-listen for anyone interested in how digital innovation is shaping the future of healthcare. It’s an insightful exploration of the necessity of prevention, early detection, and the role of technology in transforming healthcare services.

For more insights and information about our Digital Innovation Unit and its initiatives, you can visit our page: MLCSU Digital Innovation Unit.

Case studies highlighted in the podcast:

Using automation to reduce waiting lists: A detailed look at how a hospital trust tackled backlog issues through a combination of chatbot technology, risk stratification, and AI. https://www.midlandsandlancashirecsu.nhs.uk/case-studies/using-automation-to-reduce-waiting-lists/

Automation across two Integrated Care Systems: Explore how automated chatbots, robotic process automation, and human call agents helped contact over 80% of patients on waiting lists across two integrated care systems (ICSs), leading to significant reductions in wait times. This initiative was also a finalist for an HSJ Partnerships Award 2023 in the ‘Best Elective Care Recovery Initiative’ category.
https://www.midlandsandlancashirecsu.nhs.uk/case-studies/using-automation-to-reduce-waiting-lists-across-two-icss/

We are thrilled to announce that our Data, Digital and Technology directorate has achieved the prestigious “Excellence in Informatics” Level 2 accreditation from the North West Informatics Skills Development Network (ISDN).

The ISDN accreditation is a peer-assessed standard, and we were required to provide extensive evidence of our capability and skills development practice against rigorous criteria. This recognition benchmarks highly our informatics staff’s expertise and encompasses all aspects of their personal and professional development, covering areas such as infrastructure, personal and career growth, professional advancement, workforce planning, people management and leadership.

Debbie Bywater, Chief Information Officer at NHS Midlands and Lancashire CSU, said: “I am absolutely delighted that building upon our achievement of obtaining Excellence in Informatics Level 1 accreditation last summer, we have now achieved Level 2 accreditation from the North West Skills Development Network. The accreditation process involved an external assessment against a wide range of criteria all of which we demonstrated we met, and in several cases exceeded in respect of the required standards.

“We approached the accreditation as a continuous improvement opportunity for the service. It was a very positive experience, it has provided a framework to consider our workforce and service development holistically and it will inform the ongoing development of our organisational development plan.”

For our clients, this accreditation reaffirms our commitment to staff development and service quality, showcasing our focus on both staff welfare and service excellence.

Join us at the Digital Healthcare Show, part of Health Plus Care, the most significant and innovative UK event for healthcare professionals looking to revolutionise the NHS through the use of data, analytics and technology.

Our team of digital healthcare experts will be joined by experts from two other commissioning support units (CSUs) – NHS Arden and Greater East Midlands CSU and NHS North of England CSU – We will showcase how we design and employ digital solutions to improve access and quality of patient care and optimise processes for clinicians and NHS trusts.

Visit us on stand 69 to talk more about our integrated digital healthcare support including:

– Managing elective care waiting lists with chatbot and robotic process automation
– RAIDR Waiting Well – elective care waiting lists dashboard
– System Control Centre dashboard for urgent and emergency care
– OPTICA – secure cloud application that tracks patient discharges
– Digitally enabled pathway redesign for prevention
– Digital transformation solutions
– Performance reviews – what you need to deliver digitally-enabled care
– Personalised video consultations
– Digital transformation and IT for primary care.

Alongside the exhibition, there is an extensive programme of digital healthcare events and talks. The event is free for all NHS professionals.

You can register at www.healthpluscare.co.uk/Digital

We prepared a comprehensive 3-year Digital Transformation Investment Plan that seamlessly integrated into the full ICB Plan, driving digital transformation and delivering exceptional value to the ICB.

Background​

The Lancashire & South Cumbria (L&SC) ICB Digital Leadership Team engaged the MLCSU DT team to prepare a comprehensive 3-year Digital Transformation Investment Plan (DTIP). The goal was to ensure that the DTIP would seamlessly integrate into the full ICB Plan.​

Action​

The MLCSU DT team worked closely with key stakeholders, including digital and programme leadership, clinicians, and representatives from the ICS team, the 5 ICPs, Primary Care, Community Health, Local Government, VCFSEs, Academia, and the NHSE regional digital transformation team.​

The team began by refreshing the 3-year digital strategy, which was linked with NHSE initiatives, including What Good Looks Like, Who Pays for What, Who Does What, Putting Data, Digital and Technology at the Heart of Transforming the NHS, and the nationally provided Place Development Programme. ​

They collaborated with stakeholders to identify potential initiatives, priorities, and related funding sources. The team also considered other contextual documents, such as Core 20 plus 5, ICB operational plans, ICP digital and clinical plans, social care plans, sustainability, NetZero, and green targets.​

Impact​

A comprehensive portfolio of projects and programmes with a high-level timeline​

A detailed written DTIP document covering some 90 pages, including:​

– An overview of the document, the purpose of DTIP, and an executive summary with plans aligned to the ICS digital strategy strategic pillars​

– A full review of the technical architecture and financial plan​

– Consideration of risk to delivery and suggested mitigations​

– Conclusions and appendices, including an adaptive philosophy to delivery, key documents and references; programme overviews​

– An overview presentation pack of the DTIP for stakeholder playback and approvals​

– A headline summary of the PMO capability and recommendations for further development​

The DTIP was designed as a living document that set the foundation for investment, implementation, portfolio management, assurance, and benefits realisation. With a focus on adaptive philosophy to delivery and considering risks, the DTIP successfully delivered a detailed roadmap that would drive digital transformation, improve operational efficiency, and deliver exceptional value to the ICB.​

Customer feedback

The assistance provided by MLCSU gave invaluable support to the L&SC digital team, to complete a comprehensive system-wide DTIP. This DTIP is now being used to underpin a new Lancashire & South Cumbria ICB​ digital and data strategy in the next financial year.​

Andrew Thompson | Chief Technology Officer​ – Lancashire & South Cumbria ICB​

Earlier this week, Ashley Burton, Senior Project Manager at the NHS Midlands and Lancashire CSU (MLCSU), was announced the winner of the Business Contribution in a Digital Apprenticeship Award as part of the National Apprenticeships Awards 2023.

The annual awards took place during National Apprenticeships Week, 6-12 February, and celebrated the fantastic achievements of apprentices pursuing degrees recognising the impact that degree apprenticeships have on organisations and industry.

Ashley who works in our IT Programmes and Projects team is currently completing his degree apprenticeship in Digital and Technology Solutions in IT. The Business Contribution award recognises exceptional contribution to an employer with emphasis on how the apprentice has demonstrated commitment to digital technology through their technical, business, project and professional development.

Ashley said: “I’m thrilled that I have won an award for my contribution towards digital technology within the NHS. I have received amazing support from Staffordshire University and MLCSU in teaching me the skills required to reach my goal of being an IT consultant.

“The importance of digital transformation within the NHS is huge and it’s a great thing to be a part of. The new skills that I have developed (and will continue to) will not only help me in my career progression, but also help the NHS in its efforts to continue investing in digital transformation. A massive thank you to all that nominated me.”

Another MLCSU employee, Zainab Parvin, IT Apprentice Developer at MLCSU’s Development and Contracting team, is pursuing a Master Degree apprenticeship in conjunction with Brunel University and was also nominated for the Business Contribution award.

Zainab said: “I am truly honoured to have been nominated for this award, and to see how the contributions that I have made towards my team and organisation has been very fulfilling. I am truly grateful for this nomination and the support that I have received from my manager, my university tutor and my previous senior colleague. This has motivated me further to continue making an impact.”

Congratulations to all winners. Our People Services have spent a great amount of time and effort supporting our staff to pursue apprenticeships in their personal and professional development. Receiving this recognition has been a great accomplishment for MLCSU.

Through over 330 ours of focused work on engagement and gap analysis, we identified and consolidated the requirements for implementing a common Electronic Patient Record (EPR) system to enable seamless health care.

Background
Dudley Integrated Health and Care (DIHC) had already taken significant steps to integrate services, but were ambitious to push this further. An integrated Electronic Patient Record (EPR) system would be a major part of their drive towards much more seamless care for patients and efficiency for clinicians.

The Common EPR programme of work began in 2021/22 with support from the NHS Midlands and Lancashire CSU’s Digital Transformation team. The first phase to identify and define requirements has been completed, and the second phase involving the implementation is due to commence imminently.

Action

To establish DIHC’s requirements, we undertook a series of interviews and workshops with service leads, frontline clinicians, partners and other stakeholders. Building on this intelligence, we turned the identified requirements into a detailed, richer system specification.

We looked deeper by performing a gap analysis against the incumbent core clinical system supplier to establish and identify:

-how their solution could fulfil the requirements
-which requirements it could fulfil
-the implication of the gaps and the roadmap to fill these.

The team provided strategic EPR options and an executive recommendation for the project, before establishing the foundations for a Common EPR Business Case spanning primary care, mental health, children’s and adult community services.

Impact

In a truly collaborative effort, a total of 70 services and teams throughout Dudley were engaged in this project.

From October 2021 to March 2022, our Digital Transformation team spent over 330 hours of focused work on targeted service engagement, discovery workshops and interviews, documentation, follow-ups, validation and requirement consolidation and traceability activities.

The discovery process involved more than 115 NHS colleagues through more than 110 meetings, interviews and workshops. This ensured that service leads, frontline clinicians, partners and other stakeholders were at the forefront of defining what the Common EPR would look like.

We gathered 3,742 requirements through this process. These were consolidated into 843 individual EPR requirements before being categorised and prioritised.

Our iterative, analytical and fully traceable EPR Gap Analysis process involved:

-Fit and gap assessments with the incumbent system supplier
-Categorisation of requirements (e.g. Fully Met, Partially Met, Not Met) with supporting action plans
-Dashboard level analytics for communication across a wide range of stakeholder groups
-Emerging themes and barriers to progress consolidated into four strategic areas of concern for executive review and steer.

We completed a digital tools operational review for DIHC Primary Care Clinical Support Services in parallel to the Common EPR process, and established an action plan for operational system improvements.

“I was impressed with the way the team developed and implemented a programme structure which enabled a complex set of requirements to be delivered. The outcome of the EPR programme has enabled the organisation to understand the requirements of individual services, address gaps with current system suppliers and identify potential solutions for the future EPR. Thanks to everyone that has supported this project.”

Matthew Gamage, Acting Director of Finance, Dudley Integrated Health and Care

In the NHS, the cyber threat is ever present, and David Willis from our Digital Transformation team has been supporting the Lancashire and South Cumbria Integrated Care System (ICS) in the role of Acting Senior Information Security Officer to tackle the bigger issues as the integration of health and care and use of connected medical devices intensifies the risk

At a recent cyber security conference by the UKAuthority, David spoke about the strategies being deployed to increase resilience. There may be a growing number of cyber security tools on the market, but the structure and processes around how they are used are just as essential in tackling the threat. Resilience depends as much on organisations and people as it does on technology. What’s essential is to be clear on the role it plays.

“It’s a big ask, but the more you begin to understand what happens if it fails the more you will be able to explain need for your role,” Willis said.

Alongside colleague Emma Velle, Cyber Security Specialist at Cisco, the pair presented the ICS’s approach for cyber security involving four key steps. First is to get full visibility of the cyber risk at the local organisational level, and second to develop a solution for responding to incidents in real time. Third is to understand the capacity, capability and sustainability of the teams involved, and fourth to stage a series of regional events for digital emergency planning, resilience and response.

Watch a recording and read more in Emma’s article for the UKAuthority website: https://www.ukauthority.com/articles/facing-the-cyber-threat-in-health-and-social-care/

We are very proud to announce that our Digital Innovation Unit (DIU) have successfully achieved International Standard Organisation (ISO) accreditation to the prestigious ISO 9001 and 27001 quality standards.

The ‘9001’ and the ‘27001’ quality standards focus on ‘Design’ and ‘Information Security Management’ respectively.

This success follows 18 months of hard work and planning culminating with an external in-depth assessment against the required ISO standards, which will be repeated annually from now on to maintain the ISO standards.

Debbie Bywater, Chief Information Officer, added: “This is an excellent achievement for the DIU and and the NHS Midlands and Lancashire CSU and an example of our commitment to ensuring quality and efficiency in all that we do.

“The new standards help us in enhancing our credibility with clients and their peace of mind that our services carry the ISO stamp of quality assurance.”

These accreditations are increasingly a pre-requisite to the delivery of digital services at NHS organisations. The DIU will now be able to provide support to even more customers and help them meet their digital transformation goals.

Well done to our colleagues in the Digital Innovation Unit.

We have been supporting the Lancashire and South Cumbria’s New Hospitals Programme to design and deliver digital infrastructures to benefit new hospital services, enhancing usability, data driven insights and automation.

Background

As part of the national New Hospital Programme, the Lancashire and South Cumbria region has been recognised as in need of funding to replace or refurbish existing hospital estate to address problems with ageing facilities and infrastructure in Preston at Royal Preston Hospital (RPH) and Lancaster at Royal Lancaster Infirmary (RLI).

Proposals also include investment in Furness General Hospital, required due to its geographically remote location and its proximity to some of the UK’s major strategic national assets.

This funding provides the region with a once-in-a-generation opportunity to transform hospitals by 2030, with the positive effects set to enhance the lives of local people living and working in Lancashire and South Cumbria both now, and in generations to come.

Action

Midlands and Lancashire Commissioning Support Unit are providing specialist digital leadership for the Lancashire and South Cumbria New Hospitals Programme to ensure that all digitally enabled functions and services are fully understood, considered and coordinated into the vision and delivery strategy.

Designing, integrating and delivering digital infrastructure and services that meets the needs of the new hospitals users, and that is innovative and user-centric are some of the key principles.

Impact

The Lancashire and South Cumbria New Hospitals Programme is benefitting from specialist digital in construction leadership to set strategic direction and to coordinate the integration of Lancashire and South Cumbria wide and site-specific digital services within a multi-site, large-scale construction programme.

The inputs will maximise the opportunities to create digitally enabled and coordinated hospitals from concept design stage. The eventual outputs will positively impact and benefit across all new hospital services, enhancing usability, data driven insights and automation; improving health and wellbeing; increasing sustainability and reducing capital expenditure by reducing duplication, sharing resources and decreasing operational costs.

“Having specialist digital in construction advice and expertise to develop and articulate a compelling vision and ambitious strategy for what can be achieved through digital transformation enabled by new hospital facilities has been invaluable for the programme. It helps to really bring to life the potential and impact for patients, staff and local communities in a tangible way. Importantly, this has been delivered within the context of the wider NHS Lancashire and South Cumbria Integrated Care Board digital strategic objectives, with strong relationships established at a programme and a system level.”

Rebecca Malin | Programme Director, Lancashire and South Cumbria New Hospitals Programme

The NHS Midlands and Lancashire CSU (MLCSU) has been working with the Cheshire and Merseyside Integrated Care System (ICS) to lead a digital transformation programme which became the first national blueprint for digital-first primary care. It enabled remote and at-home monitoring of blood pressure to help identify, triage and treat more patients. Find out more about the programme in our Digital Transformation section.

Data showed a pronounced reduction (25.3%) in hypertension (high blood pressure) patients not being treated to target during the pandemic, and 229 GPs across the region were set up as ‘Hypertension Accelerator’ sites. To deliver this, we have been supporting the ICS with the local roll out of the national BP@home programme, which distributes digital monitors to patients diagnosed with uncontrollable high blood pressure.

Our learning from the roll out of the programme and from developing the collaboration between primary care teams, digital providers, procurement and Innovation Agency NWC (the Academic Health Science Network for the North West Coast) was recognised as a blueprint for enabling digital transformation in primary care.

It has been made available via the FutureNHS platform, so health and care systems and providers across the country can take advantage of the shared knowledge.

The Champs Public Health Collaborative, a formal partnership of Cheshire and Merseyside’s nine Directors of Public Health and their teams, serving a population of 2.6 million people, has published the blueprint, explaining that:

“It is hoped that not only will the blueprint be used to aid digital enablers and clinicians in their roles to support the rollout of BP@Home across the country, but that the approach utilised can be replicated to support other digital programmes of work…particularly those in primary care settings.”

The blueprint was featured at a Health Tech Newspaper (HTN) session focused on blueprints for supporting ICSs where the panel of experts included Sally Deacon, the MCLSU Programme Manager working with Cheshire and Merseyside ICS, who shared our approach to home blood pressure monitoring across Cheshire and Merseyside.

Alex Chaplin, Head of Digital at Cheshire and Merseyside ICS, commented that:

“MLCSU have delivered an excellent collaboration across our system using digital enablers to empower patients across Cheshire and Merseyside to monitor their blood pressure levels and submit readings electronically to their GP in the comfort of their own homes, providing the first Digital Accelerator Blueprint to share learning, supporting rapid scaling and adoption of remote monitoring.”

 

We helped the Cheshire and Merseyside Integrated Care System increase patients measuring their blood pressure at home, delivering a major digital transformation within primary care which became the first national digital-first blueprint.

Background

The most recent Quality and Outcomes Framework (QOF) figures (2020/21) show that throughout the pandemic there has been a 22% reduction nationally in the proportion of people on the hypertension register who have been recorded as ‘treated to target’.

In Cheshire and Merseyside the reduction is more pronounced. The reduction across all ages has been from 70.1% (2019/20) to 44.8% (2020/21), a fall of 25.3%.

Liverpool, Cheshire and Wirral were funded by the Digital First Primary Care national programme to become ‘Hypertension Accelerator’ sites. This included 229 GPs covering over 1million people. In collaboration with the ‘BP@home’ programme, which helps people with home monitoring for high blood pressure (BP), they tested approaches and digital tools to enable remote management of hypertension patients in primary care. The aim was to inform the approach for at-home / remote BP monitoring to become business as usual for GPs across the Cheshire and Merseyside Integrated Care System (ICS).

Action

We deployed a senior programme consultant to develop the collaboration between primary care teams, digital providers, Innovation Agency NWC (the Academic Health Science Network for the North West Coast) and MLCSU technology and procurement experts. The goal was to implement a digital solution for primary care to deliver BP readings at home, with a combination of elements:

* Ability for texting between GPs and patients and forms for patients to submit BP readings
* GP systems applying approved clinical terminology (‘SNOMED’ codes)
* GP based Blood Pressure Quality Improvement (BPQI) tool offering:

– EMIS-embedded dashboard and audit tool (aligned to National Institute of Clinical Excellence (NICE) guidance) to support patient list risk stratification and identify cohorts for further management

– EMIS-embedded consultation templates (for new and existing patients)

– Practice protocols, printable patient information leaflets and training support

* Clinical Decision Support Tool (‘Ardens’), aligned to NICE guidance, to give clinicians easy access to best practice resources.
* Sharing knowledge of the first Digital Accelerator Blueprint across all NHS health systems by providing step by step guides and learning from the local rollout via the NHS England and Improvement Blueprint Futures platform.

Impact

Within the first three months of deployment approximately 50% of GPs downloaded the BPQI tool.

There has been a more than 300% increase in the number of patients within Liverpool, Cheshire and Wirral submitting their BP readings remotely via text and over 60 practices so far using patient digital submission tools for BP readings.

These figures are likely to increase as more GPs come onboard this ongoing project.

“MLCSU have delivered an excellent collaboration across our system using digital enablers to empower patients across Cheshire and Merseyside to monitor their blood pressure levels and submit readings electronically to their GP in the comfort of their own homes, providing the first Digital Accelerator Blueprint to share learning, supporting rapid scaling and adoption of remote monitoring.”

Alex Chaplin, Head of Digital, Cheshire & Merseyside ICS

“MLCSU resource has consistently impressed, with her skills in building a community of practice and commitment to this project, bringing a range of stakeholders and MLCSU expertise together across a wide region and instilling a genuine momentum to the ongoing progress of the project.”

Mike Purdie, IT Service Delivery Lead, Cheshire CCG

“MLCSU plays an integral role supporting the programme with a pragmatic and flexible approach. As a result, we have high engagement from stakeholders. For us, there has been good groundwork set for strengthening our approaches to BP and achieving our objectives.”

Dr Julia Reynolds, Associate Director of Transformation, Innovation Agency NWC

We designed and implemented a programme of transformation to enable remote monitoring across healthcare in the Black Country and West Birmingham health system.

Background

In 2021, NHS England added remote monitoring to the national priorities and operational planning guidance.

Remote monitoring is a golden thread that spans the continuum of care, including inpatients, outpatients and primary care in the community. It also includes Virtual Wards and Hospital at Home.

For Black Country and West Birmingham health system, remote monitoring aligned with another key goal: striving for patient-centred care by digitising and personalising healthcare.

The NHS Midlands and Lancashire Commissioning Support Unit (MLCSU) launched a multi-year digital transformation programme to provide remote monitoring at pace in Black Country and West Birmingham.

Action

A programme of this size required MLCSU to deploy hundreds of remote monitoring solutions, for everything from deterioration of care-home residents for primary care to acute step-down virtual wards in secondary care.

Each deployment required its own set of procedures, which included separate documentation, information governance, clinical models, bespoke care packages, training and testing.

We began by assigning a team of five at the customer organisation to increase capability and capacity. Three areas were key to the success of this project:

Establishing processes

* requirements gathering and specifications documentation
* overarching information governance
* clinical safety documentation, including DCB0160
* pathway and standard operating procedure redesign and input into amendments

Boosting awareness and engagement

* educating clinicians on the remote monitoring solutions available in their respective areas and ensuring they know how to use them

Ensuring follow-up

* establishing a pathway for the reporting and analysis of activities from the practice or trust, all the way to national level
* delivering reviews, top-up training and incremental adjustments to the solutions wherever necessary.

Impact

Our services added the extra capability and capacity that the system needed to meet the priority of remote monitoring.

Early statistics demonstrate a significant reduction in metrics like clinical hours spent, length of stay and the number of A&E / paediatric assessment unit visits. These factors have a substantial ripple effect, since freeing up a bed in a service improves flow throughout the system and releases clinician time.

“Black Country and West Birmingham (BC&WB) CCG called upon MLCSU to assist with the timely delivery of remote monitoring at scale. As we head towards FY22/23 we expect to really capitalise on the benefits of remote monitoring.”

Mike Hastings – Chief Information and Operations Officer, ICS Digital Lead, BC&WB CCG

“We’re incredibly excited on the benefits remote monitoring will deliver for our children, young people, their parents and carers. It feels like we’re scratching the surface of what’s possible.”

Lucy Rozga – Matron, Paediatrics and Neonates, The Dudley Group NHS Foundation Trust

“MLCSU have been able to deliver an effective service at pace. It is great to work with people with such knowledge and expertise.”

Dr Zishan Yousef – GP, Clinical Safety Officer and Remote Monitoring Co-Clinical Lead, BC&WB CCG

“Remote Monitoring is a key enabler for our clinicians in the delivery of quality Out Of Hospital healthcare”

Bal McAdam – Senior Strategic Commissioning Manager, Out of Hospital Services, BC&WB CCG

Lancashire and South Cumbria’s New Hospitals Programme aims to develop new, cutting-edge hospital facilities. The Programme’s Case for Change report, states that current infrastructure does not support either the digital or environmental ambitions for hospital facilities in the region.

The NHS Midlands and Lancashire Commissioning Support Unit (MLCSU) is providing digital consultancy services to the programme. In an earlier blog, we looked at why digital advances are so important to new hospitals. This time, Steven Hipwell, Senior Programme Consultant at MLCSU and Digital Lead for the New Hospitals Programme, discusses hospital sustainability and how new technology supports the programme’s vision for creating state-of-the-art, environmentally-friendly facilities.

Why is sustainability such a priority for the New Hospitals Programme?

As outlined in the New Hospitals Programme’s Case for Change report, our current infrastructure does not support either our digital or environmental ambitions for hospital facilities in our region.

The NHS has set out a plan to deliver net zero carbon services by 2040, called Greener NHS 2020. New infrastructure and related digital services will be crucial to building more efficient spaces, using them more effectively and reducing travel by delivering care closer to home. New hospital facilities in Lancashire and South Cumbria will follow this approach, playing our part in creating a greener NHS.

Our new facilities will be compliant with Health Building Notes, the best practice guidelines for healthcare buildings. They’ll also achieve an appropriate BREEAM (Building Research Establishment’s Environmental Assessment Methods) rating, the world’s leading sustainability assessment method.

How can digital technology help to achieve those ambitions?

Digital technology is one of the ways in which we’ll be able to deliver sustainable, high quality and accessible care. However, the poor condition of our current hospital estate and backlog of maintenance needs means our buildings are not as kind to the environment as they could be and are expensive to run.

Digital technology can improve comfort and carbon emissions, which will also help with the efficient and cost-effective running of the new hospital buildings. Some examples include:

* The building’s controls for services such as heating, lighting, ventilation, and air conditioning can be programmed to automatically adjust to a range of internal and external conditions to optimise comfort, operating costs and sustainability
* Heating, lighting and other services can be programmed against occupancy levels to help measure and manage utilisation
* Devices and services can be automated to switch on in preparation for expected use, and power-off accordingly
* Location and identity management technologies can be used to track and pinpoint the whereabouts of people and physical assets for access to services, security and safety, such as in the event of an evacuation.

Are there any examples of where this is working already?

Intelligent buildings have been around for years, but have been limited by the technology available. That is changing as more and more advances take place. There are many case studies from around the world, and nearer to home, of digital innovation helping hospital facilities to become more sustainable.

Wythenshawe Hospital in South Manchester was the first hospital to introduce biomass boilers, heating the facility using sustainable wood pellets instead of fossil fuels. This gave the hospital the capacity to reduce carbon emissions by 3,400 tonnes per year. This innovation was one of the reasons the hospital is known as ‘Britain’s Greenest Hospital.’

The VA Caribbean Healthcare System is a healthcare network for veterans in Florida, Georgia and the Caribbean. Its new Mayaguez Outpatient Clinic produces up to 90% of its energy from solar panels. This new site also captures and stores storm water for safe reuse in certain clinical operations.

In proposals for new hospital facilities in Leeds, sustainability provisions being considered include; rainwater collection and biofiltration, the capture and reuse of wasted heat, outdoor gardens and green space with provisions for bee, bat and bird hotels and onsite solar energy harvesting.

Sustainable buildings are a major priority for the New Hospitals Programme. Digital technology has a big role in making that happen.

We helped integrated care systems increase numbers of annual physicals health checks for patients with severe mental illness by finding and implementing suitable technology to enable healthcare staff to complete them in a single patient visit.

Background

As part of the national policy outlined in the five-year view to increasing annual physical health checks (APHC) for patients with severe mental illness (SMI), 11 integrated care systems (ICSs) across the Midlands needed to increase the uptake.

APHC helps prevent the development of more serious illnesses by identifying and treating health issues early.

The checks include monitoring body mass index, blood lipids, blood glucose, blood pressure, smoking and alcohol use, and take place across a variety of care settings, including in the community, at a care home or in the patient’s home.

The goal is to increase the number of these checks by 10,800 through the use of digital technology by the end of June 2022, to cover the national targets of 60% of patients on the Midlands SMI register.

Action

Midlands and Lancashire Commissioning Support Unit (MLCSU) proposed to scope, define and deliver the technology needed to deliver these checks during a single patient visit.

We are working with each ICS to discuss challenges, share best practices and ensure our solutions fit into their existing pathways for patients with SMI. We are also:

* acting as a central point of contact in the Midlands to raise awareness and provide project management support
* holding the event of a technology-enabled solution with Academic Health Science Network where suppliers can present their devices for ICS representatives to express interest
* operating a single procurement exercise to acquire technology on behalf of all ICSs
* ensuring a streamlined rollout by producing all regulatory assessments, training, and clinician safety assurance materials
* sharing data performance so each ICS can monitor their progress
* integrating the physical and mental health pathways to allow the roll out of technology
* ensuring the continual review of data coming from each ICS and flagging opportunities to complete full health checks.

Impact

This project is successfully contributing to increasing the uptake of annual physical health checks for patients with SMI.

* Across England, the Midlands has seen the largest increase in full health checks in 2021/22 (32.5%).
* The number of complete checks in the Midlands far exceeded the national averages for each quarter (increases of 2,622 [Q2] and 4,915 [Q3]). We estimate the total number of complete checks to be 34,124 by the end of 21/22, surpassing our goal.

A key factor in the success of this project is the portability of the technology, meaning healthcare staff can carry it to any location. This has allowed for more opportunities for patients to be offered a physical health check.

This project provides a model for sharing best practices and engagement across systems by using a joined-up approach to better serve patients. Full data on the impact of this project will be available in July 2022.

Eloise Barnes, Senior Delivery Manager, Digital Health Team, NHSX, said: “MLCSU’s direction and leadership brought clinicians and managers together to focus on the task, and their coordination and delivery of ICS level guidance to assist procurement and other governance standards has been invaluable in assisting ICS areas nationally.”

Darren Vella, Mental Health Clinical Network Senior QI Manager, NHSEI, said: “Together we have made the policy and clinical case for change, supported the team to mobilise, and embedded into regional functions and relationships to support delivery of this policy area. This integrated way of working has supported systems to understand the integrated nature of how this solution needs to operate whilst giving a cohesive NHS England message. Our collective approach has maximised our impact and way of relating back to systems – an approach we would seek to continue.”

Lancashire and South Cumbria’s New Hospitals Programme aims to develop new, cutting-edge hospital facilities that offer modern healthcare, and digital advances are a fundamental factor. The NHS Midlands and Lancashire Commissioning Support Unit (MLCSU) is providing digital consultancy services to the programme. In the first of two blogs, Steven Hipwell, Senior Programme Consultant at MLCSU and Digital Lead for the New Hospitals Programme, discusses the benefits of technology in hospitals and why digital is so important for new hospital facilities.

What is your role in the New Hospitals Programme?

My job sits in an unusual place, somewhere between IT and construction. Digital can do more to support healthcare delivery than it ever has before. It’s my job to make sure that technological advances can enable comfort, health and wellbeing to everyone who uses our hospitals.

How can new technology improve hospitals for patients?

Lots of people are scared of hospitals. It’s often not somewhere you would choose to go. Patients go for very specific, sometimes nerve-wracking reasons. We want to be able to make it easier for patients to plan their visit and improve their experience when they are here.

Before patients even get to the hospital, we can make changes so that hospitals are easier to find. We can introduce clearer directions both on our hospital websites and at the buildings, with digital wayfinding.

We can create ways for patients to easily book and amend their appointments online, with as few clicks as possible. We can also make sure all information meets accessibility standards, for those who have additional needs.

Another benefit of technology in hospitals is how it makes the buildings much more inviting too. We can control and manage the lights, heating, and air conditioning with the click of a button, and make sure patient arrival is super smooth. We’ll also ensure WiFi is available and reliable for all.

Patients would also see the benefits of the improvements to patient record systems, some of which are still paper based, by moving them all to a digital system. This would ensure a more seamless approach to storing their personal information.

How can new technology improve hospitals for staff?

We would see major improvements if the many different electronic systems used by the different departments within the hospital (and other settings outside the hospital too) all work together. Digitising all patient record systems, for example, would not only improve the experience for patients, but also save time for staff as well.

Technology can also benefit our hardworking facilities teams, for example, automated ordering can also be used to re-order stock, book maintenance and look for the best deals on stock, against the procurement framework.

And of course, a more comfortable environment, enabled by digital advances, will make our staff’s general working day easier as well.

What about members of the public who aren’t great with technology? How will they cope with these changes?

We’ll be very careful to make sure that we keep the all-important human interaction element of our hospitals alongside new technology. For example, digital registration will be available for those who feel comfortable using it, to help speed up the movement of patients through our buildings. However, our staff will always be there to assist anyone who needs them, and we’ll listen to staff and patients to get their input as we introduce new technology, providing training and reassurance to everyone along the way.

Will this all need to be updated again in five years?

Probably, yes. Technology is advancing so quickly, that’s why it’s really important to make sure that the changes we make now are adaptable and flexible. Any new facilities that we build will have the infrastructure and power to adapt. For example, the cableways will be created so that they can be updated, and we’ll ensure cellular and Wi-Fi technologies are designed and co-ordinated to provide the best coverage and services.

Can technology help our hospitals become more environmentally friendly?

Digital is integral to the design, build and operation of new hospitals and their sustainability. Digital technologies are used right from the start of the process. Digital, 3D models of the hospitals are built to help the design process and a key part of this planning is sustainability.

These digital models can provide carbon output modelling for the building and make predictions for the future to ensure emissions are kept low and all performance standards are met.

Once operational, sensors can collect data and optimise building performance across a range of functions from power saving, heating, lighting, air-conditioning to ensure the best levels for comfort and safety. These same functions can be controlled even further at a local level, adjusting light levels to harmonise with natural sleeping and waking cycles to enhance patient comfort and experience, and to promote wellbeing.

Digital technology is fundamental to the sustainability of our new hospital facilities. It also ensures optimum patient comfort, safety and wellbeing which we hope, in turn, will enhance patient outcomes.

Look out for Steven’s next blog.

As well as producing systems such as the remote booking system UBook, the Midlands and Lancashire Commissioning Support Unit (MLCSU) Applications Development team has started to deploy the web content management system Umbraco to manage business partner websites. With its Microsoft underpinnings and state-of-the-art feature set for both developers and content editors, Umbraco has been adopted by dozens of public and private sector organisations as their web publishing platform.

The Applications Development team runs 15 Umbraco websites for clients, with orders for three new Umbraco-based sites – Black Country and West Birmingham Sustainability and Transformation Partnership, the NHS Innovation Agency and the North West Population Health Network – each going into production shortly.

Earlier this month three developers in the team, Paul Warne, Matt Darlington and Martin Parker, received Umbraco certification, making MLCSU a ‘Certified Umbraco Partner’. The team’s Business Manager, Bill Douglas, recently met with Umbraco and reported great potential in the support opportunities that our new partner status can provide.

If you would like to find out more about Umbraco, please contact Bill Douglas at bill.douglas2@nhs.net

We created a single online system which allows staff at Birmingham and Solihull Mental Health Foundation Trust to book desks, meeting rooms and clinic rooms. UBook really came into its own during the COVID-19 pandemic as it was quickly modified to enable social distancing and other infection control measures.

Background

Before signing up to use UBook, Birmingham and Solihull Mental Health Foundation Trust identified their room booking system as creating major time management issues.

Operating across several sites, the Trust had used several different methods of allocating desks and meeting rooms, including Outlook calendars, Excel spreadsheets and paper diaries. Staff often had to ring around several sites to find the size of meeting room they needed, and there was no audit trail so if bookings were unexpectedly changed or rooms were double booked there was no way to trace the source of the problem.

Action

Since piloting UBook in October 2020, the Trust now enjoys a centralised system which every member of staff across the Trust can access to determine the availability of all sizes of rooms across all sites to book the one closest to their needs. As well as meeting rooms, the Trust is using UBook for clinic room bookings, desk bookings and arranging meetings with approved visitors.

MLCSU has worked closely with the Trust’s Programme Management Office (PMO) to adapt the system to local needs, and attends regular meetings to map out future enhancements, provide updates and seek feedback on changes made. These changes have included the swift introduction of new features to help the Trust coordinate onsite working during the COVID-19 pandemic.

Impact

UBook has had a major impact on improving the efficiency of Trust systems. Teams sometimes book larger (or smaller) meeting or clinic rooms than they need, but UBook allows managers to review bookings and change bookings to ensure the most efficient use of available meeting room space is made. Ubook can also prompt a user that a better-sized room is available before they commit to a booking.

Initially, a desk booking system was introduced at the Trust HQ to support hot desking and reduce the need to provide allocated desks. This was quickly adapted during the COVID-19 pandemic to ensure that desks could be removed to comply with social distancing regulations.

UBook’s new interactive floor map showed staff which desks could be booked at any given time and the system locked out desks for 72 hours after each use to ensure that they were COVID-free before being used again. Before the pandemic, the trust intended to install touch self-check screens, but infection control measures made this inadvisable, so MLCSU quickly created a QR code ‘check-in’ capturing when staff arrived.

The Trust operates three secure forensic units and all patient visitors have to be approved by the clinical team before they visit using a cumbersome paper system. To resolve this, MLCSU worked with the Trust’s electronic patient record (EPR) team to integrate UBook with the Rio EPR, so that details of approved visitors are automatically imported into UBook.

Amanda Tierney, Project Manager, Birmingham and Solihull Mental Health Foundation Trust, said:

“MLCSU have been exemplary in their commitment to making the system work for our needs. Their response time to queries is excellent and at no point have I had to chase any updates/actions.

“Hand on heart, I’ve not had any negative feedback about UBook. The admin staff find it extremely useful and easy to use and the ward staff are all positive too. I’ve learned so much from working with CSU and I’m extremely grateful, I couldn’t recommend them highly enough. I think that UBook is phenomenal and will benefit any organisation that uses it.”

We strongly believe that improving patient experience is at the heart of all that we do. In creating the Weight Management Referral Hub, we have embraced a person-centred approach and designed a tool that allows patients to choose the weight management product which they feel they can connect with most successfully, and which then provides a flexible and tailored service to match their individual needs.

Background

Managing weight and reducing obesity have become major health issues in recent years and the realisation that a patient’s weight can have a major impact upon their experience of – and recovery from – COVID-19 has only made the issue more pressing over the last year.

This web-based Referral Hub has been developed to give eligible patients access to tier 2 weight management services delivered digitally as part of the NHS Digital Weight Management Programme, following automated e-referral from general practice.

Action

A triage algorithm process identifies the appropriate level of intervention the patient will need based on their likelihood of completing the programme and offers a choice of WMS providers to deliver the service. The patient selects the provider of choice and the system links to the chosen WMS and passes across key information to enable the patient to register and get started.

The NHS Digital Weight Management Programme (DWMP) is targeted towards people with a diagnosis of diabetes or hypertension who are living with obesity (BMI 30+ adjusted appropriately for ethnicity), where we know we can have a significant impact on improving their health, reducing health inequalities and costs.

It is also designed to offer effective weight management services to people with obesity and co-morbidities (diabetes and/or hypertension).

The programme features interventions of varying intensities, delivered by commercial providers, offering tailored approaches which target people from Black, Asian and minority ethnic groups, men, younger people, and those from deprived communities – and make a real difference to their health and wellbeing.

The Hub provides a single point of access for health professionals to manage patient referrals and allocate patients to appropriate DWMP providers and acts as a single point of contact for all potential patients, offering them a choice of provider appropriate to their level of intervention, and sending the chosen provider details of the person’s eligibility assessment.

Impact

Following extensive testing of the Hub, we have signed up 218 practices to take part. Staff have reported saving significant amounts of time in processing referrals as the Hub makes the relevant templates electronically available to all GP practices.

Referrals are then automatically generated into the Hub via an application programming interface which then leads to swift contact with patients. Each user can then access the Hub via their smartphone or computer, and by following a series of simple steps they can select their chosen provider and begin their programme.

The savings produced in terms of time and resources and the improved completions of the programme by patients using the Hub have demonstrated the value of this approach and the potential for major efficiency gains, as well as a large reduction in the amount of money spent on treatment for patients with weight management issues.

By cutting back on applications paperwork and making referrals through the Hub, and by making the transfer of patient details automatic, the Hub leaves NHS staff free to concentrate on other tasks.

Feedback from early testers:

“Very simplistic process and easy to follow. From what I remember it was only about 6/7 steps so very user friendly.”

“It was simple to use and and quick to use. Very easy to understand.”

“It looks great on the phone and really easy to use !!”

“All went smoothly. Received a text message, clicked the link, answered all questions through to choosing the provider, shut it down and clicked back on the link in the message. Previous answers were pre-filled, chose the provider and it said everything completed. No issues.”

PrimaryPoint is a website, designed to provide primary care organisations with fast and easy 24/7 access to the latest policies, procedures, toolkits, and other services. Developed exclusively for primary care, the online portal helps our customers be compliant with current legislation and best practice. The site has templates, ready to be personalised with the customer’s information and logo, helping to cut down on day-to-day administration. Currently, services accessed through the site include information governance (IG), human resources (HR) and finance.

A bit of history…

Our very successful IG portal was already serving more than 600 GPs, providing them with essential documents and guidance. This made us think whether other services across the CSU could be provided in a similar way.

Our in-house app development team, the Digital Improvement Unit (DIU), was drafted in to build a site that would extend the IG service and offer other services to primary care. There is a useful homepage which explains what the portal is and shows all the services MLCSU offers to primary care. The IG portal was migrated across to PrimaryPoint, and our HR and finance departments got to work producing a library of policies, procedures, and standard letters.

In October 2020, we successfully launched PrimaryPoint. Since then, the IG service has gone from strength to strength, with now more than 900 GPs accessing the portal. The IG service on PrimaryPoint is comprehensive, covering contracts and agreements, IG policies and processes, DSP Toolkit guidance and help (for the annual return GPs must send to NHSE), as well as policies and templates and a monthly newsletter. In addition to the online service, our IG experts can also train GP staff and answer any questions primary care organisations have in relation to IG.

Our services

HR is well suited to an online service too, offering tailored policies, procedures and standard letters. Based on best practice, the HR section of Primary Point provides support with absence management, annual leave, flexible working, disciplinary procedures, grievances and performance management, among others. The online service can be used independently, or it can be supported with additional HR advice, guidance, and training.

Our finance service on PrimaryPoint is at its best when used together with additional finance expertise supporting GPs and PCNs to manage their accounts. The online service includes help with financial governance documents, an accountable officer template, a standard finance report template, as well as a guide to coding transactions. There is also a comprehensive guide to the Xero accounting package (which MLCSU uses with its primary care customers), although other systems can be used.

Later in 2021, we will be adding business continuity services to PrimaryPoint, with more areas to follow later this year, such as procurement, communications, and medicines optimisation.

What our customers say

“I have found the resources available from MLCSU most useful in completing the IG annual return.  It was useful to have documents populated with our information which we have been able download and save for staff to access.  Once set up, the portal easy to use and self-explanatory with correlating GDPR reference numbers.”

Katrina Dipple, Business Manager at Darwin Medical Practice

“I have accessed the IG section of the portal frequently since its launch in January 2020. The quality and detail of the policies available appear to be of a high standard and where possible we are using these to replace our current policies/processes. We are also grateful to MLCSU for taking requests for policies that we feel would be a useful addition to the portal, such as a National Data Opt Out Policy.”

Stephen Fitchett, Practice Manager (IM&T), Leicester

NHS Midlands and Lancashire Commissioning Support Unit is delighted to have won a place on NHS England and NHS Improvement’s Framework for Digital Solutions for Sessional Clinical Capacity in Primary Care. This enables us to easily offer our digital Find me a Locum solution to clinical commissioning groups (CCGs) across England and help relieve capacity pressures for practices.

Find me a Locum has been co-developed with partner GP Federations – people at the sharp end of general practice. This keeps costs low, delivering great value. Tried and tested, it is already helping practices to find locums quickly, securely and at low cost, making significant savings on agency fees.

Access to Find me a Locum is through a straightforward annual subscription per practice. It delivers a return on investment for the price of just four locum agency fees.

Find me… provides fast, efficient, high quality ‘pairing’ between practice vacancies and locums. It is accessible 24/7 by a website and easily downloadable app.

It facilitates payments by providing tools to practices and locums to manage the invoicing process, end-to-end. Practices retain full control and benefit from support of a dedicated account manager and service desk.

Other benefits for practices include:

* quick and easy digital advertising of slots to a wide audience
* assurance that locums are accredited and registered (with evidence for CQC)
* automatic validation of locums against national performers list and GMC register
* training and awareness-raising to encourage clinical and managerial uptake and ongoing use
* regular system updates and enhancements.

Staffordshire practice manager, Kirsty Moore, said: “Find me a Locum has taken the stress out of finding GP Locums. It’s made it easy to fill our locum sessions quickly, with experienced, knowledgeable, reliable clinicians. I highly recommend this fabulous resource to practices.”

Designed originally for use with GP locums, the solution can easily be expanded for other staff groups, for example nurses.

Details of the ordering process have been disseminated to CCGs by NHSE.

For more information, contact mlcsu.commercial@nhs.net or go to www.findmealocum.co.uk.

As a key system partner, Midlands and Lancashire Commissioning Support Unit (MLCSU) is actively supporting the COVID-19 vaccination programme in Lancashire and South Cumbria. In partnership with system leaders, we helped to establish a network of vaccination services. We have been working closely together with colleagues from across the integrated care system (ICS), in much the same way as when we developed a tactical command room to help manage winter pressures.

Across Lancashire, the Midlands and North West, we are also supporting over 100 vaccination centres with IT and other services. Our partnership and system approach, following government direction, is enabling the most vulnerable patients to receive their vaccines quickly and safely.

Strategic Vaccinations Operations Centre

Rapidly forming vaccination centres across Lancashire and South Cumbria was no easy task. When the programme took off in November, there was a need for a control room. A Strategic Vaccinations Operations Centre (SVOC) was created at our Jubilee House site in Lancashire with the full support of ICS leads. The centre is resourced with members of MLCSU, clinical commissioning groups (CCGs), trust and wider system colleagues. Having recently built another tactical command room, also in Jubilee House, we were well positioned to support the setup of the SVOC.

Gold Command Winter Pressures Room

The earlier command room’s purpose was to support the operational activity of the Lancashire and South Cumbria NHS organisations and Out of Hospital services facing winter pressures. The Gold Command Room is a tactical support service where we monitor and analyse pressure on individual trusts and organisations – number of people in A&E, COVID-19 cases, people who cannot be admitted because they are waiting for a COVID-19 test result, and other issues such as staff sickness, lack of beds, discharge delays, ambulances queueing up, and so on. Data is looked at from a system perspective and capacity redistributed to where it is needed most. For example, pressure can be taken off one hospital or ambulances diverted to another. Business intelligence expertise is fully covered by MLCSU analysts.

System working

Work at the command room, as well as the SVOC, is ongoing seven days a week in collaboration with partners across Lancashire CCGs, all trusts, NHS England and Improvement (NHSEI) leads and ICS executives. It has made a phenomenal difference in terms of collaborative working, system thinking and helping each other for the benefit of patients.

Across Lancashire and South Cumbria, the vaccination programme is fully coordinated from the SVOC:

* We provide strategic nursing capacity, together with chief nurses from the local system, to ensure resilience through clinical governance arrangements and senior clinical oversight of vaccination delivery

* We provide strategic pharmacy capability, with the medicines lead ICS system role supported by our Medicines Management and Optimisation (MMO) Team

* We have supported the development of seven vaccinations sites in Lancashire and South Cumbria including our estate in Jubilee House and Blackburn Cathedral’s crypt

* We have supported the vaccine programme Board for Lancashire and South Cumbria with a range of other services, including managing the communications across partners to coordinate activity, programme and project management, equalities and diversity advice, IT and data advice as well as IT kit deployment.

* Vaccination programme support elsewhere in the country

In addition to the huge amount of work we do directly with the ICS in Lancashire and South Cumbria, we also help individual trusts, PCNs and NHSEI with COVID-19 vaccinations across the Midlands and North West:

* Digital enablement of more than 100 vaccination centres including training of staff on point of care delivery systems and technical support seven days a week

* Data management for University Hospitals Birmingham

* Pharmacists deployed to NHS Nightingale Hospital North West in Manchester

* Over 50 additional members of MLCSU staff recruited to carry out employment checks of vaccination centre staff

*Administration, project management, nurse training and marshals in other parts of the country.

A key part in mobilising the vaccination programme has been the outstanding work from multiple partners working collaboratively across the NHS, the Police, Fire Service, military and local authorities.

MLCSU has provided the programme management team for the introduction of the integrated care record (ICR) in Staffordshire and Stoke-on-Trent. Our team comprises senior information management and technology managers, project coordinators and communications and engagement specialists.

The team is responsible for day-to-day operations of the flagship One Health and Care project and reports to the ICR Project Board and the overarching Digital Programme Board representing the 16 partner organisation making up the STP.

Action

To date, work we have undertaken includes:

* Development of terms of reference
* Construction of the ICR Partnership Agreement and coordination of its sign-off
* Management of the ICR budget and the wider Digital Programme budget to ensure allocated finances allow for flexing through resource intensive stages of the project
* Production of the system specification and coordination of the procurement process including all supporting documentation
* Completion Equality Impact Assessment
* Completion of Quality Impact Assessment
* Creation of the full business case, project initiation document, project plan, and communications and engagement plan
* Administration of STP partner organisational readiness and preparatory work required for the ICR, including data scoping and specification, and system configuration, testing and training.
* Management of information governance, including and the Data Processing Agreement (DPA), Information Sharing Agreement (ISA), and Data Protection Impact Assessment (DPIA)
* Facilitation of the Fair Processing campaign for the ICR and the development and issuing of all communications and engagement material to STP stakeholders
* Planning the ICR service support model, including helpdesk and associated service level agreements.

Impact

The ICR is now being rolled out across the county. With Staffordshire placed as frontrunners regarding ICR in the region, the programme team is liaising with counterparts in Shropshire & Telford, Wolverhampton, Walsall, and Worcestershire to share experiences and lessons learnt.

In May 2017 our IT team received alerts from our software of an irregularity within some of the managed networks: 300 machines in two CCGs in Lancashire and Cheshire were subject to a WannaCry attack.

Action

We immediately activated our Business Continuity Plan and rapid response procedures, prompting the quick collection of intelligence and establishment of an emergency task force. Managers of the acute trust were contacted, and, with their agreement, isolated from the wider network to contain the damage. Whilst some deep processes were affected, the hospital continued to operate, isolated from further risk, and patient care continued using an interim (paper-based) system.

We opened emergency internal communication channels over the weekend and the team worked around the clock, developing an action list of software to replace and systems to fix. We used our solid supplier relationships to rapidly source the equipment and skills needed.

To minimise the impact on primary care, a community team was set up to repair and replace systems. Our response was rapid, intense, robust and continually reviewed as the situation evolved.

Impact

Our good work ensured that no surgery was affected by closure or disruption to work. We linked to NHS England Gold Command and collaborated with other affected organisations. Knowledge, best practice and solutions were shared – a critical success factor. Our exemplary response earned us a seat on the National Cyber Security Group, regarded as the voice of expertise for managing scalable cyber security incidents.

During the WannaCry cyber attack, the MLCSU experienced a range of impacts. Using a root cause analysis approach to examine a wealth of information in our service desk knowledge base tool, we examined variations and identified two key areas for learning and investment.

Firstly, we have invested in enhanced software resilience to achieve a more robust infrastructural barrier to future cyber attacks. Secondly, we are tackling the risk of human behaviours. In January 2018, we became the first NHS organisation to secure GCHQ accreditation for our bespoke end-user cyber security awareness course, CyberStrong, which now forms part of our organisation’s mandatory training programme.

When GP surgeries across Worcestershire came together with a need to transfer their communication systems, they called on us to deliver a robust and tailored solution.
We aimed to source a Voice over Internet Protocol (VoIP) solution to help manage calls, patients, and staff through their own configuration consoles, along with tools to support a flexible, mobile workforce and deliver business continuity in the event of damage to a building or circuit. The project’s high-level aspirations included:

* VoIP based solution with resilient cloud-based or centrally hosted solution with high service availability
* Improved functionality to enable customised interactive voice response, messages and recordings, call recording and monitoring, call forwarding, ‘follow me’ functionality, teleconference facilities and enhanced reporting functionality
* Integration with existing EMIS software applications
* Reduction in hardware requirements, including introduction of soft phones where appropriate
* Allocation of equipment to the CCGs, with invoicing by the end of the financial year.

Action

We held soft market testing events to gain intelligence on the viability of the outcomes required by the GP surgeries and to enthuse the potential marketplace.
We used the Crown Commercial Services RM1045 framework, which gave us a swift effective route to conduct a mini competition with specialist, motivated suppliers. The specification and tailored question bank we created gave suppliers clear understanding of our requirements and flexibility to create a solution to meet the GP surgeries’ needs.

Impact

The result was strong interest from the marketplace and one solution from Maintel Europe achieved an exceptionally high evaluation score. As well as proposing an excellent technical solution and enhanced warranty, Maintel Europe partnered with X-on, who integrated their ‘Surgery Connect’ into the offering.

The commercial solution achieved the project’s aspirations and came in significantly below project budget, offering excellent value for money.