12 million people to benefit from better joined up NHS and social care work

NHS Improvement | May 2018| 12 million people to benefit from better joined up NHS and social care work

Over 12 million people will soon benefit from better joined up NHS and social care as four more areas, covering four and a half million extra people, are given more control to improve local services.

NHS England chief Simon Stevens and Ian Dalton, head of NHS Improvement, have called on the NHS to ‘supercharge’ integration as Gloucestershire, West Yorkshire and Harrogate, Suffolk and North East Essex and North Cumbria will join the ten areas already part of the integrated care development programme (NHS Improvement).

The full news item is available at NHS Improvement 

London Hospital pioneers AI technology to reduce patients’ waiting times

University College London Hospitals | May 2018 | Revolutionising healthcare with AI and data science: UCLH and The Alan Turing Institute announces breakthrough partnership today

University College London Hospitals Biomedical Research Centre and the Alan Turing Institute are working in partnership to improve healthcare through artificial intelligence (AI) and data science.

The Alan Turing Institute will use AI and machine learning techniques to enable analysis of large data sets which will identify bottlenecks and barriers, after identification these could be resolved to improve efficiency and reduce patient waiting times.  (via UCLH).

Professor Marcel Levi, UCLH chief executive, said:

“With ever increasing numbers of patients and ongoing financial pressures, we need to try something different, something innovative, something longer-term.  The partnership with the Alan Turing Institute provides an opportunity to work with the world’s leading data scientists to do just this.

“Imagine a scenario where patients present to A&E with abdomen pain – our standard response is to check bloods, order X-rays or scans and in probably about 80% of cases, discharge for home management.  What, if through analysis of thousands of similar scenarios, we were able to identify patterns in the initial presentation of the 20% with serious conditions, such as intestinal perforation or severe infections? This could enable us to fast track them through to a scan and a swift diagnosis and could support clinical decision making to manage the 80% who need no further clinical input more effectively. Machines will never replace doctors, but the use of data, expertise and technology can radically change how we manage our services – for the better”.

Sir Alan Wilson, Institute CEO of the Alan Turing Institute, commented: “At the Turing we believe that data science and AI will revolutionise healthcare: not only through new technologies, as in the recent break-throughs in image recognition, but also through applying cutting-edge algorithms to the every-day problems facing the NHS such as A&E waiting times and other crucial services. We are very proud to be working with UCLH to begin a multi-year research partnership and driving the outputs of our research forward to deliver real impact across the whole NHS.”

The full press release can be read at University College London Hospitals 

Related:  University College London Hospitals A Research Hospital: implementing research innovation for healthcare improvement 

In the media:

The Guardian London hospitals to replace doctors and nurses with AI for some tasks

Evening Standard London hospital uses AI to cut A&E queues

Daily Mail Major London hospital is replacing doctors with ROBOTS to tackle mounting A&E waiting times and prioritise the sickest patients

Paramedic’s ‘light bulb moment’ saves the NHS more than £2 million

NHS England | May 2018 | Paramedic’s brainwave eases A&E pressures by keeping “frequent callers’ away

A senior  paramedic who noticed that a small number of patients used a lot of NHS resources and staff time came up with the idea to address their problems with an innovative programme. Rhian Monteith arranged a scheme where the frequent callers were able to meet for coffee and a chat.  The scheme The High Intensity User programme was innovated by Rhian who collaborated with other teams to compile  a list of 23 patients, many suffering from mental health problems or loneliness, who had visited A&E more than 700  times during the previous three months, mostly by ambulance. Through personal mentoring and one-to-one coaching, as well as getting them involved with community activities, the patients were encouraged to phone her rather than dial 999.

Rhian helped A&E attendances, 999 calls and hospital admissions drop by about 90 per cent among the group.  The scheme was then scaled up to cover about 300 patients in Blackpool over the following three years, saving the NHS more than £2million. It has now been rolled out to around a fifth of the country with 36 local heath teams adopting the scheme. (Public Health England)

The full news story is at NHS England 

£20 000 funding available for 12 innovative digital adult social care pilots

NHS England | May 2018 | New £1m funding for innovative digital adult social care pilots 

NHS Digital and the Local Government Association have announced new funding for digital pilots that benefit people who access adult social care and improve services. 

A share of the £1m funding, provided by NHS Digital and managed by the LGA, will be awarded to local authorities that put forward projects that support innovative uses of digital technology in the design and delivery of adult social care.

Twelve authorities will receive £20,000 to design a digital solution to address a specific issue with their service, with six receiving up to a further £80,000 to support its implementation.

This year, local authority bids should focus on one of the following three themes:

• Efficiency and strengths-based approaches
• Managing marketing and commission
• Sustainable and integrated social care and health systemsAll information from NHS Digital 

Full details and information about the application process are available from NHS Digital 

Community pharmacy integration and innovation

Primary care home: community pharmacy integration and innovation | The National Association of Primary Care  

Image source: http://napc.co.uk

This guide is intended to further the integration of community pharmacy within primary care homes (PCHs) to improve patients’ health and support them to manage their conditions.  It looks at ways local pharmaceutical committees, community pharmacies and PCHs can make greater use of pharmacists’ skills as part of a whole population health approach.

It focuses on the three key roles outlined in the Community Pharmacy Forward View: a facilitator of personalised care for people with long-term conditions (LTCs), trusted, convenient first port of call for episodic healthcare advice and treatment, and a neighbourhood health and wellbeing hub.

The guide also proposes a list of actions to galvanise PCHs and community pharmacy to come together to create innovative solutions to the current challenges and improve services for their local population.

Making data count

Making data count | NHS Improvement

This guide is designed to encourage analysts and decision-makers to work together to ensure the most relevant data is presented in the most effective way.  The accompanying resources are intended to build knowledge to construct and interpret statistical process control (SPC) charts.

In this short video, NHS Improvement Executive Director, Adam Sewell-Jones, talks about how different presentations of data can lead to different conversations, conclusions and actions:

Additional link: Statistical process control tool

Improving the Physical Health of People with Serious Mental Illness

AHSN | May 2018 | Improving the Physical Health of People with Serious Mental Illness

Bradford District Care Foundation Trust, has developed a template to support healthcare professionals to identify patients with conditions including high blood pressure, diabetes and cardiovascular problems. The template improves the quality of health checks for people with a serious mental illness (SMI) who are at risk of dying prematurely due to preventable physical conditions.

Potential cost savings in the Yorkshire and Humber region alone are estimated to be £11.3 million over the next 10 years. The AHSN piloted an initial rollout across two Mental Health Trusts and two Clinical Commissioning Groups (CCGs). It has also supported organisations nationally to trial or implement the template.

The template is available through the SystmOne, EMIS and RIO web platforms and has been used by 74 CCGs. An eLearning module produced by the AHSN went live in January 2017 (Source: AHSN).

The full story is at The AHSN Network 

Effectiveness of assistive technology in improving the safety of people with dementia

Study finds assistive technologies can improve safety for people with Dementia through reducing falls risk, accidents and other risky behaviour | Aging & Mental Health

Objectives: Assistive technology (AT) may enable people with dementia to live safely at home for longer, preventing care home admission. This systematic review assesses the effectiveness of AT in improving the safety of people with dementia living in the domestic setting, by searching for randomised controlled trials, non-randomised controlled trials and controlled before-after studies which compared safety AT with treatment as usual. Measures of safety include care home admission; risky behaviours, accidents and falls at home; and numbers of deaths. The review updates the safety aspect of Fleming and Sum’s 2014 systematic review.

Method: Seven bibliographic databases, the Social Care Institute for Excellence website and the Alzheimer’s Society website were searched for published and unpublished literature between 2011–2016. Search terms related to AT, dementia and older people. Common outcomes were meta-analysed.

Results: Three randomised controlled trials were identified, including 245 people with dementia. No significant differences were found between intervention and control groups in care home admission (risk ratio 0.85 95% CI [0.37, 1.97]; Z = 0.37; p = 0.71). The probability of a fall occurring was 50% lower in the intervention group (risk ratio 0.50 95% CI [0.32, 0.78]; Z = 3.03; p = 0.002). One included study found that a home safety package containing AT significantly reduced risky behaviour and accidents (F(45) = 4.504, p < 0.001). Limitations include the few studies found and the inclusion of studies in English only.

Conclusion: AT’s effectiveness in decreasing care home admission is inconclusive. However, the AT items and packages tested improved safety through reducing falls risk, accidents and other risky behaviour.

Full reference: Lucy Brims & Kathryn Oliver | Effectiveness of assistive technology in improving the safety of people with dementia: a systematic review and meta-analysis |  Aging & Mental Health | published online: 10 April 2018

See also: Assistive technology and dementia | Alzheimer’s Society

Prescribing indicators

A series of indicators to inform safer prescribing practice, helping pharmacists, clinicians and patients to review prescribed medication and prevent avoidable harm | Department of Health and Social Care

The Department of Health and Social Care is introducing prescribing indicators to inform safer prescribing practice.  The experimental indicators link prescribing data from primary care with hospital admissions for the first time. The purpose is to identify prescribing that could potentially increase the risk of harm and that may be associated with hospital admission.  The first indicators focus on how different medicines may be contributing to people being admitted to hospital with gastro-intestinal bleeding. The programme will cover more medicines and associated conditions later in the year.

Additional link: DHSC news article

Spotlight on the 10 High Impact Actions

New report outlines a series of recommendations for NHS England and for GPs | Royal College of General Practitioners 

Image source: http://www.rcgp.org.uk

This report is the result of research by the Royal College of General Practitioners on the effectiveness of NHS England’s Time for Care Programme, specifically its 10 High Impact Actions: a range of initiatives that were introduced with the aim of increasing capacity in general practice and reducing GP workload which were introduced two years ago.

The Time for Care Programme is part of the commitments outlined in the GP Forward View and this research is part of our ongoing work monitoring and evaluating all aspects of the GPFV.

The research found that whilst there has been some success helping spread pragmatic advice for GPs, and tools to help tackle workload across general practice, NHS England should expand those schemes with the highest potential to reduce administrative work for GPs and other effective measures.

The report outlines a series of recommendations for NHS England and for GPs. The RCGP is calling on NHS England to expand schemes with high potential to reduce administrative work for GPs and are calling on government to ensure every GP surgery has funding to have access to a dedicated social prescriber in a bid to tackle crippling GP workload and effectively signpost patients to the right services.

• Download the Spotlight on the 10 High Impact Actions report