interviews

Improving access to patient information at the country’s biggest health and care trust

Amy Freeman, chief information officer at Staffordshire and Stoke-on-Trent Partnership NHS Trust, spoke to NHE to explain how investing £13m in a new clinical system at the trust will improve efficiency, patient information and safety.

In April, the NHS Trust Development Authority gave its formal stamp of approval for Staffordshire and Stoke-on-Trent Partnership NHS Trust (SSOTP) to go ahead with plans to procure and develop a new state-of-the-art clinical system to improve the recording and access of patient information.

By investing £13m in a new electronic system, the partnership trust, which is the largest integrated health and social care provider in the UK, serving a population of 1.1 million, aims to transform the way its staff work and help patients be more involved in their own care.

Amy Freeman, chief information officer at SSOTP, told NHE that when the trust was established in September 2011 – following the integration of three provider arms from North Staffordshire, Stoke-on-Trent and South Staffordshire primary care trusts – SSOTP inherited more than 30 different clinical IT systems.

And, although they meet the needs of the individual services, they are disconnected from any central record and result in an incomplete picture of the patient. Freeman said: “At the moment we have got very disparate systems that don’t talk to each other. Because of that we don’t have a single care record for our patients.

“But, by investing in a single clinical system, we will be able to create a single care record that anybody who is providing care to that patient knows what other services they are in receipt of and what has been done for that patient in the past. This will be a major achievement.”

The £13m investment programme, which is meant to be introduced – in part – by summer 2015, is made up of four main workstreams.

Project workstreams

Firstly there is the procurement and installation of the new clinical system, which will cover all of SSOTP’s community hospitals, community services, and all of the 6,500 staff that are employed at trust, and “who will all use it at some stage”.

Secondly there is an electronic patient record scanning and management facility. This will allow historical paper records to be scanned and made available electronically and added to people’s care records.

Jonathan Tringham, director of finance and resources at SSOTP, said: “A large proportion of our clinical records are manual or paper. Records of this kind can only be used in one place and time and restrict joined up working both within the Partnership and externally with our partners, often delaying some aspects of care.

“We are therefore delighted that we are one step closer to introducing a new electronic system, which should be available in summer 2015.”

The third stream the team will focus on is the integration engine, a tool that will allow the trust to integrate its clinical system with a myriad of other systems that are already being used across SSOTP, allowing it to create a single care record.

Freeman told NHE this will allow care providers to know everything they need to about a particular patient. For example, it will integrate with SSOTP’s social care system – a product called CareDirector – that allows a district nurse to know whether or not somebody is receiving social care services and a summary of what those services are – allowing the trust to prevent duplicate referrals.

She added: “It will also integrate with our GP colleagues, meaning we can share information with the GPs about what we are doing for a patient. It will also allow them to do electronic referrals to us and give us information on allergies etc.

“We also have integration with the acute services, such as A&E, so if we’ve got a patient in our care having an acute episode, we can easily share those records with the acute team.”

Fourthly, the team will look at the hosting and support of the service. This is to make sure the service is resilient, robust and secure. It also means SSOTP can make sure it has a good quality service arrangement in place. “If we are going to move from a relatively paper-based system to an electronic one, then we can’t afford to have it down,” said Freeman. “We need to have robust arrangements in place.”

Timeframe

The investment programme has already started, and a programme team is in place, which includes an SRO (Senior Responsible Owner) who is overseeing the programme and a range of stakeholders.

The team is also expecting to cut the time for procurement by half. “We are shortening the procurement procedure by using an existing procurement framework, so we don’t have to run an OJEU (Official Journal of the European Union), which is a lengthy and quite expensive process,” said Freeman.

“There are existing frameworks with suppliers who have the capability to deliver the services we need. We are going to be using an existing framework, which should shorten the procurement time by about half. So we are expecting a three-month procurement, which gives us nine months to implement.”

Additionally, as part of its ongoing programme, SSOTP is defining what it means by going live in summer 2015, because Freeman conceded “it isn’t going to be to all 6,500 staff by next summer”. Go-live is initially likely to be rolled out to an area, potentially a speciality, which will have some level of functionality available to it already. And, then, over a number of months, SSOTP will add more users and functionality.

“So I don’t think the programme will be finished fully for probably two years, but we should be able to have some users live with the service in that time,” said the chief information officer.

Technology and training

On top of the £13m investment, SSOTP has just won £1m as part of the NHS England Innovation Technology Fund to roll out a suite of devices, such as digital pens, tablets and clinical software, to help save frontline staff time, while hopefully improving the patient experience. 

“We’ve called the roll-out a ‘persona matrix’,” said Freeman, “so, the type of work someone does, and their interactions with patients, will determine the suite of equipment they get.”

For instance, for people who need to regularly make notes, a laptop may be available; or a smartphone or tablet if someone has to make house calls.

Freeman stated: “We have got a blend of technologies available, but it really does depend on what role you do, which will determine the mixture of technology you get. And these technologies are being rolled out now.”

Along with the roll-out of the technology, staff will also receive an induction session with the kit to go through the basic features of the device, such as how to use it when they are in a patient’s home or how to use it when they are in the office, for instance.

Over £1m has been put aside for training staff to use the new technologies and the incoming clinical system. But as Freeman told NHE: “We could have the best tool in the world, but if we can’t get people using it we will have failed.

“This project is going to be about winning the hearts and minds of the staff as well as implementing a new system – that’s why we are getting the kit out to them now so they have a year to become familiar with it, before they have to start using it in real earnest.”

When the go-live date does come around, though, there will be support on hand for staff. “We will have plenty of floor walkers,” noted Freeman. “So when we go live we will have people who know what they are doing with the technologies, providing support. We have made an assumption for these staff to be on site for a number of weeks, and will reduce them over time.”

Tina Cookson, director of operations and executive lead for the project, concluded that the new system will streamline, simplify and standardise the capture and use of patient information by clinicians, meaning they have more time to deliver care and improve services for patients, service users and carers.

“The ability to join all these systems up and improve the way we record and share information about patients will provide a safer, more efficient and more effective standard of care,”  she said. 

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