Comment: Seizing the opportunity. Making the most of the Technology Fund?

Donald Kennedy, managing director of Patientrack, on how the Government's Technology Fund will revolutionise clinical IT systems

The Safer Wards, Safer Hospitals Technology Fund represents a welcome chance for the NHS to introduce systems that will have a positive impact on clinical outcomes and patient safety. Here, DONALD KENNEDY, managing director of Patientrack, outlines the conditions that projects must meet if they are to successfully deliver the goals of the fund, and calls for hospitals to focus on capturing vital signs electronically and introducing automated alerting

The new fund is an example of the Government getting it right when it comes to investing in the NHS

This month sees the launch of the prospectus for the Government's £260m Safer Wards, Safer Hospitals Technology Fund, with NHS organisations having just a few weeks to submit an expression of interest.

The new fund is an example of the Government getting it right when it comes to investing in the NHS. It will provide match funding for NHS providers in England to support the move from paper-based systems for patient notes and prescriptions to integrated electronic care records, e-Prescribing and e-Referral systems, meaning over half a billion pounds will be invested in NHS IT in the next two years. What's different about this fund is that it will exclusively support projects that use IT for improvements in patient safety and the patient experience, and which create a better working environment for healthcare professionals.

That focus has been driven by NHS England really listening to what doctors and nurses are saying they need from IT to deliver immediate real clinical value. According to comments made by Tim Kelsey, national director for patients and information within NHS England, the two priorities for doctors are the ability to safely prescribe on the ward and real-time ward-based observations on their patients.

Taking leadership of the technology revolution

NHS England has not only listened, but issued its own challenge: Kelsey says it is putting money on the table in return for doctors and nurses ‘taking leadership of the technology revolution in [their] hospitals’. In other words, unlike many previous schemes, the Technology Fund will work with doctors and nurses from the bottom up to help them implement solutions that actually address their local needs, rather than imposing yet more top-down national systems, which have often proved so unsuccessful.

There's a place for exploring new approaches, but the NHS mustn't fritter this money away on reinventing the wheel in 'pilots' that fizzle out once the funding is gone

In addition, the kinds of systems to be supported by the fund, which deliver reduced variability and increased reliability, will help the NHS deliver safer care in a tightly-resourced, high-pressure environment, by reducing adverse events – which in turn will release time and money to deliver more care for more patients. Further, these systems will create new data resources to support collaboration and research to drive further improvements in healthcare delivery.

Delivering the goals of the fund

However, the fund is likely to be oversubscribed and NHS trusts will no doubt find themselves besieged by IT vendors armed with proposals they claim are perfect candidates for the fund. It's therefore critical that those applying for funds – and those deciding which projects should receive match funding – choose projects that will actually deliver the goals of the fund - Safer Wards, Safer Hospitals. This means:

  • Choosing solutions with a strong track record of delivering improvements to patient safety and ward life. There's a place for exploring new approaches, but the NHS mustn't fritter this money away on reinventing the wheel in 'pilots' that fizzle out once the funding is gone
  • Working with vendors who can help NHS trusts quickly and easily build strong, sustainable benefits and a business case
  • Choosing solutions that can be implemented quickly, so the benefits begin to flow sooner rather than later. Patients and staff need to see improvements now, not in two years' time
  • Choosing solutions that can be introduced with minimal disruption and are quick and easy to learn, so staff are not distracted from delivering care, yet which can also support change if the ward team is looking for that
  • Choosing solutions that support and integrate with other initiatives, such as the targets in the IT strategy for England, the Royal College of Physicians' call for national adoption of the National Early Warning Score (NEWS), and the recommendations of the Francis Report
  • Supporting UK suppliers with proven solutions that work in harmony with existing investments, avoiding the risk of importing systems that then need extensive rework to operate effectively within the NHS environment
  • Applying appropriate assessment and procurement processes so that solutions are evaluated rigorously to ensure they meet local requirements in harmony with national initiatives

A key area for the Technology Fund to support – one of the recommendations of the Francis Report and also highlighted by Tim Kelsey – is technology to improve the capture of patient vital signs and allow early identification of deteriorating patients. Timely, complete and accurate vital signs are a cornerstone of good clinical decision-making. There is a direct relationship between the reliability and regularity with which vital signs are taken and measures of patient safety. Improving the speed and accuracy with which Early Warning Scores are calculated, and ensuring an appropriate clinical response is made has also been shown to significantly reduce adverse events.

Proven impact on patient safety

We hope hospitals will seize the opportunity provided by the Technology Fund to introduce this kind of evidence-based IT as a foundation for the NHS to provide truly 21st-century healthcare

The impact on patient safety of deploying systems that capture vital signs electronically and automatically alert staff based on EWS has been proven in hospitals across the UK. At Western Sussex Hospitals NHS Trust, automated 'track and trigger' is helping reduce intensive care admissions, reduce lengths of stay in intensive care and reduce mortality. The business case for the system also includes helping the trust meet CQUIN targets for a range of assessments and screenings. A peer-reviewed clinical trial of a similar system at Central Manchester University Hospitals NHS Trust demonstrated a 40% improvement in clinical response and substantial reductions in mortality, unscheduled intensive care admittance and length of hospital stay.

If the NHS is to deliver Safer Wards, Safer Hospitals, all hospitals need to begin capturing vital signs electronically and make use of automated alerting based on EWS as soon as possible. We hope hospitals will seize the opportunity provided by the Technology Fund to introduce this kind of evidence-based IT as a foundation for the NHS to provide truly 21st-century healthcare.

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