Integrated Health Awards 2023: best elective care recovery initiative

And now we come to the finalists in best elective care recovery initiative.


Overview. C2-Ai’s  patient prioritisation system has been shown through NHS reports to reduce emergency admissions by 8 percent, saving 125 bed-days per 1,000 patients and potentially thousands of years of surgeon time.

Why? As well as saving staff time and reducing pressures, the system helps the NHS to avoid selection bias through its algorithm; it incorporates the impacts of the social determinants of health on clinical need, such as the number and severity of comorbidities. In addition, risk-adjusted outcomes are analysed post operatively to ensure that vulnerable groups are not being disadvantaged.

What happened? The system builds on 30 years of research and 400m episodes of care, processed from 46 countries. It uses historic data to consider many different permutations to derive a patient’s medical conditions. These are combined with the prospective operation to derive a priority score – built on detailed mortality/complication risks for the patient today, and if the procedure is delayed. As well as the 8 percent reduction in emergency admissions, data shows 27 percent reduction in patients waiting more than 52 weeks, reduced deterioration in patients which would increase length of stay and cost, financial savings, positive staff response and more.

Looking ahead. In the initial and expanded deployment, a Clinical Senate was created to share learning and case studies from the initial project to facilitate rollout across all the acute trusts (funded by NHS England), including development of an ‘operational playbook’ to share real world evidence of benefits achieved across the region. The findings have been shared by regional AHSNs via conferences, webinars and blogs across the NHS. The approach was also included in the GIRFT best practice guide as an exemplar.

Surgery Hero

Overview: Surgery Hero is a digital clinic that helps people prepare for and recover from surgery at home. Their mobile app-based solution combines expert health coaching, personalised digital guidance and a toolkit of educational resources to help members understand and adopt lifestyle habits proven to improve surgery outcomes.

Why?  A lack of preparation for surgery results in avoidable cancellations, extended hospital stay and postoperative complications.

What happened?  Surgery Hero empowers patients to take a more active role in their own care. Working in collaboration with NHS partners, Surgery Hero equips people with the knowledge, confidence and skills to better prepare for and recover from their operation at home. In the first week of registration, patients complete the Surgery Hero Foundation Course, an interactive educational course designed to support patients in gaining foundational knowledge required to optimise for surgery. Patients can communicate with their assigned health coach and have access to an extensive catalogue of learning modules, workouts, recipes and meal plans designed to support ongoing preparation. Surgery Hero has secured multiple NHS ICS deals and has achieved a Net Promoter Score of 90 and above

Looking ahead. Surgery Hero is participating in the Digital Health London programme and won a place on the inaugural AWS accelerator.

ECG On-Demand

Overview: ECG On-Demand offers a 12-Lead ECG interpretation service as a solution to improve patient and clinician experience within mental health trusts across the UK.

Why? The entry states cardiac changes such as increased QT levels have been found in mental health patients taking anti-psychotic drugs; ECGs are recommended for these individuals. Due to accurate QT measurements required for mental health patients, the 12-lead reports include a manually adjusted measurement view as the automated ECG machine derived values are often inaccurate. Additionally, the ECG is examined by an experienced clinician in near real-time, which is particularly important for mental health patients as they are often reluctant to attend conventional healthcare settings.

What happened?  Along with continuous (24 hours and more) monitoring and analysis, ECG On-Demand uses a hybrid approach of human expertise and machine learning, as assistance, for accuracy and speed. Once there is an ECG recording, an expert cardiologist examines the trace and returns the results to the clinician as a digital report. Included in the report is an automated traffic light risk rating system that is constantly refined and allows patients to be triaged efficiently. Consultant cardiologists are available for clinician-to-clinician advice and guidance if required through an e-consultation service.

Looking ahead. ECG On-Demand has cut diagnosis waiting times, improving patient experience, and reduced unnecessary hospital visits, supporting workforce pressures and further reducing patient anxiety.