Integrated Health Awards 2023: best partnership with the NHS

Next up, best partnership with the NHS finalists.

Vygon UK Ltd

Overview. Vygon collaborated with University Hospital of Wales to develop a system to allow heart failure patients at end-of-life to be cared for at home with a seven-day infusion treatment, with the 12-month trial showing improved patient experience, cost savings, time savings, reduced environmental impact and better infection control. 

Why? The hospital had championed the use of at-home infusions for heart failure patients at the end of their lives, giving patients a preferred place of care and place of death along with hospital admissions; however, the model was costly and highly resource intensive as it required daily visits from district nurses. 

What happened? Vygon’s Accufuser elastomeric pump is a single use balloon infusion pump, designed to deliver a continuous flow of safe and accurate infusions for a variety of treatments including post-operative pain management, cancer pain management, chemotherapy, treatment of Thalassemia and delivery of antibiotics. Vygon took part in a 12-month pilot with the hospital using the Accufuser product to deliver pre-prepared furosemide for heart failure patients. Working closely with the hospital staff and pharmacy, a pre-prepared infusion was developed to expand stability which allowed for continuous seven-day infusion. Preliminary data shows that patients benefited from a mean average of 3kg fluid loss and reduction in fluid swelling in arms and legs, with improvement reported in pain intensity and breathlessness. The hospital has calculated financial savings of over £1,500 per patient and a reduction of district nurse time by 104 hours, per patient. The service also allowed patients to maintain some semblance of a normal life as they were having their pump changed once a week rather than every day. 

Looking ahead. Following the trial, further research is now underway to gain in-depth feedback from the district nursing team; if it is possible to batch produce the seven-day stable formulation, this model could be scaled and rolled out to support more heart failure patients.

Chime Social Enterprise 

Overview. Chime aims to develop new and better ways to deliver NHS audiology services now and in the future. 

Why? Audiology services in the UK face massive pressures with increasing needs due to the ageing population, with three out of four people over 70 said to benefit from hearing care, but only 20 percent of this cohort wearing hearing aids.

What happened? In 2011, Chime set out to create a new and more resilient standard in delivery of hearing care services as a social enterprise/not-for-profit organisation. With NHS audiology services as the bedrock, their vision is to deliver excellence in hearing and balance care, in order to transform lives. With 16 locality clinics across Exeter and East Devon, Chime says that it was the first audiology service nationwide to achieve IQUIPS2 multi-site accreditation. In addition, it has hospital and high street locations available, enabling patients to access walk-in clinics and repairs. During the pandemic, Chime set up a full remote hearing test and fitting service, helping over 7,000 people to remotely access expert care. They also deliver home service hearing tests and fittings, including in residential care homes. In 2020, Chime became prime provider tasked with subcontracting as needed, and on a financial level they have saved NHS Devon approximately £0.5 million per year since 2011 when compared to neighbouring trusts of a similar size. 

Looking ahead. Chime has been approached by a national supermarket chain to place services in their healthcare centres as it moves forward with its vision of providing more and better quality hearing care for patients.

Definition Health

Overview. Working in partnership with the Royal Surrey NHS Foundation Trust, Definition Health has delivered an end-to-end digital surgical pathway that supports patients from referral through pre-op assessment and into post-discharge phase. 

Why? Definition Health highlights the need to move away from traditional processes in order to deal with the current backlogs and build better resilient processes for the future. 

What happened? Definition Health partnered with the Royal Surrey NHS Foundation Trust and the KSS AHSN and secured funding from SBRI Healthcare to support the rollout of its suite of digital surgical solutions. The primary objective was to reduce the backlog of 7,000 patients awaiting surgery and to improve the legacy pre-assessment pathway that met the needs of just 30 percent of patients. Definition Health have delivered a digital perioperative pathway, resulting in a single digital solution for all surgical specialities. Royal Surrey is using the three interoperable solutions offered: Definition LifeBox, a digital pre-operative assessment tool; Definition Connect, a virtual consultation and secure file-sharing platform; and Definition Recovery, which allows the hospital to operate a post-discharge virtual ward. As an example of an outcome, LifeBox has already, in under a year, saved over 300,000 pages of paper.

Looking ahead. A full study on the implementation is set to be published shortly, with partners committed to presenting findings at national conferences and Royal College meetings. In addition, following the introduction of the Definition Health Total Digital Surgery Tool, Royal Surrey’s sister hospital the Ashford and St Peter’s Hospitals NHS Foundation Trust is in the process of procuring the solution. 

thevaluecircle

Overview. North Cumbria Integrated Care (NCIC) and thevaluecircle’s partnership is built on trust and shared values. This three-year relationship has been the catalyst for organisational shifts in culture, executive team relationships, and confident decision-making, addressing key organisational risks and improving patient care.

Why? When chief executive Lyn Simpson joined North Cumbria Integrated Care (NCIC) in January 2020, she prioritised an external assessment of organisational risks so she could be confident in providing assurance to the Board. Since this first risk audit in January 2020, thevaluecircle has worked as a partner providing continuous strategic support to Lyn and her executive team across numerous issues.

What happened? Using the Mechanics and Dynamics model, thevaluecircle has supported NCIC with both systems and strategies (Mechanics), along with how people interact and with culture (Dynamics). This has helped shape the transformation approach, informed changes to culture, helped the executive team work better together, provided expertise to inform the equality and diversity strategy, and facilitated NCIC’s development of a new operational model. As a result, NCIC has been able to make swift decisions and respond confidently to strategic risks such as workforce, leading to no longer being subject to any new external review or intervention; a £15m investment in a new community diagnostic centre with aims of reducing waiting times; recruiting 100 people in one day at a health recruitment event called “the most successful in the region”; CQC praise in the January 2023 maternity survey; and recognition from NHS England in improving the patient experience and engagement in care.

Looking ahead. Supported by the trusted partnership, the executive team is implementing a new development and assurance model with a deepened understanding of the roadmap to being truly clinically-led.