Leading Healthcare Awards 2022: seven of the most promising pilot programmes

The Leading Healthcare Awards 2022 are an opportunity for our panel of expert judges and the team at Leading Healthcare to showcase the innovative ideas and hard working take place in the world of health and care.

The winners of each category will be announced on 7 April 2021.

Read on to find out more about our finalists; here, we take a closer look at the Most Promising Pilot programmes across the industry.

Inhealthcare – Blood Pressure at Home (BP@H)

The first entry comes from Inhealthcare, who have piloted a service for patients to manage their blood pressure at home.

According to NHS England, regular home blood pressure monitoring across a population of 50,000 patients could prevent up to 500 heart attacks and 745 strokes over five years. The issue of high blood pressure has been exacerbated during the COVID pandemic, with many patients reluctant to visit their GP for readings.

In 2021, Inhealthcare and Surrey Heartlands ICD piloted a remote monitoring service for NHS patients to manage high blood pressure at home. The pilot aimed to support self-management and reduce emergency hospital admissions and GP workload.

BP@H allows patients to monitor their condition on an ongoing long-term basis. Using a device provided by the NHS, patients record their blood pressure and heart rate readings on a twice-daily basis, with reminders automated and an alert created if readings are missed. Patients submit their readings for clinical review through fully inclusive communication channels. Inhealthcare analyses the readings, calculates averages and alerts healthcare professionals if thresholds are breached. 

Results are positive, showing that 53% of service users moved from high to normal threshold blood pressure within three months.

Patient feedback included feelings of empowerment and reassurance at the ongoing monitoring.

Dr Jagjit Rai, Partner at St David’s Family Practice, Stanwell, said that patients “develop a better understanding of conditions from home… [and] feel empowered to manage it better through remembering to take their medication and making lifestyle choices. This will lead to better preventative care.”

The West of England Academic Health Science Network – Keeping Active During COVID-19

Next we have Keeping Active During COVID-19, launched in May 2020 in response to clinician concern that patients with chronic respiratory conditions would not be able to maintain adequate levels of physical activity during lockdown. 

For the purposes of this pilot, the online intervention service KiActiv® Health was evaluated for use with Pulmonary Respiratory patients. KiActiv® Health provides an interactive personalised dashboard to display physical activity data, with initial support from a dedicated mentor and ongoing access to the personal dashboard. As vulnerable patients with respiratory problems were unable to attend Pulmonary Rehabilitation due to lockdown and shielding measures, the pilot offered them use of KiActiv® Health as a remote support solution. 

Patients who had been assessed by the Wiltshire Health and Care respiratory team were invited to take part in the pilot by using KiActiv® Health. They received person-centred care and tailored advice on managing their daily activity to best support their respiratory diagnosis. 

Results showed high levels of engagement from patients, with a statistically significant number of participants reporting that their confidence in their ability to be physically active had grown. Of the participants who provided feedback, 95% indicated that they believed it was important to receive at-home care for their condition during the pandemic, with 85% of respondents feeling that this would remain important for them post-pandemic. 

The pilot suggests that KiActiv® Health can provide an alternative management solution for some patients who experience difficulty in accessing existing face-to-face services, and may also provide a good alternative for patients who would otherwise receive no intervention. The programme supports self-management skills, helps patients from the safety of their own homes, and overcomes access barriers due to its remote nature.

North Central London CCG and Redmoor Health Ltd – Digital Improvement Pilot across five boroughs in North Central London

Our next finalists are North Central London CCG and Redmoor Health, who are delivering digital transformation to frontline health and care teams through an extensive coaching and training programme.

North London Central CCG appointed Redmoor Health to work with existing training hubs to improve and embed digital knowledge across 201 practices. Redmoor Health’s team of experts developed an innovative training programme to support practices move towards a digital-first approach, whereby patients can easily access advice, support and treatment using streamlined digital and online tools. 

The team created a Digital Majority Index to grow understanding of digital variation in practices and PCNs across a range of indicators such as access, demand and capacity and patient online services. They also helped practices and PCNs develop through the Digital Journey Planner, a diagnosis, coaching and support tool that enables practices to understand their current level of knowledge and identify areas for improvement. 

Redmoor Health worked with the existing training hubs to prioritise, coordinate and deliver a series of coaching, webinars and resources on topics such as use of social media, making the most out of your practice website, access to online records and blending the digital world into your patient journey.

For the final element of the programme, the creation of Digital Champions, North Central London CCG identified funds to increase digital support and provided allotted time each week for Digital Champions to support each PCN with advice and support. Digital Champion Daniel Gollop said, “I have found the programme very informative so far, and the tools provided have been extremely useful in benchmarking current digital capabilities and creating plans for improvement.”

Early results are promising and confirm a marked improvement across the practices in the CCG. As a result of the pilot’s success and the positive experiences of the practices involved, NHS England and Improvement is now planning to roll out elements of the programme across the rest of England.

Cornwall Partnership NHS Foundation Trust, Kernow Health CIC and Turnstall Healthcare – remote health monitoring for eating disorders 

The next finalist introduced remote health monitoring during the pandemic to enable clinicians to support children with eating disorders from their homes.

Due to pandemic restrictions, patients were unable to attend clinics for monitoring of their vital signs and symptoms as per the normal care pathway. An alternative approach was needed, leading to Kernow Health working with Turnstall Healthcare to introduce a pathway of remote health monitoring for use in children with eating disorders. Cornwall Partnership NHS Foundation Trust already uses remote health monitoring in other areas, which meant that a pathway adapted for children with eating disorders could be swiftly implemented.

Using the myMobile app, ICP triagemanager software and a health interview based on Junior MaRSiPAN (Management of Really Sick Patients with Anorexia Nervosa) risk assessment framework, a pathway was developed whereby patients can use devices in their homes to take vital signs such as resting pulse rate, blood pressure and weight to support daily and monthly reviews. They then answer symptom-related questions such as whether or not they are experiencing light-headedness or fainting episodes. Any breaches of parameters set for individual patients raises an alert on the system. Results can be viewed by clinicians through a secure portal which prioritises patients according to need for intervention.

Numerous advantages of the technology have been identified, such as a reduction in anxiety caused by face-to-face appointments and the early identification of trends which can help avoid the need for more complex intervention further down the line.

“The children we support are extremely vulnerable, and any delay or interruption to the treatment they receive could have serious implications for their recover,” said Michele Boyce, Service Lead Nurse for Kernow Health. “

The technology has enabled Kernow Health to prioritise the most at-risk patients, and has ensured ongoing service provision to every patient, offering reassurance to the patient and their family. 

Northamptonshire Integrated Sexual Health & HIV Service and Northamptonshire Healthcare – pilot study of locker system for delivery of sexual health services during COVID-19 pandemic 

Up next is Northamptonshire Integrated Sexual Health & HIV (NISHH), who piloted a locker system with 24-hour access to deliver testing and treatment for sexually transmitted infections, in answer to necessitated changes brought about by the pandemic.

With previously trialled alternatives approaches – telephone triage, postal kit testing and pick-up of medication at the clinic door – facing issues such loss of privacy for patients and potential exposure to COVID-19, NISHH sited a 24-hour accessible locker system and aimed to use a pilot system for the collection of STI test kits and medication.

Patients are emailed a unique QR code to access an individual locker and provided with a video link to show where the locker is and how to use it. Toilet facilities are available nearby for patients to undertake the tests, and then test kits are placed in a secure location next to the lockers. Staff members process test kits daily for pathology testing.

Locker usage showed an initial gradual increase, followed by a rapid increase after three months. In 2021, 63% of test kits were collected from lockers and 85% of those were returned for testing, In contrast, the return rate for postal kits was 60%. The locker system also reduced costs, for example eliminating the additional costs from extra packaging and postage.

Ad hoc patient feedback has been positive, particularly around its convenience and its independence from clinic opening times. Staff found the pilot locker system was significantly less stressful for them than arranging the collection of medicine from the clinic door. Going forward, NISHH believe that the locker model will remain essential to their ongoing offer of service.

Gloucestershire Hospitals NHS Foundation Trust – Machine Learning algorithm predicts long term stay score 

The next finalist is Gloucestershire Hospitals NHS Foundation Trust (GHNHSFT), who have worked with NHSX and Polygeist to develop a machine-learning algorithm that can predict a patient’s length of stay from the moment of their arrival at hospital.

With around a third of the beds occupied by long-stay patients staying 21 days or more, resulting in huge impacts on hospital capacity and patient flow, GHNHSFT sought to use Machine Learning and Artificial Intelligence to alleviate the issue.

The trust’s Business Intelligence team collaborated for 12 weeks on a Proof of Concept AI Skunkworks Project with NHSX, ACE and Polygeist, working as a project team to devise a tool which would help the team profile and quantify a patient’s risk of long-term hospital stay soon after arrival. The model was created by analysing seven years of historic admissions data to understand the factors closely linked with length of stay. The core goal was to use that historic data to employ an AI risk algorithm to create and assign a Long Stay Risk Score to every patient upon arrival.

The project has been a success, demonstrating good prediction of patient length of stay and excellent risk stratification based on this and other factors. The lowest risk group consisted of 99% short-stay patients and minor cases, with less than 1% of long-stay patients classed as very low risk. Proportions of long-stayers steadily increased throughout the risk categories. GHNHSFT plan to integrate the tool into their Electronic Patient Record systems to enable clinicians to access these scores in their daily work, to assist with decision-making and patient care. 

GHNHSFT believe that this will lead to a multitude of benefits and has the potential be rolled out across any NHS Trust, giving it the potential to improve outcomes for the whole health and social care sector. 

Leeds Teaching Hospitals NHS trust – #alerts reporting system

A new radiological alerts system has been developed by the teams at Leeds Teaching Hospitals, to automate the notification of significant findings on radiology imaging examinations. 

In line with LTHT’s approach to continuous improvement, and to improve patient safety as a key priority, clinical teams led by Radiology worked closely with the LTHT digital team to develop new functionality in PPM+, the electronic health record system.

The new functionality uses a hashtag alert system which triggers a task alert in PPM+ when inserted into radiology reports. It automatically notifies the appropriate teams for further action, prompting them to review findings and ensure all appropriate steps have been followed. As such, it provides a clear audit trail of when the alert was placed, when it was actioned, and an easily searchable resolution within the patient record.

The entry states: “As Emergency Departments are generally recognised as higher risk for potential communication errors, LTHT’s ED departments were used for the initial pilot. Between March to May 2021, 300 alerts were processed. 100% were pulled through to PPM+ and all were actioned within a short timeframe. User testimonials were very positive, with the system reported to be user-friendly and easy to monitor.”

Following on from this pilot, the system is now being considered for an initial roll-out in Cardio-Respiratory Medicine and Surgery, and has recently been accepted by the Royal College of Emergency Medicine as part of their 2021 Showcase of Good Practice.