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Jonny Sammut, Chief of Digital & Innovation and Deputy CIO, and Matt Dugdale, Head of Clinical & Digital Innovation at North West Ambulance Service (NWAS) NHS Trust, share how they have worked towards creating a culture of innovation.
he North thatjourneybeen(NWAS)AmbulanceWestServiceNHSTrusthasonanexcitingofdiscoveryhasseenit explore new technologies and innovate from the ground up in recent years.
Jonny Sammut, Chief of Digital & Innovation and Deputy CIO, is responsible for all things digital at NWAS, be it the IT services, business intelligence or innovation services, while Matt Dugdale, Head of Clinical & Digital Innovation, has worked in the innovation space for the last three to four years, looking at new ways of working and bridging the gap between the clinical workforce and the digital teams. Jonny takes up the story. He begins, “Our starting point was to ‘be more pirate’. Pirates were the world’s first innovators. In 1718, Captain Blackbeard held a blockade in the port of Charles, as he knew a single pirate can steal a purse, but you need a crew to take down more than that, so he held everyone in the port to ransom. In this way, he used co-operation so a small crew could succeed. “We took on some of the pirate mentality and developed our
Jonny Sammut, Chief of Digital & Innovation and Deputy CIO
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“We took on some of the pirate mentality and developed our own pirate code to tackle issues such as social equality, driving cooperation, and preventing conflict”
6 own pirate code to tackle issues such as social equality, driving cooperation, and preventing conflict. Setting out our pirate code led to us towards making some small bold actions in the first instance, whether turning off our emails for the day, or working on a radical project that was not in any corporate plan. There’s no shying away that pirates were thieves and murderers, but their approach did stand out because of their innovations.” These initial steps resulted in the creation of NWAS’ Digital Design Forum. A range of people from different disciplines and backgrounds, from technical and clinical teams, to operational and corporate staff, meet on a weekly
“Technology presents further opportunities, but how do we sustain the pace and make sure that as technology develops, we can keep up? That will be the challenge, but there are certainly very exciting times ahead”
7 basis to discuss their issues and present their ideas. Jonny says, “It is a safe space in which to attempt to solve any problems and test new ideas. This has allowed us to move from being less pirate and more pioneer, by embracing new technologies and breaking out from the norm.” Matt continues, “There was no safe space for people to innovate prior to the creation of our Digital Design Forum. You would have staff facing problems on a daily basis and they would have ideas for new ways of working, but changes could only be achieved on a small scale. It is great that they now have the opportunity to take their ideas into this safe space, and test and develop them with the right people around the SafeChecktable.” was the first project that NWAS worked on around the trust’s vehicle check books. Matt explains, “Every vehicle has to have a number of safety checks completed, which were previously done on paper. Thick books had to be stored and collected, and there were many issues that typically come with any paper process. We wanted to turn this into a digital process, and rather than buying a product off the shelf, the clinical and digital teams worked together to make sure we had something fit for purpose.”
The project was tested at the ambulance station in Millom in Cumbria. Matt continues, “We first needed to understand what the user requirements were across the trust, so we engaged with staff to find out what they wanted out of a digital system. We then built the platform and took it to a minimum viable product over a six-week period, before testing it with the team at Millom. They provided feedback and we made improvements to the platform, and it grew from there. The team at Millom felt part of the process. It was the first co-designed product with our clinical staff that we implemented at the trust. I think that having that clinical co-design right from the start helped with the success of the product because
Matt Dugdale, Head of Clinical & Digital Innovation
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“We partnered with Sony to develop a digital wallboard product, allowing us to take all paper noticeboards down. It has a live news feed, live vehicle information, and cuts out the wastage in terms of staff having to update things manually and multiple times”
We partnered with Sony to develop a digital wallboard product, allowing us to take all paper noticeboards down. It has a live news feed, live vehicle information, and cuts out the wastage in terms of staff having to update things manually and multiple times. It also keeps staff posted on information such as road closures etc.”
partnered with Deister to develop a secure electronic key cabinet. Previously, we had four or five different cabinets dotted around the station, and now we have a single secure cabinet, which records who is accessing the keys at any given Digitalisationtime.”hasalso played a key role in installing smart devices around Kendal ambulance
Following the success of SafeCheck, NWAS started asking how they could take this data and present it on a digital wallboard. Matt explains, “We engaged with the team at Kendal and quickly came up with the concept of our Smart Station. It is a collaborative piece of work around how we can use technology in a meaningful way to deliver real value to the staff working in the ambulance station.
Another partner that has been key to the success of NWAS’ digital key cabinets is Deister. Matt says, “We it was those members of staff that would be using it after it was Thereleased.”platform has since been scaled across the entire organisation and has been used 16 million times. It has been a massive achievement for NWAS. Jonny adds, “I must say that the partners we work with are really vital in this space. We explore ideas with our partners that we wouldn’t have traditionally worked with before.”
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Jonny continues, “It was our mission statement that got us thinking about drones, where we highlighted
11 station that monitor occupancy, temperature, humidity, waste, and stock room levels. Matt adds, “Working with our partner ISTL, we switched to to energy-efficient lighting and smart monitoring, which has reduced the energy usage at Kendal station by as much as 76 per cent. That is a huge figure, especially in current times when energy prices are rising and we are making the push towards net-zero. This model is the first of its kind and something we are very proud of. We are now seeing it being rolled out across other trusts in the UK.” When embracing new technology, Jonny says that the foundation is always an understanding of what NWAS is all about and who it serves. He explains, “We look after over 7 million people across the north west, with 1.3 to 1.4 million calls taken by our 999 service and 1.5 million journeys taken by patient transport every year. Our two use cases. The first is around surveillance and getting eyes in the sky. As we have such a disperse patch, it is important for a central dispatch and control team to be able to have eyes on the scene in order to deliver the right care at the right time, in particular rural areas. “The other interesting use case is around delivery drones. We have large rural areas with challenging country roads, so we thought it would be great to have drones
organisation is made up of around 7,000 people and we have over 1,000 vehicles, so our patch is huge and clearly very important to us. Our aim is to look at where we can make a genuine difference to that service.” The purpose of the organisation is to deliver the right care, at the right time, in the right place, every time.
“We partnered with Deister to develop a secure electronic key cabinet. Previously, we had four or five different cabinets dotted around the station, and now we have a single secure cabinet, which records who is accessing the keys at any given time”
“We have done a lot of work around usercentred design and in creating the safe space, as well as encouraging people to get hands-on with the new technology and get a feel for what does and doesn’t work” delivering emergency medical equipment such as defibrillators to give patients a better chance of survival. We have collaborated with different organisations to explore how we could look to start changing regulation and policy to allow the delivery of defibrillators, trauma packs, and medication via drone. Our innovation space allows us to test at a small scale, whilst trying to break down barriers.” There are between 10,000 and 13,000 cardiac arrests and between 20,000 and 30,000 overdoses in the area covered by NWAS each year. Jonny continues, “They might just seem like numbers, but they are people – people with lives and families that deserve a better chance. For us, that is the driving force behind our culture of Asinnovation.”farasVR and AR are concerned, Jonny says the trust has explored use cases in paramedic training. He explains, “With augmented reality, we can give new paramedics exposure to major incidents. We have installed two immersive reality rooms to create a realfeel environment, with built-in distractions at an incident, just like the ones you would have in the real world. We are also working on a virtual reality piece around road traffic collisions from the patient’s point of view, so you are able to sense their feelings and emotions,
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Last but not least, Jonny expounds the virtues of artificial intelligence. He says, “We are aiming to automate manual processes within the trust in an intelligent way. For example, AI can listen to natural language on a real-time basis. As our call takers are on a 999 call, the system provides prompts and detects tones of language to save vital seconds, assisting teams in having an easier journey towards delivering the right care to the patient at the right time. It would not be possible if we weren’t able to test our pieces of innovation. We are not afraid to try new things, and it comes down to having the right people who will push boundaries in this safe space. They understand the pain points and will look at how technology can help to solve them.”
13 giving a deeper understanding of what they are going through.”
By testing on a small scale, it mitigates the risk of failure of engagement. Matt explains, “By engaging the teams with our co-design projects, it helps to overcome any barriers and bring other staff along with them. Doing something new will take people out of their comfort zone, but having the opportunity to feed into the process and contribute to the changes means they can see the benefits for themselves.”
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Jonny adds, “Without the user engagement piece, you won’t have the adoption. You could spend lots of money on technology, but if the users don’t buy in, it is a waste of time. We have therefore done a lot of work around user-centred design and in creating the safe space, as well as encouraging people to get hands-on with the new technology and get a feel for what does and doesn’t work.”
NWAS has adopted an agile methodology, so Jonny, Matt and their teams are able to redevelop small sections of technology to make it purpose-fit for the user. Jonny continues, “We use a framework that allows us to think wider than just the technology. How is it embedded into the system? How is it embedded into the organisation? But, perhaps most importantly, how do we help people adopt it through training, use, and interoperability? You don’t want to simply throw a load of technology at the organisation. You want to make it meaningful and drive benefits. Our framework allows us to understand the value proposition of what we are trying to deliver, and for us, that is so important. We will always have challenges, but we are open to managing them because we are transparent in our approach.” Matt says NWAS is lucky to have some fantastic people in the
15 team, coupled with the ability to reach out to a number of different partners to tackle any issues the organisation may be facing. As for fostering an innovation mindset going forward, Jonny enthuses, “Digital is the future and the challenge for us will be innovating whilst still maintaining a safe day-today, considering the increase in cyber-threats, for example. I am keen to continue the innovation piece, keeping the constant stream going of exploring new things. I want to maintain that hunger. We are on the right tracks in terms of looking at AI, ML and drones, and it is set to grow, as we partner with more people both in and outside of the industry. There is lots still to come, so watch this space!” With UK ambulance services under immense pressure, Matt believes it is a real opportunity to innovate and utilise digital to improve the service offering. He concludes, “Technology presents further opportunities, but how do we sustain the pace and make sure that as technology develops, we can keep up? That will be the challenge, but there are certainly very exciting times ahead.” For further information on NWAS, visit www.nwas.nhs.uk
16 www.nwas.nhs.uk