PAHT 2030 - digital health

Our achievements - 2022 Digital health

Welcome

A warm welcome to our first PAHT2030 magazine – a celebration of all that you have achieved in the first three years of our long-term plan that is PAHT2030.

Our PAHT2030 strategy began as the COVID-19 pandemic arrived along with the unprecedented challenges that the pandemic presented us all at home and work.

With the main thrust of COVID-19 now behind us, we can turn our attention more to planning and putting in place changes to assure that we achieve our aims of being a modern, integrated and outstanding place to be.

Many of you have already been part of improvements and campaigns to develop the care we provide. The improvements belong to us all and over 100 PAHT senior leaders have completed a PAHT2030 Ready course last year (2022) to support the skills of leading change.

Our five key priorities for PAHT2030 are:

y Transforming care

y Our culture

y Digital health

y Corporate transformation

y New hospital

And they each lead focused transformation actions that provide a clear focus on our patients and people together.

This magazine captures the successes of each element of the plan and a huge thank you goes to everyone who is involved and to everyone who is getting involved this year. Take part and help make things better for the patients and people we care for and the people you work alongside. This is Us.

Best wishes

Lance McCarthy Chief executive

Our vision

To be modern: always using up to date treatments, technology and facilities.

To be integrated: working as one to provide joined-up healthcare that always puts patients first.

To be outstanding: delivering healthcare that our patients deserve and that makes us proud.

Our strategic priorities

Through our work developing PAHT2030 we have identified five areas of focus that we believe will deliver our ambition to be modern, integrated and outstanding:

Transforming our care

The most up to date and expert care designed to meet the individual needs of the patient, where and when they need it.

Our culture

Fostering and nurturing an inclusive environment that champions diversity and equality, and where our people are engaged, supported and helped to learn and grow.

Digital health

Harnessing new technology and digital solutions to transform patient care and improve how we work.

Corporate transformation

Modernising our corporate services to support our clinical teams in providing outstanding care.

Our new hospital

A world-class hospital for the future, providing first-rate care for our patients and the best place to work for our people.

Our future PAHT

We are on a journey of transformation and improvement that will lead us successfully into the future, enabling us to deliver modern, integrated and outstanding care that keeps our growing and ageing population healthier.

Against a backdrop of NHS and system transformation, the relentless pace of scientific, technical and clinical innovation, and our amazing opportunity to build a brand-new hospital, we need a strategy that is big, bold and ambitious.

This is PAHT2030, our organisational roadmap. It is designed to inspire and challenge us, to guide and unite us in working smarter and better to achieve our vision.

Since its launch, PAHT2030 has made great progress – thanks to your hard work. However, there is much more to do. Now, more than ever, we need to come together as one team, working with our local, regional and national partners, our patients and our communities to make PAHT the centre of excellence we know it can be.

Our progress so far...

PAHT2030 is well underway, with all divisional leadership teams implementing detailed delivery plans to ensure that we achieve our strategic priority milestones and realise the benefits to our organisation. We are continuing to track progress against the PAHT2030 strategic priorities.

Outcomes framework

The PAHT2030 outcomes framework is designed to focus our work on the issues that really matter and which will contribute to the successful achievement of our PAHT2030 ambitions. The aim is to provide our people with a clear direction of what needs to be achieved at personal, team and organisational levels by clarifying the direct links between the outcomes of the services they provide to wider PAHT2030 strategic objectives, and the shared health improvement outcomes that they are working with partners to achieve.

Your role in PAHT2030

PAHT2030 envelops all that we do at PAHT. It sets our ambitious goals and the pathways to achieving the transformation and change involved.

As this magazine illustrates, no one change will provide PAHT with the required change. Change is across all divisions and needs everyone to support the plans and achieve the positive outcomes.

We do not have a varied mix of stand-alone focus areas and targets – every action provides a way for the successful delivery of the PAHT2030 strategy. A real joined up approach with many examples of cross-divisional work and change.

However, putting the change in place is being done by a joined-up approach with specialists and those close to specific actions taking the lead to deliver. This means that there are clear leadership roles and accountabilities. This is aligned with a wider responsibility for supporting the actions through testing, analysis and operational change management that is supported by the central teams in each division.

There is a role for each of us to be part of leading the way to PAHT2030 and making a difference to our patients, improving the quality of the care provided and way we all work together.

PAHT2030 matters.

The Care Quality Commission - ‘must and should’ programme

The Care Quality Commission (CQC) noted 74 ‘must’ and ‘should do’ actions following their inspection in summer 2021, across our divisions. This was part of their latest report in which PAHT was rated as Requires Improvement >

We are pleased to update that we have made significant progress, with 31 additional projects being fully embedded as business as usual in 2022, with 44 actions completed in total (blue rated). There are now 17 green rated projects (three more than 2021), 10 amber rated projects (18 less than 2021) and three red rated projects (two less than 2021). Thank you to all involved in this important work towards PAHT2030.

Key

Red: Where there is risk to the timeline of a project or risk to the overall delivery of a project it is rated as red to highlight this concern (escalated)

Amber: Where a project may have fallen slightly behind schedule and more attention may be required to ensure this does not move to red

Green: Where a project is on schedule for delivery as planned and there are currently no concerns about delivery

Blue: When a project has been closed down (has been delivered) and fully embedded into the organisation as business as usual

Digital health

Electronic health record - preferred supplier announced

The electronic health record (EHR) will transform the way we provide patient care.

We have appointed Cerner as the preferred supplier for our forthcoming EHR implementation. As a preferred supplier, we are not yet in a formal contract with Cerner, it means that we are working closely with their specialist teams to take the EHR forward to a full business case. A public announcement of our contracted supplier will be made following that, this is likely to be early this year.

Thank you to everyone who has given their expertise and time to get us to this important milestone in the project and we look forward to sharing more details on the EHR with you very soon.

Alertive – non-emergency communication

To enhance our ways of working and communication with each other, we have introduced a clinical and corporate communications tool, Alertive, to replace all non-emergency bleeps. If you have not already, you can download the Alertive App via your smartphone App store. Once downloaded, please enter the ID code princessalex.

We have sent more than 700,000 messages via Alertive since we introduced it in December 2021. Alertive was also selected as a finalist in the Innovate Awards: Best Workforce Innovation Award and shortlisted for a HETT Unexpected Innovation Award in September.

We are now working towards replacing emergency bleeps and pagers early this year - look out for more updates soon.

eConsent introduced in all areas

Following the successful introduction of eConsent in the obstetrics and gynaecology and trauma and orthopaedics departments, we have now rolled out electronic consent (eConsent) technology to all areas across PAHT. This is to improve patient experience at our hospitals and help to relieve pressure as we recover from the impact of the pandemic.

The solution chosen with your input was a web-based digital consent App called Concentric. Concentric allows patients to receive information about their treatment and provide their consent online via a link sent by email and/or text message.

Phil Holland, chief information officer

Executive sponsor for the digital health strategic priority

“Realising the potential of new technology is essential to providing high quality care for our patients and a great place to work for our people.” - Phil Holland

Where appropriate, they can also consent for procedures on the day using existing computers/devices during their appointment or on the ward. It is used for all specialties and types of consent to fully replace the previous paper process.

The benefits of eConsent include:

y Patients have more time to review and understand information

y Saves time for clinicians and administrators, allowing more time to care

y Enables remote consultations and care pathways

y Fewer cancellations and delays to surgery/treatment

y More personalised information and better documentation which meets new national standards

y Better patient engagement in shared decision making

Thank you to all involved.

Paper-lite

We are focusing on reducing the amount of paper used across PAHT. We have made great progress, including with the below initiatives:

Digital information guide and child health record introduced for parents and carers

We have introduced eRedbook, a personal child health record, that is given to parents and carers to provide them with support and information about the healthy child programme. The eRedbook provides useful information at the click of a button for expectant parents and carers across west Essex.

The eRedbook also allows parents and carers to:

y Feel empowered to take control of their child’s health

y Interact with maternity care professionals online

y Find out more about their baby’s development through approved guidance and articles that are tailored to their baby’s age

y Record and track their baby’s weight and create a safe, long-term record of their baby’s health and development

y Record their baby’s firsts with photo uploads

y View information on what screening tests, checks, clinic recorded weights and immunisation details that are offered as part of the healthy child programme

y Reduce the number of face-to-face appointments they need to attend after their baby is born

Further information is available on the eRedbook website >

Letter viewing system for our patients

Outpatients can now easily view and download their hospital appointment letters and follow-up appointment letters using the Dr Doctor online system. The letters can be viewed online via a smartphone, tablet, computer or device, at any time.

If patients have provided their mobile phone number to their GP surgery, or with our outpatients’ department, they will receive a text message that will take them straight to the secure log in page to set up an account.

If patients are unable to view their letter online or do not click on the link from the text that is sent, we will send their outpatient appointment letters by post, ensuring that all can access the information they need.

Digital training courses for our #PAHTPeople

Our IT team has provided a variety of digital training courses, supporting 2,200 delegates in 2022.

The courses are designed to assist our people with their understanding and learning of key digital topics. In total, 204 people are in progress with one of the courses, and 94 have completed them. They include:

y Digital literacy

y Digital skills

y Microsoft Excel

y Microsoft Teams

y Microsoft Office 365

y Microsoft Outlook

y Microsoft PowerPoint

y Microsoft Word

Other training available includes for NHSMail, NHS Digital Workforce, and Microsoft Office specialist training, to enable our people to enhance their digital knowledge for the future.

Feedback from delegates demonstrates benefits including new skills, increased productivity and faster performance.

Other highlights include:

y Nervecentre was introduced in our emergency department in July: This provided a transition from manual, paper-based patient information processes to utilising software and mobile devices for a more sustainable working environment, to increase patient safety and to ensure efficient data flow

y Microsoft 365 OneDrive introduced: We have now enabled OneDrive for 3,044 users, providing improved functionality, including flexible access to files anywhere at any time; enhanced collaboration by sharing links to files and the ability to view and edit documents simultaneously without overwriting changes; and more storage space

y E-Health governance mechanism in place: A mechanism for monitoring the progress against our digital strategy has been established, including an ICT Programme Board. This is ensuring that the digital solutions being rolled out at PAHT focus on meeting our objectives, to ensure our people can maximise the potential of available technology to support in caring for our patients

y Completion of Business Information Provision refresh: A new Business Intelligence Strategy has been approved to increase access to available data to support in planning care provision and improving services

y Shared Care Record initial implementation: The Shared Care Record is available to facilitate seamless care for patients across healthcare providers in Hertfordshire and west Essex

y We have replaced laptop and desktop devices and upgraded over 100 devices with increased memory to improve performance. In the year, we bought 716 new iPads, 331 laptops, 103 desktop PCs (also used for computers on wheels) and 80 new drug carts. Customer relationship officers (who are travelling around the wards) have located and repurposed more than 20 computers on wheels which are now being used in various departments

y We have supported a large number of ward moves, allowing us to replace our old 19” screens to 22” screens and 24” screens with built in webcams and multimedia, for use with Microsoft Teams. This supports our people to engage and collaborate effectively

y Portable landline phones (DECT phones) have been issued to wards to allow them to be contactable by external partners, reducing the need for callbacks and minimising missed calls

y Viewpoint to Agfa migration completed: This integration allows data and imaging to be captured, stored in our imaging solution and to generate diagnostic reports that can be accessed by those who do not have access to Viewpoint, including GPs

y New service desk callback scheme introduced: At busy times, callers have the option to request the IT team to call them back later, rather than wait on hold for the next available agent

y Improved call centre options introduced for the outpatients’ appointment department: We streamlined the options for patients, with more information on waiting times, other ways to contact the call centre, and improved capacity to allow more callers in the queue

y Robotic process automation: a form of artificial intelligence that can digitally replicate human repetitive manual tasks. We have two robots live, for digitally transferring patient referral documents and managing patient discharges

What PAHT 2030 means for you...

y You will continue to see a significantly increasing emphasis on digital care and information with many services, clinical and non-clinical, transforming as a result

y You will experience integration and partnership working with our local and regional partners on a scale not seen before

y You will see the movement of services from their existing hospital location into other settings, including care at home and virtual appointments and treatments

y You will see far less patients stay in hospital overnight with an emphasis on day case services

y You will be working as part of an organisation which will be transforming and changing, with many new ways of working and thinking

y You will be working in an environment that allows you to be the best you can be and you will be supported and developed appropriately

y You will be part of an ambitious and exciting programme of work which will see us become a modern, integrated and outstanding organisation

PAHT 2030 Ready

Launched in May, our PAHT2030 Ready development programme concluded with its sixth and final day in October. Here is a snapshot of why the programme was developed and how the participants will take forward their learning to deliver our PAHT2030 strategy.

What?

PAHT2030 Ready was a six-month programme for our senior management teams to develop their knowledge and skills in taking forward the transformational changes set out within our PAHT2030 strategy. Over 100 participants explored these key topics critical to taking PAHT2030 forward:

y Understanding the PAHT2030 strategy and outcomes framework

y Building self-awareness as a leader

y Involving teams in achieving our vision

y Engaging communication techniques

y Creative thinking approaches

y Giving and receiving feedback

y Overcoming problems and barriers

y Managing change

y Accountability vs. responsibility

y Effectively planning how we spend our time

Pictured left: the PAHT2030 delegates.

What now?

Senior management teams are putting their learning into practice to continue our journey towards PAHT2030. To make big changes happen, we need to take lots of small steps – and we want everyone to feel they are part of this journey together. You can expect to hear more conversations driven by your senior managers about…

y The aspirations for what the future at PAHT will look like

y The types of changes within your departments that will be key along this journey

y Projects which have already started in your division and opportunities to get involved

y How our work towards PAHT2030 will impact you and your team

y Team culture and how our ways of working with each other are critical to our success (including participating in culture huddles)

y How we positively hold each other to account for our responsibilities in supporting our success (including having more feedback conversations with each other)

For more information

y Visit the PAHT2030 section on AlexNet >

y Listen out for updates about PAHT2030 as part of ongoing conversations, such as at team meetings

y Reach out to a member of your senior management team, who will be pleased to hear from you. You can find out who this is in our senior management team booklet on AlexNet >

PM3 project management tool

In March 2022, we introduced PM3, an integrated project management tool to support oversight, governance, and data-led decision making. It also features a broad range of project management functionality across our services.

PM3 provides one source of information, demonstrating the progress we are making with our programmes of work. The project management office (PMO) team use this to identify, highlight and escalate any areas of concern and provide support where required. Since its introduction, the PMO team have trained a total of 205 people to use the system. We are using this to track progress with the PAHT2030 milestones and will keep you updated.

Project management office AlexNet workspace

We have introduced a project management office AlexNet workspace, where you can access further information about the service and PAHT2030 progress. It includes guidance on using PM3 and the latest updates >

Our next steps

With 2023 underway, we have a set of fresh plans to deliver the next stages of our five main focus areas.

Plus, new to PAHT2030 is the Patients – Quality – Productivity way of working to support the action plans for the strategy.

Designed for all, the Patients – Quality – Productivity (PQP) programme, sits within our PAHT2030 strategy.

The PQP approach ensures that we focus on improving the quality of care and experiences for our patients, while driving forward our productivity and financial efficiencies.

You will be aware that post-COVID, we are experiencing challenges in meeting demand from our community, both in waiting times for urgent and emergency care and for planned care, such as outpatient appointments and surgery. We are also in a financially challenging position, anticipating approximately a £24m underlying deficit for this financial year (2022-23). We have seen a decrease in productivity of 20% since the end of 2019-20, meaning our clinical colleagues are seeing and treating less patients, which impacts on waiting lists.

Some of the reasons for our overall operational and financial position include the impact of COVID-19, increased demand for our services and changes in the income we receive. We all need to continue to work together to improve our services for our patients and for the people we work with.

You will hear your divisional leadership teams discussing PQP plans and seeking your ideas for innovation and ways to improve in your areas.

Please get involved to make the care you deliver more efficient and makes a difference to our patients.

Please contact your line manager with ideas of how you could improve quality of care, productivity and financial efficiencies in your area in the first instance. It is time to be different and innovative change is encouraged.

Please look out for more updates on the Patients – Quality – Productivity programme coming soon.

Our next steps

Our next areas of focus are:

Transforming our care

y Completing all clinical strategies for each specialty

y Ensuring that all clinical documentation is accessible in one place

y Developing a patient portal, supporting two-way communication between our people and our patients

Our culture

y Implementing a new learning management system to ensure our people can easily access developmental opportunities to support with their roles

y A new approach to performance conversations to support our #PAHTPeople

y Refreshing the way we roster our people, so we are able to safely care for our patients whilst maintaining fairness and equity in shift allocation

Digital health

y Continuing on our journey towards our new electronic health record (EHR), with the support of our people

y Piloting new monitoring technologies to identify which will best support the delivery of patient care

Corporate transformation

y Focusing on Patients - Quality - Productivity (PQP), improving the quality of care and experiences for our patients, while driving forward our productivity and financial efficiencies

y Continuing to digitise corporate functions to ensure our people can access the support they require

y Modernising our financial systems to support management of funds - this will focus on upgrading our ledger (Integra) and the implementation of a contract management system as part of the Integrated Care System (ICS) (Atamis)

y Rolling out a new digital pathway for pathology services to improve patient experience

y We are continuing to focus on self-service, following the rollout of ESR Manager Self-Service, working towards more robotic process automation, including for invoice processing as far as is possible

y Future focused finance (FFF) accreditation - a national programme designed to support our people by engaging everyone in improving NHS finance, for which we are working through the application requirements

y Optimal customer focused support, focusing on areas for improvement in finance

New hospital

y Following the announcement of a decision on funding from the Government, which is expected early this year, we will proceed to our Outline Business Case

The Princess Alexandra Hospital NHS Trust, Hamstel Road, Harlow, Essex , CM20 1QX

ThePrincessAlexandraHospital

@NHSHarlow