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Community health mobile drive delivers results for Northern Devon Healthcare Trust

£750,000 of cost savings realised and income generated per annum

Clinical staff spend significantly less time on administration

A little over a year since Northern Devon Healthcare Trust (NDHT) rolled out a mobile working programme to 800 community health professionals, the Trust is reporting a significant increase in the amount of time clinical staff spend caring for patients, together with improved patient pathways, compliance and income generation from Department of Health directives. The Trust now also has a strategic over view of the demands placed on its community services and as such is well positioned to plan for the future.

The mobile working project, known as ComPAS, was created using integration and mobile working toolkits from specialist software house NDL, which works with around 70 NHS Trusts. NDL’s technology was used in conjunction with the Trust’s own in-house patient information system to allow nurses and therapists working in the field to access and update information hosted on back office systems via Samsung Galaxy tablets. This creates real-time patient records that can be accessed by multi-disciplinary teams - the system has seen over half a million appointments created to date, with 9,000 contacts entered by over 130 teams each week.

Keri Storey, assistant director of health and social care at NDHT commented: “When we started ComPAS we had two aims – to help NDHT deliver excellent community care and to ensure compliance with the Department of Health’s Community Information Data Set (CIDS) directive, which requires clinicians to collect various data sets on their activities and patient outcomes, which the Trust then passes to the Department of Health.

“To deliver the very best community care, we knew we had to build a better understanding of the demands placed on our community teams and help individuals deliver across organisational boundaries, so the parallel between CIDS and our wider objective was clear.  The final impetus was when we looked at the financial ramifications of implementing CIDS and realised that, done conventionally, it would cost around £1.1m to administer at a time when frontline resources were under considerable strain.”

A year into the project, the Trust is reporting the following outcomes:

• A marked decrease in the time clinical staff spend completing administrative or travel tasks
• CIDS compliance has been achieved while avoiding the need to either divert clinical expertise or employ additional administrative staff to input data twice.
•  ‘Outcoming’ of appointments is at 90%, well above Monitor’s target of 50%.
• CQUIN* data, worth £250,000 annually, is collected at no extra cost
• A further £500,000 of savings have been identified around planning and resourcing

Keri continued: “ComPAS has made a significant impact in a relatively short space of time, which is attributable to several factors. Firstly our IT teams worked in close conjunction with end users ensuring ComPAS dovetailed as closely as possible with existing working practices, thereby helping us to achieve the all-important buy in, both from field workers and managers. NDL’s toolkits, which allow us to design our own apps rather than use off-the-shelf templates, were certainly a real help here.

“Secondly, we were careful to ensure a robust, practical system and to build in value where we could. Our Trust covers 1,300sqm of largely rural communities, so we knew we couldn’t rely on flawless connectivity. NDL’s software allows the apps to continue to function on the device regardless of connectivity, with data automatically synchronised next time signal becomes available.

“We also knew that for clinicians working in a rural area, mapping technology would be incredibly useful, as would access to email – these tools have really improved communications with both patients and colleagues. Camera functionality was another relatively simple-to-achieve bonus, allowing staff to share images with GPs and consultants, thus speeding up diagnosis.  Interestingly, since patients are better able to see their progress, they are more motivated to follow clinicians’ advice and outcomes have improved.”

Commenting on the overall impact of the project Keri said: “This was about much more than complying with CIDS – the quality of the data ComPAS delivers far exceeds CIDS requirements – it’s about delivering better care and helping individuals live independent, healthy lives in their own homes.  ComPAS allows us to do this by measuring activity levels, providing evidence of trends and allowing us to plan for the future.”

*Commissioning for Quality and Innovation Payment Framework (CQUIN) was introduced by the Department of Health in 2009 and makes a proportion of healthcare providers’ income conditional on demonstrating improvements in quality and innovation in areas of care specified by local commissioning groups.