The Princess Alexandra Hospital NHS Trust

Accelerating patient pathways: End-to-end referrals


Eliminating rekeying and streamlining patient referrals, The Princess Alexandra Hospital NHS Trust (PAH) combined robotic process automation (RPA) and eForms to achieve end-to-end transformation. Not only has the project delivered significant time and resource savings, but it has also paved the way for a sustainable governance framework – the first of its kind in the NHS.

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  • Improved patient care and experience
  • Maximised ROI with a Trust-wide approach
  • Released time back to clinicians
  • Decreased data risks
  • Improved data quality

The challenge

Though the Trust receives referrals digitally, inputting this information into its electronic health record system (EHR), Cosmic, was originally a manual process. Administrative teams scanned and uploaded referrals by hand, processing a volume of 2,323 documents every month – with transactions taking between four to five minutes each in data entry and a further 2 minutes per clinician.

This was incredibly time-consuming, with administrative teams sometimes unable to meet demand. As a digitally pioneering Trust, it identified the process as one that would benefit from end-to-end transformation – choosing NDL Automate and NDL Digitise to streamline its referrals with the support of NDL’s expert Delivery Team.

The solution

Due to the repetitive and rule-based nature of referral rekeying, the process was the perfect candidate for RPA. Where each referral would take around five minutes for a member of the administration team to process, bots complete each transaction in seconds – meaning information is available to clinicians almost instantly and appointment entry backlogs are avoided. Referrals are merged into one PDF, accessible from the EHR with a single click.

However, the Trust’s innovation didn’t end there – a bespoke eForm application was also created to ensure automations can be managed and controlled by the outpatient appointments department. This control includes both the overall automation, as well as the individual referrals as they’re processed, at any time from any device.

“The combination of RPA, eForms, workflow and API connectivity allows our development team to tackle most digital automation requirements across the trust” Anoop Murala, Head of Digital Automation Development at the Trust.

The benefits

The project sparked the NHS’s first sustainable digital transformation governance framework - a programme governance structure created to ensure the Trust only automates those processes that meet a minimum ‘ROI hurdle rate’. Financial savings gained as a result of automated projects from any department are reinvested into the RPA initiative, and then used to deliver new projects across the wider Trust. This is allowing the Trust to propel its streamlining of processes, improving both patient and staff experience.

This has been a revolutionary framework within the Trust. PAH is currently focused on sharing this methodology with other healthcare organisations across the NHS, contributing to the sustainable transformation of healthcare processing across the country and paving the way for growth. The project delivered several other impactful benefits, including:

  • Improved staff and patient experience: With the introduction of autonomous referrals, administrative and clinical staff are relieved of a significant administrative burden with repetitive and monotonous demands – speeding up patient outcomes and increasing time for people-centric care
  • Significant time savings: Overall predicted time savings are set to exceed 120 hours per week, across giving time back to administrative teams and clinicians for human-centric, high-priority public services
  • Improved data quality: Data entry with RPA eradicates human error, with bots only able to input the exact data provided
  • Decreased data loss risk: As referrals are now fed directly into Cosmic, there’s no opportunity for data loss – ensuring information reaches its target destination without risk

What’s next?

The success of PAH’s initial end-to-end process has sparked a plethora of opportunities for digital transformation in other departments. PAH is currently investigating a huge number of opportunities to implement similar processing elsewhere in the Trust - including 15 potential projects within its radiology department, 17 in HR, 9 in Cancer Support Services, 6 in maternity, and many more.

To accelerate its transformation even further, the Trust is adopting the full NDL Evolve Digital Transformation Platform – incorporating complex APIs quickly and easily with Connect, and streamlining end-to-end workflows with Flow.

Applying its own in-house developed delivery methodology and governance framework, the Trust is currently delivering digital transformation at an incredible rate. It aspired to share this methodology and framework with other Trusts within the NHS – sharing its benefits with patient experience at heart. To learn more about PAH’s project, get in touch with a member of the team.

For more digital transformation inspiration, browse our library of real-life public sector use cases or join us at our upcoming online and in-person events. Ready to kick-start or accelerate your digital transformation? See NDL Evolve in action and book a free demo today.

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“Our gated delivery process ensures only those processes with a proven ROI are taken through to development and deployment stages”

Marcel Horst, Programme Manager of the Digital Automation Programme