Key steps for implementing innovation in a crisis

A common reflection on last year is that if there were any positives, it was how quickly technology-based innovations were introduced to the NHS and how effective they were in addressing the crisis. What would have normally taken six months was achieved in less than six weeks. This led NHS England CEO Simon Stevens, in his ‘Stage 2’ Covid-19 recovery letter, to encourage Trusts to take advantage of the IT initiatives they have successfully implemented during the pandemic.

But how have innovations been implemented so quickly? Particularly in an environment that has traditionally been slow to adopt change.

At the start of the pandemic last year, when significant restrictions were placed on elective care, several North West London CCGs and Trusts requested Vantage Health’s support to ensure that patients continued to receive appropriate care during this period. The Advice & Guidance (A&G) platform we implemented would allow patient information to be sent from a GP, directly to an appropriate hospital consultant, with no paper or manual intervention; and to allow for the consultant to offer advice and guidance directly to the correct GP.

Following our successful implementation of the platform at these CCGs and Trusts, we wanted to share our experiences of the key steps for implementing an innovative technology in a crisis.

Effective agreement and coordination

• Critical to effective implementation was for all stakeholders to understand the value and necessity of the service in addressing the crisis and for them to remain engaged through each stage of the project, from concept, through development and realisation.
• This project was enabled by excellent coordination between the hospitals, Clinical Commissioning Groups (CCGs), the Integrated Care System (ICS) and the North West London IT team, who produced a joint proposal that was agreed by all. The project also benefitted from the CCG chairs being very supportive and the Chief Information Officer being familiar with the Rego platform given its existing use in one of the hospitals.

Ensuring high levels of adoption and security

• Two groups of stakeholder involvement were important in this: first was the engagement of the users (consultants and GPs) to ensure they were confident and comfortable to use the platform. Some consultants initially expressed concern with giving advice electronically but were given confidence once they became familiar with the service, its ease of use and its effectiveness.
• GP engagement was made easier by integrating the service into their local practice patient record system for ease of access.
• Second, was the close involvement of the technical team, to ensure integration with all NHS systems, including e-referral service (eRS), EMIS and Systm One, and for the system to be configured to allow for home and work connections. The service also needed to be fully GDPR compliant.

Rapid roll out

• Clear goals were set and each organisation was committed to delivering on their elements. A detailed plan was agreed between all stakeholders with progress reviewed weekly. Informal communications on a daily basis were encouraged. The project was broken into phases covering three months, with the final phase to provide additional support to those who required it.
• This setup was critical during a crisis period, providing assurance to all stakeholders and ensuring that the necessary actions were taken, albeit in a more urgent timeframe.

Continuous support and training

• Effective support is important for any new technology, but in a crisis, where users have used their current practice for years, close and regular user support is imperative for an innovative solution.
• During the implementation, bespoke, targeted videos and guides were produced to explain the service and there were daily reviews of critical tasks.

Keeping hospitals fully functional

• Within four weeks the first 50 practices were connected to Northwick Park Hospital. This allowed the hospital to remain fully functional during the remainder of the pandemic, to date. Prior to this the hospital had to declare a critical incident on at least two occasions. Within a further four weeks the second CCG and Hillingdon Hospital were fully connected and operational. The remaining two CCGs became operational during the following four weeks.

Following implementation, we received the following feedback:

“Delighted our 2nd CCG @NHSHarrowCCG went live today with @VantageHealthUK advice and guidance. Great tech and team effort between @LNWH_NHS and @NWLCCGs ! Good tech = functional + delightful” – Sonia Patel, CIO, NHSX

“We have used the Vantage Rego platform to seek advice and guidance from specialists in Ealing and Northwick Park Hospitals.  This platform is easy to use and has allowed us to engage with specialists in a way we have never been able to do previously.” – Alex Fragoyannis, GP, Ealing CCG

We are extremely proud of the work here, particularly given the challenging circumstances, and of the collaboration with the CCGs and Trusts. Without close working with clinicians, commissioners and managers, the implementation and results would not be possible.

If you are interested in discussing how technology could be implemented in your organisation, particularly over this difficult period, please contact David Ezra, Head of Transformation or sign up to our mailing list for our discussion on the Practicalities on Delivering Outpatient Transformation.

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