A look at the everyday reality of swiftly implemented digital innovation, and the real benefits it can bring for both patients and staff.

At a macro level much is spoken of the digital change being seen across NHS trusts, but what does this actually look like on the ground? What are the products in use and who are the people on the frontline that drive these innovations forward?

These were some of the questions I sought to answer when I spoke to Dr Georges Ng Man Kwong, Consultant Chest Physician and Chief Clinical Information Officer at Pennine Acute Hospitals NHS Trust. Georges has been leading a project to revolutionise communication platforms used across the Trust.

Age-old problems, exacerbated by Covid

Even before the pandemic, Pennine NHS had identified issues with communication, particularly across specialist-to-specialist referral. Based in respiratory medicine, Georges knew that there were simply too many steps in identifying, triaging and responding to referrals. Lack of coordination meant that even with referrals in electronic form, Georges’ team would often still have to print these in order to coordinate care pathways.

“There were referrals coming in from every direction. It was messy and inefficient, and we wanted to streamline this process to make it easier to manage them,” says Georges, who was keen to develop a more proactive and responsive referral process.

The idea of doctors using social media, text messages and WhatsApp to communicate sensitive information may be alarming to those outside healthcare, but it is all too familiar for specialists like Georges – and clearly there are major security issues and implications for patient confidentiality in doing this.

To begin to address these issues, the respiratory team at Pennine started piloting Bleepa, Feedback Medical’s CE-marked encrypted messaging app that allows staff to share clinical-grade diagnostic imaging securely through smartphones, tablets and desktops.

When the pandemic struck, the Trust was faced with immense challenges, particularly with the anticipated demand for X-rays and CT scans – both key aids in dealing with Covid-19. Despite this pressure the team knew there was an opportunity to rethink and redesign the hospital’s referral system, and Bleepa was identified as a potential solution. Key learnings from the pilot launch were rapidly adapted and consolidated – a technical testing process was turned into a successful clinical application, at pace.

With Pennine’s research teams having to literally walk around the Trust to locate Covid patients, Bleepa was identified as a secure solution that could not only enhance clinical decision-making across specialities on referrals, but also identify patients and register those suitable for the landmark RECOVERY trial.

Within a two-week period, Feedback Medical introduced new features that were developed and quickly implemented, such as enabling Covid cases to be tracked as they moved through clinical pathways, and making team-to-team referral easier. Within a few weeks over 200 frontline clinicians were enrolled onto Bleepa. The team are not resting on their laurels, and the app is being rapidly expanded across specialities, disciplines and a multitude of clinical departments, beyond the considerations of Covid-19, and improving workflows across all corners of the Trust.

“There is a buzz about the app across the Trust,” says Georges, citing the number of other departments lining up to use it. As with any good technology, innovators will start finding more applications for it and then demand more from it.

Pioneering transformation, rooted in collaboration

“Looking back, it seemed like such a crazy time to be looking to implement such a change,” says Georges, but as he astutely notes: “it sometimes takes seismic change and unprecedented challenge to spark innovation.”

The reason this implementation has been so successful, in Georges’ mind, is down to the buy-in and collaboration seen at every level of the Trust – and with their industry partners in Feedback Medical. “We had excellent clinical engagement from all specialties, and a great working relationship with the Bleepa team.” This collaboration helped to embed a newfound sense of agility, following proof of concept, decisions were made at pace on a collective basis – identifying need and solving issues.

Pennine NHS is one of 17 Acute Global Digital Exemplars supported by NHS England to further digital ambition. It was selected for its already high level of digital maturity and in looking over the implementation of Bleepa it is easy to see why. The Trust harnessed the innovative vigour which had already defined its working and used the Covid experience to bring teams together and share learnings, and to bring IT into clinical teams to generate improvements that would previously have taken months to implement.

This innovative spirit is not limited to the Bleepa project, and the Trust has been implementing a range of digital tools to improve care and drive efficiency in the face of the serious challenge of Covid-19. As an external observer, Dr Tom Oakley, Chief Executive Officer of Feedback Medical notes, “this Trust has long displayed digital excellency, and buy-in for technology has always been there, but the Covid experience has brought these things together from a managerial side and streamlined decision making.”

Digital partnerships require digital leadership

The implementation of Bleepa at Pennine is but one example of the Trust’s digital maturity. At the heart of this co-creation lies proactive and digital leadership from the frontline – and that’s where Georges comes in. Georges has helped the Trust form an effective partnership with industry and has rapidly deployed solutions to the frontline that will ultimately improve clinical care.

Ultimately, these are people that should be credited with the NHS’s record sprint to digital transformation above all else, driving innovation from the ground up to deliver lifesaving solutions to the frontline.