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Provider Digitisation

Getting the right people, to the right ​place – at the right time

Capacity and Flow is a Provider Digitisation Programme within the Integrated Care System (ICS). It is about using digital technology to manage how people move through and between services across our sites. Our vision is to be a flexible and efficient system that uses digital infrastructure to get the right people, to the right place, at the right time, to meet the needs of people across Nottingham and Nottinghamshire.

The Capacity and Flow programme is governed by an established programme board with representatives from partner operational, technical and transformation functions across the ICS. The board approves funding requests and offers support to scope or unblock any challenges – leaving capacity for overall delivery of this programme.

Benefits to our people and region

  • Access to the right care, in the right place, at the right time.
  • Better coordination of care so that patients don’t have to spend time waiting when they could be at home.
  • Confident that the professionals providing care have the capacity to only deliver high quality and safe care.

The Capacity and Flow programme is governed by an established programme board with representatives from partner operational, technical and transformation functions across the Integrated Care System. The board approves funding requests and offers support to scope or unblock challenges, leaving capacity for overall delivery of this programme.

Roadmap

The Capacity and Flow Roadmap

2019

Phase 1

Programme Initiation

Phase 2

System-wide workshop to take stock and identify opportunities

Phase 3

Launched several tactical projects for winter

2020-2021

Phase 1

Long-term priorities agreed

Phase 2

Operational vision defined

Phase 3

Focus on improved flow management and richer data

2022-2025

Phase 1

Sharing ICS data in new ways

Phase 2

Using techonology to streamline handovers across boundaries

Phase 3

Maximising system-wide benefits across our investments

Frontline Digitisation Projects

Digital technology is used to enable integrated working throughout our ICS. Our projects help partners to identify where investment in digital solutions will most benefit their ability to manage capacity and flow. This could be a digitisation project to move partners away from paper and spreadsheets onto more efficient and accessible systems or tools, or a project to access information in one system and share it with others as required, to help improve and automate the sharing of key data items between system partners. Some examples of our work are shown below:

Alignment of flow management tools and processes in acute hospitals

Our two largest acute hospital; Sherwood Forest and Nottingham University Hospitals, have used this project to collaboratively align processes and terminology, particularly around discharge management.

The project has supported Sherwood Forest to implement a ‘live flow’ view in the Nerve Centre, using the successful and well established Nottingham University Hospitals’ model.

This went live in November 2020 and allows those colleagues working on supported discharge to seamlessly receive ward referrals, manage a complex and dynamic workload, and have a clear oversight of which patients to prioritise at any given time.

The ICS has also benefited by the use of consistent technology, terminology and key performance indicators (KPIs) across the two trusts. 

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Before we had live flow we were very reactive, which was stressful for staff and made the team’s work hard to manage. Now, we’re able to plan proactively and monitor incoming work throughout the day. We can go straight to the patient record from the overview screen and immediately view information from all over the hospital. It’s better for the team and better for our patients.

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Improved bed management and data provision within our community settings

This project supports all the ICS bedded capacity (acute and community) to achieve at least a basic level of visibility of real-time patient level occupancy and data regarding ‘who is waiting’. This data will primarily drive internal flow but will also be accessible externally for the system-wide objectives of the Capacity and Flow programme.

In May 2021, Nottinghamshire Healthcare Trust delivered a complete digitisation project at Lings Bar Community Hospital, moving teams off paper and into a comprehensive patient and flow management ICT system. This saves time for staff and improves patient experience by reducing waiting and clearly indicating to our ward staff where action is needed to ensure a safe and timely discharge.

For every new admission, we are saving over an hour on administration and staff movement around the hospital.

Interoperable referrals between partners working together to support residents through hospital admission and discharge pathways

This priority encompasses a series of ongoing projects to build on exemplary interoperability work completed by Nottinghamshire County Council to automate social care referrals from partner acute and mental health services.

We are currently supporting a project to deliver interoperable discharge referrals and updates from Nottingham University Hospitals to Nottingham City Council, to reduce manual information gathering and the risk of miscommunication. We plan to replicate this approach for our community health partners, so that all hospital discharge referrals within the ICS are sent, received, and updated, automatically without double keying.

Managing and planning these projects collectively facilitates shared learning and standardisation across the ICS, and also gives colleagues working on similar projects for different organisations a useful forum for collaboration and peer support.

System-wide view of capacity and demand to allow the ICS to respond more flexibly when flow is disrupted or at risk of disruption

This project is an operationally-led initiative to create a meaningful view of those metrics which reflect both capacity and flow for all our key urgent and emergency care and discharge services, at any given moment. It will create a system-wide view which reduces operational barriers and improves transparency and ease of collaboration.

To ensure we deliver the right product for the operational and tactical teams managing resilience and flow across the ICS, we are conducting an extensive business analysis exercise with multiple stakeholders within each partner service, to ensure we deliver a tool that is relevant, future-proof, and supports the ICS to manage patient movement and safety as one integrated system.

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