National Health Executive Podcast

With the brunt of winter fast upon us, and the flurry of increased demand that has followed, the NHS is drawing upon all its nous and creativity to see how it can generate efficiencies and optimise patient pathways.With that in mind, National Health Executive sat down with three leading industry voices to discuss how we can arrest the backlog and keep patients flowing in and out of the door this winter. CommunicationOne of the more notable things that was addressed during our discussion was the necessity of not just communication but effective communication – that doesn’t just apply to patients either, it also includes colleagues and sector partners too.Sue Moore, the Director for Outpatient Recovery and Transformation at NHS England suggested that by collaborating with the NHS’s various regional bodies, Primary Care, the Royal Colleges, and sector providers, the healthcare industry has an opportunity to identify what ‘best practice’ is – or, at the very least, what best practice is not.This is one of the “key areas” being focused on by biopharmaceutical research and development experts AbbVie, according to its Head of Medical Affairs for Immunology, Rachael Millward.She said: “One of the key areas that we are trying to establish is how do we, as an organisation, partner better with the NHS?”Because it is only through that communication and collaboration with providers and stakeholders that the health sector can establish what best practice – the best practice that will help serve the seven million people who are currently waiting for treatment.One of the best examples that was mentioned was Super September, where providers are given the chance to trial small initiatives and ideas that might help expedite treatment pathways.What Sue and her colleagues at NHS England found was that, during the two-week period in which the Super September scheme ran, over 66,000 more patients were seen and “significant” inroads were made into the lists housing the very longest waiters.Sue explained: “Some people did some work on Did Not Attends, some people did work on the validation of lists and asking patients if they still wanted or needed that appointment, there was work on looking at how clinics are constructed and the templates [they used] – a whole range of things.”But the question is, how do we take initiatives like Super September and scale them up? How do we ensure the best and most effective methods are adopted nationally? Because as is said a lot in this industry, and indeed many times during our discussion, there isn’t one thing that is going to solve everything; there is no panacea for patient backlog and treatment pathways – one size does not fit all.The answer: That word again – communication.One of the first things Sue noted on the podcast was what the Outpatient and Recovery Programme is focusing on. Two of those things were ensuring that patients see the value of even going to an appointment in the first place and the other centred around exploring and developing the idea of creating clinical environments where patients, who are medically suitable, can initiate their own follow-up appointments. Or in other words a patient-initiated follow-up (PIFU).The key to achieving success in both those areas goes hand-in-hand – by empowering patients and seeing them more “as a partner”, as Rob Music the CEO of The Migraine Trust alluded to, the health sector can help patients see the value of appointments and give them more ownership over their care.By doing this, and providing patients with the requisite education around the relevant diseases, clinicians can help the public optimise their own treatment pathways and reduce delays and waiting times. TechnologyGuidance around how best to implement PIFUs was released by NHS England back in May 2022; the document detailed everything from how many specialities to start up with and what specialities are even suitable, all the way to the benefits and potential pitfalls of this method of care.This is also something AbbVie have been able to help other providers with. Rachael explained that when they collaborated with some rheumatology services and explored the potential of PIFUs, a lot of services said they still needed help developing and then establishing their PIFUs. She said: “It became very clear to us that we needed to help services connect together, so that they could understand what the pitfalls are, what the hurdles are, and what are the things you need to consider in order to set up a PIFU service that would be successful, whilst also mitigating some of the challenges.”It was then flagged how a lot of “myth busting” needs to be done around PIFUs and how some staff’s notion that they would be overwhelmed by an avalanche of triggered appointments isn’t actually true – or doesn’t necessarily need to be true.As long as you have the right technological infrastructure in place, implementing successful, effective, and efficient PIFUs is “not that difficult to do,” according to Sue.Sue explained: “There needs to be a really effective tracking mechanism to enable patients to trigger an appointment, if they meet the criteria. But similarly for the clinical team to know that a patient has triggered an appointment.”Sue added: “For me, this is about confident patients, clinical leadership, and being really respectful that not one model fits all.”In support of that mantra, Sue’s Outpatient Recovery and Transformation Programme worked in conjunction with the Getting It Right First Time team to produce outpatient guidance for the top 10 by-volume specialties that identifies, by subspecialty, which people would be suitable for PIFUs and which people would not.Sue commented: “It collates all the best practice guidance of really where you start, and what we've said on an individual basis is we're very happy to support and make the connections for people to do that.” Final thoughtsRachael Millward·         There isn’t one thing that is going to solve everything – it will be a range of different factors and measures that combine to achieve the desired outcome.·         But we also need to be clear on what those desired outcomes are and understanding that patients present in very complex ways.·         PIFU and education around things like remote monitoring will be a key part of that solution. Sue Moore·         Providers need look at the entire pathway when exploring innovations and they need to employ an enthusiastic approach and drive themselves forward to implement the necessary change.·         Communicate, collaborate, and congratulate.·         Use technology for the right reasons and when it is necessary, rather than for the sake of it. Rob Music·         More people need to be trained as specialist GPs and nurses, drawing upon some of the best practice in the community.·         Better leadership from ICSs in terms of their service design and how patients interact and ... 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In this episode of NHE's Finger on the Pulse podcast our host, Saskia Hicking, speaks with Dr Giles Yeo,a Geneticist at Cambridge University and Dr Stephanie De Giorgio, a General Practitioner, about the stigmas that surround obesity and why we as a society suffer, not only physically, but also mentally with the affects of being overweight. Whilst our guests look to help raise awareness and educate health professionals on how to correctly treat and talk to obese patients, we delve into the solutions our healthcare system could adopt to abolish obesity stigma. Hosted on Acast. See acast.com/privacy for more information.

In this episode of Finger on the Pulse, NHE's Saskia Hicking spoke to Alex Church, programme lead at Norfolk and Waveney CCG about some of the ways his group are preparing for the introduction of the ICS and how he thinks this new way of working combined with digital technology will help to create a better care system for all. Hosted on Acast. See acast.com/privacy for more information.

On Episode 26 of NHE's Finger on the Pulse podcast, host Matt Roberts is joined by Jon Constantine-Smith, Managing Director of Bluetree Medical, to discuss how the organisation adapted it's manufacturing line to produce face masks for the NHS, and why it has now become a long-term direction for the business. Hosted on Acast. See acast.com/privacy for more information.

On episode 25 of NHE's Finger on the Pulse podcast our host Saskia Hicking spoke to Anne Cooper, former Chief Nurse for NHS Digital about the benefits and drawbacks of implementing technology and digital within the NHS. Hosted on Acast. See acast.com/privacy for more information.

“What we’ve got to do is look at what is the impact of having a wound infection, or a surgical site infection, on the patient, on the doctor and the healthcare professionals, as well as the economic burden within the NHS.”As somebody who has become highly knowledgeable on these what these impacts of a surgical site infection (SSI) are, it is why Giles Bond-Smith is so passionate around improving the processes and attention paid to it within the NHS.The Emergency General/HPB surgeon at Oxford University Hospitals NHS Trust joined host Matt Roberts on NHE’s Finger on the Pulse podcast discussing some of the challenges commonly faced around this type of infection prevention, but also the opportunities to innovate as well.“We should be doing everything possible to look at how we can mitigate surgical site infections for our patients.“Typically, as surgeons, we don’t really pay much attention to our wounds, but the patients do. How does a patient judge whether an operation went well or not? They look down at their wound; they see how big it was.“If the wound is less in size than the wound is in their mind, they think we’ve done well. If the wound heals beautiful, people show it and say the operation went very well.“Whereas, if someone’s had a complete wound dehiscence due to infection, they feel the operation was a disaster. Now, it might not have been, but that’s how the patient perceives it, and we’ve got to take this more seriously.”But how do we tackle surgical site infections and ensure the wounds can heal neatly, safely and quickly for the patient?One of the ways, as Giles explains during the podcast episode, is to look at some of the really simple but innovative technology out there – such as the antibacterial Ethicon PLUS sutures he and his team uses – as ways to improve patient outcomes without having to drastically alter the way in which these surgeries are performed.Much of the success instead can come from small, incremental gains in the procedures, awareness and tools being utilised by surgeons.Listen to Ep 24. of NHE’s Finger on the Pulse podcast with Giles Bond-Smith  Hosted on Acast. See acast.com/privacy for more information.

What leads to a digital healthcare solution being adopted?Every situation is unique across the healthcare service, but often these innovations span out of some of the simplest of circumstances. For Open Medical’s Innovation Director, Piyush Mahapatra, he remembers the instance of a cleaner accidentally wiping down a whiteboard which had been used to track orthopaedic patients. A momentary lapse in the system, which presented a sudden challenge and an opportunity for a digital alternative.“I’m a practising orthopaedic surgeon in London, and an NHS clinical entrepreneur.“Most patients who have surgery for broken bones within the NHS are often managed on systems such as Excel sheets, Word documents or physical whiteboards.“In our particular organisation, it was a physical whiteboard and, we came in one weekend and the cleaner had rubbed the whiteboard off.“After that, version one [of our trauma digital solution] was created. It was a fairly simple database system at that point, designed to help manage those lists of patients in a better way.“Since then, things have really moved on [at Open Medical]. We became a cloud native platform in 2017, and things really escalated. Now, we’re helping about 70 NHS trusts around the country manage their patients.“We’ve got over a million patients on our systems today.Through Open Medical, Piyush and the team have been able to leverage their own personal clinical experiences to develop a solution which addresses a significant need felt in the NHS, with patient management, pathways, and efficiencies. It has been built to address a need Piyush and his colleagues themselves feel in their regular NHS roles, and allows the team to talk clinically with partners, as well as technologically.“One of the things that I tell everyone is that I use [our Open Medical system] when I’m working clinically. We all use our systems quite a lot.“We get a real understanding of what it is like to utilise the platform, so if things are not user-friendly or don’t work as well as they should, we can adapt and change them.“We can get that feeling if something doesn’t provide the functionality clinicians need, because we see it from that perspective too.”  Hosted on Acast. See acast.com/privacy for more information.

On Episode 21 of NHE's Finger on the Pulse podcast, host Matt Roberts is joined by Matt Inada-Kim, Irem Patel and Catherine Dale to discuss how pulse oximetry was identified and scaled out during the pandemic to support the pandemic response. Matt, Irem and Catherine offer a range of different perspective, brought together by the Health Innovation Network South London. Hosted on Acast. See acast.com/privacy for more information.

On Episode 20 of NHE's Finger on the Pulse podcast, Dr Shanti Vijayaraghavan of Barts Health NHS Trust and Will Warburton, Director of Improvement at the Health Foundation, join host Matt Roberts to discuss the innovative work on video consultations that Shanti and her team have been carrying out for a number of years in Newham, in London. Hosted on Acast. See acast.com/privacy for more information.

On Episode 19 of NHE’s Finger on the Pulse podcast, host Matt Roberts is joined by Annie Laverty, Chief Experience Officer at Northumbria Healthcare NHS Foundation Trust, and Will Warburton, Director of Improvement at the Health Foundation, discussing an innovative ‘Corona Voice’ staff wellbeing programme being ran at the trust.Annie explained: “Looking after your workforce is really important. It makes sense from a human perspective, as you want to hold onto good staff.“The NHS relies on the goodwill of people being deeply committed to a purpose to provide the best care to patients, but we know that providing that care sometimes comes at a cost to individuals.“NHS organisations need to do all that they can to protect staff wellbeing because we know that it is inextricably linked to the care that patients receive, and also the safety and reliability of those organisations.”The trust’s Corona Voice programme came out of a project being undertaken before the pandemic, to provide more up-to-date data and staff feedback to the trust and which allowed Northumbria Healthcare NHS FT, alongside support from Will and the Health Foundation team, to expand the scope of the project and better understand and support their trust colleagues through the challenges of dealing with Covid-19 and hospital care.Listen to the full episode of NHE’s Finger on the Pulse podcast with Annie and Will above. Hosted on Acast. See acast.com/privacy for more information.