What the HealthTech?

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Unknown
Hi. What the hell? Tech listeners, I'm your host this week. Mark Fewster. This is a podcast where we tackle some of the trending topics, ideas of best practice in health and social care. This week we're speaking to Marcus minus head of LFC and our less patient Sophia. And just Improvement. And Paul, you as risk manager at Milton Keynes University Hospitals, NHS Trust.

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Unknown
Marcus is a mathematician and health information scientist and has over 30 years of work and experience in the field of informatics. With the last 16 years spent in the NHS, he's been leading operation aspects of the and our less systems in its since its early days. And from August 2021 when learning from patient safety events went live. Max and his team have been supporting healthcare organizations and staff to transition to the new system.

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Unknown
Paul has worked for the NHS for over 17 years. He began working for hospitals across Buckinghamshire before moving to Cancer UK in 2008. It was here that his passion for risk management began. Paul led the implementation of radar health care and its integration with NHS. Is L.F. Pierce's PC system becoming the country's first organization? To do this outside of work?

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Unknown
Marcus has just finished his Ph.D. Imperial College London, and he's getting married in a few weeks. Congratulations, Marcus. He's a competitive rower and enjoys taking part in regattas and rowing championships, and Paul is happily married with two children, loves music, plays piano and saxophone. It's a local church and he's a massive Everton FC fan. I love the Pope.

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Unknown
Paul So it's probably going to be awkward conversation on Monday when we've won. So hi both and welcome to what the health tech. Hi, thanks for the introduction and no problem. You both need slightly shorter job titles I think because it took me a while to read those out. So in terms of today, I'd like to talk about I left PSA and basically the purpose of it, what we're trying to do with I left.

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Unknown
Percy was probably trying to solve and ultimately what are going to be the overall benefits to the NHS. So I guess Marcus is probably starting more with you. So what made the NHS start the PC projects in the first place? And ultimately what problem are you trying to fix? Yeah, so this is something that we always try to go back to, to visit all the time.

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Unknown
So why we're doing this and why this is necessary and why now so we as patients, the National Patient Safety Team at NHS England and NHS Improvement, we have the remit to to collect patient safety information from all providers of NHS funded care across England and for the last almost 20 years. So we've been doing that, relying in in what is today a kind of very old legacy systems, one being STI's that's been around for about 24 years and the other one is DNA release.

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Unknown
So the national reporting and learning system that has been around for 19 years. So not a lot has changed in terms of technology and they are cheaper and more efficient ways of doing things today. And so one of the motivations is to make sure that we benefit from the technology that's now available to us. And some of the problems that we are trying to solve is one around the time that it demands from NHS organizations to consolidate records, to generate example files and then log into a portal and then upload that to it to be able to share those records with NHS England.

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Unknown
So that's a lot of time that is required from the NHS providers. So we trying to move away from this manual process and make sure that things can can happen in the background where those records are shared automatically. So this is one main thing that is going to give a lot of release, a lot of time from staff within those organizations.

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Unknown
Then not just the issue of about up in doing the uploads, but also then going back and try and reconcile the data as well. So that's a big part of of, of this. And one so another problem that we're trying to solve is to make sure that we have a consistent taxonomy across all organizations so everybody can have all the organization and all health care staff within those organizations are presented with same set of questions and answers.

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Unknown
So this is to increase the validity and the utility of the data that we collect. So we try to improve data quality that not just in terms of unifying the questions, but also tackling issues in terms of timeliness of reporting by this now happening automatically through in the backgrounds. So there's a lot of data quality issues that we were trying to to improve or to address within within this new system.

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Unknown
Okay. My method point is and just a quick point, is that to that we have a DNA release forms that quite old and out of date and and provides very little functionality to primary care. So we're doing a lot of work under this development of a PSC to make sure we have a better product to serve primary care within England.

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Unknown
Okay. So I mean, you mentioned quite a few things that I think a couple of things interest me almost that the outcomes and the data integrity and the fact that you get in the information faster and in theory it's more accurate. What does that now enable you to do that? You couldn't do that now. And I saw if I'm from an NHS organization and I'm supplying this information to you, you know, ultimately what's what's the outcome for this?

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Unknown
What's what's the what's what's the real driver behind it. Yeah. So you don't before we had to to give like a a data cut data cut a cutoff date to organizations to make sure that everybody are able to catch up with their uploads by a certain date. And then after that, that will take about three months after that to for us to release the statistics that we would be able to create out of that data.

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Unknown
So that will no longer be necessary. So the data should be available kind of almost real time to organize sessions to access and make use of that. So we are developing new tools that will allow NHS staff to have access to that data quicker because it's quicker. Is is is is almost real time now available to us and we will pass on that that information to the access to to staff.

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Unknown
So we are putting together some before because of all this delay you take a long time for us to be able to create some any kind of analysis because we need to allow to have the right volume to start deriving insights and making assumptions from what the signals we're receiving as now everything is real time, so this insights can be available much quicker and accessible to everyone.

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Unknown
So the Alan left PSC of learning then how do we share that? How do how does that get communicated out? If you detect something, you find some insights. The information's telling you something. What's the plan for then? Disseminate that out to the to the people who were providing that information in the first place. Yeah. So as part of our left PSC, we are also going to develop kind of create a community hub for collaborate in this space for collaboration as well.

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Unknown
So we will still continue using the existing mechanisms to disseminate or information to the NHS, as we always did through the alerts and and other systems that we have in place for that. However, now within LRF, PSC is going to be a much more kind of self service approach so that people can go and search for things and get more information through our platform instead of wait to some kind of formal communication to arrive to them.

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Unknown
Okay, now this is a great idea. So that idea of a community then, is that something that would be open to us is kind of a local risk management system to also be a be a mechanism to share that learning? Yes. Is open to everyone. And even in in in terms of how we capturing the data now, we developed something that's about capturing examples of of good care and things that can help others to improve that systems and learn.

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Unknown
So yeah, that's open to everybody too. So create a community and has to be, you know, the, the, the, the vendors of risk management systems should be involved in to that because you guys you are the guys that going to enable the your your customers to make better use of this technology and the information that's becomes available to that through that technology.

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Unknown
So in terms of data, for example, whenever we make data available to the platform, so you would be able to extract that data and integrate that with any API solutions that you might have or any kind of dashboards that you offer to your customers. So you'll be able to plug in and enhance your products and enhance the information that you make available to to your customers.

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Unknown
Great. I can't wait to get my hands on that to before. So this I'm really interested in probably a maybe a difficult question. To be fair, what's your definition of success? So let's say for example, we've three years down the line, we've got some data in the system, we've got some examples of, you know, good care, good practice that we've shared.

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Unknown
How do you judge and understand if what you're doing is making a difference? Yeah, So this is a very key point for us because then they are the different dimensions to this one is is is the how happy the user is in terms of the system. So is it easy for the, the user to interact with the system and is it rewarding?

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Unknown
Are they getting anything back of that? So is that kind of around the user satisfaction? Mm hmm. That we will be measuring that around, that the the kind of the KPIs for a digital service. So the normal thing in terms of are you happy with the performance of the system, the you happy happy with the, the volume volume of information you receive and all of that.

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Unknown
But then there is another aspect of it is about measuring the impact. So how is that helping you to deliver or to achieve improvements within your organization? So is is trying to then measure that impact and this is another piece of work that we will be doing with the users and try to see how best to capture that.

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Unknown
And hopefully we we're going to be surprised by identify some some kind of positives or benefits that we even realized yet that it will be possible. So that's that's that's the goal and this is is about working with users measuring the the use ease of use of the application of the taxonomy and improving those things with that feedback and then make sure that we can link the use of the new system with actual impacts and improvement to outcomes of patients.

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Unknown
Yeah, I mean, ultimately, I guess this is the patient focus, the patient outcome and I guess if you've got that data, you've got I know you're almost Kate on the word benchmark, but you've almost got that stop point where you would understand his, his background run rate of incidents, for example, that certain locations have been once they have implemented good example of good care that might have originated in a different organization.

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Unknown
Even from that point, you can then track what impact it had. I think that I think it's really interesting. I think understanding it is a challenge we share as well. It's how do you how do you understand which things are making an impact? So how do you understand where to spend your time and where you did to spend your time?

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Unknown
Actually, did that have any meaningful impact? Yeah. And by for example, as I said in the beginning, that is about cutting off the system, some of the manual unnecessary jobs that can be done automatically. So it's that time that we're giving back to the local risk teams that they will be able to apply in other areas and then observe the improvements that they would be able to deliver with this extra time that they're going to have.

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Unknown
And then there's all this trying to monitor all of that as and capturing the this umbrella of impact and then see idea we will or hopefully we will see that translated into better outcomes for patients. And that's that's the whole goal. On testing. Paul, I'll just bring you in if I may. So I mean, are the first first just to go live, so well done.

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Unknown
So after just listening to Marcus there and obviously you've you've, as I said, just gone live with it. Yeah. What does that make you think about that in terms of how we are kind of submitting deaths and the benefits you might see as an organization? Yeah, I mean, we've already seen from from day one we saw the reduction in administration that Marcus was talking about.

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Unknown
So as soon as somebody submitted an instant it where we know it's gone to an FBC, we don't we don't need to do the the uploads and all the the bits that we needed to do with the NRC. So we see massive benefits there already. And so yeah, it's, it's been, it's been, it's been really good in terms of the things Marcus as we mentioned and about learning from that data and using those learning to then bring back into the organization and to implement improvements that that vision.

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Unknown
Then I think I'll be interested from a, from your perspective on that community and how you would tie in to that vision, because I think that's the goal, isn't it? Obviously we're talking about improving patient safety ultimately. That's right. Yeah, yeah, yeah. Ultimately that's the that's the goal to try med processes and and the care that we provide safer make make it more efficient, all that sort of thing.

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Unknown
So that goal of being able to look at things from a national perspective and learn things that are happening across the whole of NHS is really beneficial. And so getting that by much so I guess in that time back to be able to spend time on, on looking at those sort of things and looking at what the learning is, are really sort of vital in doing that really.

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Unknown
Is it a gap now? Is it something that you do as I'm going to just say, the NHS? But is it is it something to trust? Do you share this information now kind of outside of an hour or less? Is there any sort of a community where these things are shared or is this kind of a step towards that?

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Unknown
Well, I think it's a step towards that really. I mean, we it's mainly through the end, the release that we have that that community of see local organizations do so work together on on different things but not to the sort of the level I don't think to the level that we're talking about with the nevertheless well the PMC form as it is now.

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Unknown
So that could be like say that community if there's a community there so that we can have a mechanism for discussing things better than I think that can only be a benefit. And with you being the first, just to go live in terms of the feedback and, and you communicating back into Marcus in the team, how do you feel that's gone?

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Unknown
Do you feel like you've had the opportunity to, you know, contribute to or maybe shape the questions that they're asking? Yeah, definitely. I mean, you can you can say I mean, obviously they want the LFC to be a success, clearly. And it's really important therefore that they speak to and listen to the people that we are using on a day to day basis.

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Unknown
And so they've been really, really good at that, you know, so people can interpret questions in a slightly different way or not quite understand what it is. The questions asking or what the response means. And so by having that kind of feedback be, we've seen changes already. So we've we've already made sort of sort of feedback and comments and suggestions to Marcus and the team.

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Unknown
And we've seen some of those come through already. So, you know, there's a there's a good sort of relationship and feedback mechanism with the team. So yeah, it's been really positive. Great, Fantastic. So back to you then, Marcus. In terms of, you know, going life, we know we spoke probably a couple of weeks ago about NHS and good life deaths.

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Unknown
Can you just clarify the timescales? If you're an NHS organization or if you are an independent provider? Yes. So yeah, we need to to be very clear about that because we are the majority of the organizations reporting to the general. Yes. NHS trusts. I mean, using the and nevertheless reporting platform. All primary care has been transferred already into Alphabet at left PSC.

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Unknown
If an AI is to go within next. So. So the primary care is already using the the new general system and we have a number of organizations as to using the DNI or less. Most of them are NHS trusts. So for those, the expectation is that by the end of March 2023, so within 12 months, almost like 11 months from now, we expect that all those organizations will complete that transition.

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Unknown
So then we can start commissioning the less we will be. We are already decommissioning parts of the in our last, just to be clear about that, that the commissioning work already started so that the E forms would be used for ABI by most of the independent sector and primary care that all has been already transferred to the new platform.

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Unknown
So that's the kind of the timelines for the NHS trusts which are already, they are already reporting today and or less in terms of independent healthcare, that is, we is reporting from those organizations mostly voluntary so we can give them a deadline on anything or timeline because they might not decide not to join the the reporting through us.

00:22:03:03 - 00:22:42:21
Unknown
And that's absolutely financed out to them to make that decision. However, some of them they are providing service to NHS funded patients. They might have different requirements agreed locally, agreed with their commissioners, so they'd need to go and and play in line with already has been decided and agreed with the Commission as this commission as might say, that they expect them to be reporting to Lfb next month.

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Unknown
So that's if there is a kind of local agreement and relationship that and some of them might not have the the that feel that they don't want to join it. So therefore there's no kind of a timeline set to them. So it's more about their own decision. I, I see that most of the private organizations, independent health care provide us once to to report.

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Unknown
They want to join the the national report and they want to contribute to national learning. They also want to be able to learn from the insights and data that we will be making available. And therefore, that is a motivation for them to join that they can join at any time. So the system is live and they can use the online platform or if they have a local risk management system, they can come and talk to us and see how can we connect them as soon as they they want to move.

00:23:45:23 - 00:24:12:18
Unknown
Right. Okay. So in terms of a left pair, see them, what's next? So I know we've kind of talked about things like space. So what was the road map? What what comes next? Yeah. So we are working on the analytical part of the system. So the analytical tools that we making available to provide us, they are joined systems.

00:24:12:18 - 00:24:42:17
Unknown
So they are already a number of kind of analytical tools and functions that they can perform in a system, some data that they can already access, and we are working to enhance that. So as more organizations come on board, so more data becomes available, then more analysis we will switch on and types of analysis that will be able to to make.

00:24:42:17 - 00:25:19:19
Unknown
But we we need more volume of data so to to enable those functions. So we do a lot of work on that aspect as well as exploring the use of machine learning. Okay. If you to be able to generate those insights and also to monitor data quality. So you, you, you already are able to see things that when we scan for personal identifiable information, we send message real time to the user asking them to review the text.

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Unknown
And then we really point out what text that needs to be reviewed and so this is all making use of machine learning. And we go and we continue to explore that, to enhance the the this kind of a that's a use of data and any insights that we can provide. So that is as you said the that that the decommission of STI's and bringing that function that STI provide into health DSC so bringing the two systems together, the two legacy systems together and there are less and less PSC, but this is alongside the T Cerf So you might be aware that we have a new framework for this in terms of response to serious incident

00:26:13:05 - 00:26:59:20
Unknown
and, and this is this called like PSA and is something that we are piloting now with some early adopters. And we learned from that experience. And then we, we are working on the new version of the A C taxonomy that's going to be version six. We are now on live on version five, the next one, version six that we will include that kind of incident investigation, governance aspects that is existing in STI's and now which is going to be recreated on the lfb A C must not as is best but adapted to meet the new framework.

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Unknown
So this is one one of the bigger things that are coming this year. Okay. And I believe you going to have some sort of insight on that around June time. Yeah, we are expecting by June to be able to be sharing with the vendors the kind of what the what changes will be required. Yeah, but not making this live in June.

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Unknown
So June timeline is in terms of when I'm going to come to you and say this is the plan. Those are the new data fields and those are the new lists. And, and then we start talking about timelines for implementation. Okay, fantastic. In terms of today's session, then, guys, it's really interesting. I'm conscious. We've got to speak to Paul a little bit more on the next episode.

00:27:56:07 - 00:28:14:08
Unknown
So I'd just like to say thanks for joining us this week and thanks to everybody for listening. We're going to continue this conversation. As I've just said on the 19th of May. Next week is Mental Health Awareness Week, and we're talking to mental health First Ed Turner at Curve Learning. Georgina, please don't forget to subscribe whenever you get your postcode podcast from.

00:28:14:10 - 00:28:32:14
Unknown
And if you've got any questions for us or our guests, please email what the health check even read to health care dot com. Thank you.