What the HealthTech?

Mark Fewster: 00:10

Hi. What the health tech listeners? I'm your host this week, Mark Fewster. This is a podcast where we tackle some of the trending topics, ideas, and best practice in health and social care. This week we're back speaking to Marcus Manhais, who's heading up LFPSC for the NHS Improvement Team, and Paul Ewers, who's risk manager at Milton Keynes University Hospital NHS Trust, to continue the conversation we've been having around LFPSC and the implementation.

Mark Fewster: 00:36

So, Paul, I basically just start by saying well done. So, you're the first just to go live, I believe.

Paul Ewers: 00:43

Yeah. Yeah.

Mark Fewster: 00:44

Yeah. And I guess the launch of LFPSC was a bit of a double whammy for you because you had to swap your, systems over as well, so you're going with live with radar and LFPSC at the same time. It must have been a bit of a challenge, I guess.

Paul Ewers: 00:58

Yeah. It was a challenge. It's been it's a positive one, but it was, yeah, yeah, it had it's has been a challenge. Has been a challenge. So, yeah.

Paul Ewers: 01:05

I mean, the the it kinda started really several several years back where we, had our, obviously, our existing system, and we wanted to find a system that was able to do what that could do. Obviously, moving into, more upstate technology, but also to be able to, do other functions. So audit and document management were 2 things that we were very interested in moving across into the system. So kind of during 2021 mainly, we were looking we we looked at several different systems Yeah. And made decisions move across the radar.

Paul Ewers: 01:41

And then quite early on in that project of of, looking at the implementation of that, we started looking also at the LFPSC and, moving across to that as well. So, yeah, it was, it was was quite a challenge. There's still challenging moments as I'm sure you'll you'll you'll know any any implementation of an IT system. There are challenges and Yeah. Absolutely.

Paul Ewers: 02:05

But,

Mark Fewster: 02:06

I mean, why is why is why is choice, though? Picking radar, but yeah. Not not that it's a good plug. So tell me about the successes then. You know, what what you're happy with?

Mark Fewster: 02:14

What's gone really well?

Paul Ewers: 02:17

Yeah. So we kinda touched it on the previous, podcast, but one of the big things, we saw it from from day 1, a significant decrease in the administration time, for the instance and, you know, not having to, upload them onto the NLS. It just reports directly as soon as, when our reporter completes the form, press submit, it it then goes across. So it's been significant, amount of, administration time that that's that's helped with. And it means that our team can concentrate and and the investigators can concentrate on making sure the data is accurate, rather than having kind of the uploading side of it.

Paul Ewers: 02:55

So if we notice something that's perhaps not as it as it should be or something that's incorrect or something we discover later on that makes, the information that we've that the reporter put through, change, then, we can update the system, and then it replaces on the LF or PSC. So, you know, all all of that kind of upload time, you know, that's that's been a a huge thing from day 1 that's that's helped.

Mark Fewster: 03:21

And in terms of that implementation, both from ourselves and and Marcus' team, I mean, is there anything that you would have done differently?

Paul Ewers: 03:30

So, I mean, due to the timing of the implementation, and the time it took for the, to do the NLS mapping if we were to to move, system onto NLS mapping. Yep. It did kind of, direct us down the path of going straight with the LFPSC at the same time. And I guess in truth, we probably would have done them separately and and gone for radar first, got it settled in a bit, and then slightly later on, gone for the LFPSC section. But that said, you know, Milton Keynes is kind of, an innovative.

Paul Ewers: 04:02

You know, we like like to do things first. And so it kinda didn't phase us doing both at the same time. But probably in in retrospect, you know, we we probably would have chosen to have done 1 first and done them as 2 separate change projects rather than, doing 2 things at once in in in a way. But as I say, it was it was positive, and the responsiveness from, what both teams, the LFPSC and and and radar has been, fantastic. So we've been able to provide feedback and and work through things.

Paul Ewers: 04:33

So yeah. No. It's it hasn't really, phased us. And we guess the other thing probably would we'd probably would have liked to have engaged staff more on the LFPSC, before we went live. That's probably the other thing.

Paul Ewers: 04:47

So, I guess, because it became part of the project quite early on, that was good. But I think we would have liked to have perhaps let them know a little bit more, I guess, from because, obviously, LFPSC is very focused on national learning Mhmm. Just from a national perspective. And so the questions in there are a little bit different to what the the the, day to day instant reporters are used to. So probably giving them a little bit more of a heads up around that would have been would have been something we would we would have done in in retrospect.

Paul Ewers: 05:23

So, you know, but it it's one of one of those things because we're in an acute trust, and there's hospital pressures. We we need to be flexible and adaptable. So, you know, the the the plan that we put in, you know, we felt that we could still still go with that. And and we're keen to sort of share our experiences so that other trusts can, can learn from those things. So, you know, that's probably one of the things I would say, to, people looking to do it.

Paul Ewers: 05:48

It's just to make sure that the staff are aware that, that is kind of a national perspective that it's looking at. So the questions aren't quite what they'd necessarily be used to filling in, before moving across. Just just more of a heads up than anything. So they're, prepared for that.

Mark Fewster: 06:05

So, I mean, how did you go about doing that then? And and almost we mentioned it in the previous podcast. Did you did you did you sell the vision and the types of things that Marcus was talking about in terms of the, you know, the why? Why is it we're capturing this data, and and what what difference is it going to make? How did you engage, you know, your employees?

Paul Ewers: 06:23

Yeah. I mean, obviously, they, were already well, generally, they're all they were aware of the, NRELs and the reasonings behind that. And so, obviously, we could we could kind of add to that about the LFPSC. So the, you know, making sure there's shared learning across the, across the whole NHS, not just our our trust. But one one of the things we did do is kept the the two forms kinda separate.

Paul Ewers: 06:49

So Mhmm. You would complete, you get early on, you get a question, does this involve patient? If it does, then the LFPSC form effectively appears, sort of for them to work through. Again, just so that we could kinda separate this and say, okay. These questions are from a national perspective, and then they can kinda go to next form, and then that's what Milton Keynes Hospital need for, local learning, kind of a probably sort of detail that's more relevant locally than from the national's perspective.

Paul Ewers: 07:22

I guess some of the, the the data that isn't isn't required for LFPSC. So I think that's kind of one of the key things we did with the engagement. We have kept them quite separate. Obviously, it's, you know, relatively early days or any kind of, what, about 5 months in roughly. Yeah.

Paul Ewers: 07:38

So we we'd we'd kinda review that. So it might be that we, feel that now that people are kind of familiar with the system that that we look to, you you know, perhaps change how we've got it. But I think that was I think it was the right decision to go with these 2 separate forms, so that it or 2 separate steps, if you like, on an instant form, so that it was easier for them the the users to understand the, different perspectives of the form and why those additional questions were there.

Mark Fewster: 08:09

Yeah. I mean, I guess that's an important point as well, isn't it? This doesn't stop you from asking the questions that mean something locally. So it's not you're not restricted to just answering the LFPSC question set. You're actually you can support that question set with things that mean more to you locally.

Mark Fewster: 08:24

And again, I think Yeah. You know, working with with us as a team and working with Marcus, that's kind of been a big thing, isn't it, about how we use radar to make sure we're still capturing that local information as well.

Paul Ewers: 08:35

Yeah. That's right. That's right. And and and one of the challenges is, always, trying to make, reporting quicker and easier. Yep.

Paul Ewers: 08:44

And, I guess one of the things, that did become apparent because these are from a different perspective and different questions, we what we haven't been able to do is reduce how long it takes. But, I think if we hadn't gone with the NLFPSC and we just had the Milton Keynes form, it would have been quicker and easier to report. But it's kind of with those additional questions, it's kinda brought it up to about the same length of time. So, I think as we kinda touched on, making sure that staff are aware that, this is all about learning, about making it safer, making improvements. So, actually, that bit of time, you know, the the time it takes to report is worth taking.

Paul Ewers: 09:25

Yes. Because, obviously, time's precious in all organizations, but particularly the NHS and in clinical areas that report the majority of the incidents. But actually that if the time is well spent, then it's it's worth doing. So I I think it's kind of finding that that balance between trying to make it short as possible, but also making sure we capture what we need to be able to learn, and improve because ultimately, that's that's what the whole purpose of it is.

Mark Fewster: 09:51

Yeah. Absolutely. And I guess back to back to the vision thing of if if you've communicated that as to what you know, what's the purpose behind what we're trying to do here. And and ultimately, you know, once you're starting to get information, feed it back through an RLS that should be showing you or or even, you know, other trusts giving you information where you can improve that you might not currently be doing. So yeah.

Mark Fewster: 10:10

I think I think you're right. Even if it does take a little bit longer sometimes, that's not necessarily a problem as long as the, you know, the outcome is the right outcome. So a question for you and Marcus now, and, you can you can be honest even though I'm here. So how was it kind of working kind of across teams and and working with us at Red Eye Healthcare? I'll ask Paul that first.

Paul Ewers: 10:32

Yeah. Yeah. Just yeah. I wasn't sure if Marcus could answer that first, but, no, that's fine. Yeah.

Paul Ewers: 10:37

So, I mean, from from day 1 when we spoke to, Radar, they talked about seeing it as a, as a partnership, rather than just us purchasing a system, if you like. So working together, working things through where where there are things. And I would say kind of, you know, over a year on, that that kind of relationship's still still there. You know, you you can see it's more of a partnership than, just being given a system to to go ahead and and work on. So that's that's really good.

Paul Ewers: 11:05

I mean, the team were always friendly, knowledgeable, and yeah, it's pleasure to work with them. Similar with, NHS England, as I say, they've always been, open to feedback and and, able to sort of be responsive, and make changes he needed to. So, yeah, hoping, overall, really, really pleased.

Mark Fewster: 11:24

Good. That's good to hear. And yourself, Marcus, how has it been working with?

Marcus Manhaes: 11:29

Yeah. No. That's fine. It's absolutely fine. It's, I I honestly, I found it very easy, and, because as I think we we develop almost like a a kind of a good, I hope we have developed a good relationship and then even a friendship out of this.

Marcus Manhaes: 11:50

And, and I believe that that was due to the fact that when we first met and and and sat down to discuss the the what what LFPSC was trying to achieve and then we will be able to identify common interests and goals. So we were there trying to achieve kind of similar things. So it's about making the reporting experience bet better to the users in in more rewarding and more valuable and make the best of that time that they have to to invest in in in in providing the information. So we have that in common, and then that kind of help us to to to almost like we we we we, once you have the shared vision and we we're clear that we both are trying to achieve similar things, then the collaboration came quite easy.

Mark Fewster: 12:52

Good. That's good to hear. And I think you're yeah. I mean, you've hit the nail on the head there. It's about it is about that vision, and we're both ultimately trying to achieve the same goal, which is

Paul Ewers: 13:01

Yeah.

Mark Fewster: 13:02

To reduce incidence and to improve patient safety. You know, we and we're kinda going about it the same way. So that's that that that's good to hear. So another question for yourself, Marcus. In terms of kind of working with Milton Keynes then and that kind of feedback mechanism, because I'm guessing when you you know, as as we onboard more trusts and obviously more people are moving over, that kind of work with Milton Keynes and that kind of engagement.

Mark Fewster: 13:23

How how do you kind of one, how did that go? And then, I guess, in future, how do you foresee that working with others who were coming on board?

Marcus Manhaes: 13:32

Yeah. I think that that, is going really well because first, there was a relationship already there by then being under the NHS family. And they were already our kind of customers in the sense of by being an organization that already was reporting into the NOLS and already had some interactions with us and already so you were already there to support them, when they were connected to the NLS. And then, and they were open to and brave to to be the first ones to go live and then and that was really exciting. And we we, start engaging with them and explain, look.

Marcus Manhaes: 14:19

This is, we don't have all the answers yet. We're learning, and we're gonna learn together in this process. And Yep. We're here to listen. We want to receive your feedback.

Marcus Manhaes: 14:28

This is and and we are honestly listening, and we are making change based on this, on the feedback that we receive. And I think that's as as as Paul mentioned before, this is exactly what is happening. Yeah. It was it's it's it's a very it's a very good collaboration, and, and still, there's a lot more as we both are evolving. Then now they are best placed to help us with the use of data that now we're making available to them.

Marcus Manhaes: 15:03

So they are the first ones to provide data. And, obviously, they're gonna be the first one to make use of the data and the insights that we're able to to generate with the data that you're giving us. So that work will and this partnership will evolve and continue.

Mark Fewster: 15:20

Great. And probably final question then for yourself, Paul. In terms of, you know, another NHS NHS trust going live, what advice would you give them from what you've learned working with, you know, radar, and the LFPSC team?

Paul Ewers: 15:34

Yeah. So I think that we've just got a cup covered a couple of them already. Like you say, it's about sort of sharing that vision with the with the, with the staff so they know why we're doing it. It's not just a change for change sake. It's Yep.

Paul Ewers: 15:46

You know, there's a real vision behind it, and it's all around patient safety. So it is it is important. I guess to say that, you know, you will be supported through it. I'm sure there were things in in the background from a technical perspective. But, from, my my experience, it was relatively smooth moving across to the LFPSC from, NLS.

Paul Ewers: 16:10

So I guess what I would say is, you know, don't don't be afraid of it. It's, something that, you know, it's it it will involve. It will you know, there will be, some challenges. So, you know, you'll be able to provide feedback and and and make it smoother. But it was actually relatively speaking, it was a a a quick and and sort of smooth transfer across from from our perspective.

Paul Ewers: 16:35

I'm sure there's a lot more work behind the scenes.

Mark Fewster: 16:38

Perfectly smoothly outside as well. Okay. Great. So in terms of kind of final question for you both, it's a a what the health tech moment. So at the end of each episode, we're asking everybody to describe their what the health tech moment.

Mark Fewster: 16:51

It's basically a question for a bit of fun, and we're after kind of a weird or wonderful story that you might have experienced in kind of your your work in health and social care. So I'll I'll pick on you first, Paul. I don't know if I don't know if you've got anything for us, but

Paul Ewers: 17:06

Yeah. Well, one one of the things that kind of impacted me most, I think, was the first time I saw, there was a TED talk by doctor Brian Goldman, called doctors make mistakes. Can we talk about it? It's a really, really powerful, video where he shares kind of real life experiences where he's made mistakes and has tried to talk to people about it, and talk about culture, but, you know, you can't you can't share. You can't, you know, talk about things.

Paul Ewers: 17:33

It really highlights the importance of open, being open and learning from mistakes, and it's, yeah. So it's a really, really powerful video. It kind of tackles it through, humor and sadness, all the different emotions you when when you look through it. But that that kinda really struck a chord when I when I saw that. And it kind of really kind of, I guess, links in with the LF about the learning from you know, making sure we are sharing, we are learning, and making improvements.

Paul Ewers: 18:03

So, yeah, that that was a really, you know, one of those wow moments. It's kind of that I can't cross.

Mark Fewster: 18:11

Well, send us a link.

Paul Ewers: 18:13

Yeah. Yeah. We'll do. Yeah. Yeah.

Mark Fewster: 18:14

Yeah. We we can

Paul Ewers: 18:16

in our training, for instant reporting in in in the past, as well to sort of share it with staff. It's definitely would recommend it to, sort of people interested in, kind of health care and, and sort of patient safety. But yes. Yeah. Really good.

Mark Fewster: 18:32

Great. Yeah. Yeah. Please send a link over. I'll definitely have a have a watch of that.

Mark Fewster: 18:35

And then same question to yourself, Marcus.

Marcus Manhaes: 18:38

Yeah. One of the things that I can think of is, back in 2007 between 2,007, 2008, when we started to publish, the the numbers of incidents reported into the NLS broken down by organization. So we we we put that on our website. Yep. And then by that information being available to patients in public, it really, kind of triggered the whole, I think, a change in the reporting culture across the NHS.

Marcus Manhaes: 19:19

Because after that, numbers start to increase and everything organization that were was not reporting, then they start reporting, and and people really start paying attention into this because of what's out there. So it's the power of of of sharing data and make the data available, and people really can see what's going on, who's reporting, who is not, what numbers, and and all of that. There was a big shift in terms of reporting culture across the NHS from that that moment when we, publish the data. So that was quite interesting and some is one of the things that comes up to my mind.

Mark Fewster: 20:00

Okay. Well, thank you both very much for your time. Kinda leave it there. In terms of, next week, we're going to hear from Hannah Wilkinson, head of people and culture at Radar Healthcare, about how a positive work culture can help health and social care organizations hire and return staff. Please don't forget to rate and subscribe wherever you get your podcasts from.

Mark Fewster: 20:21

And if you have any questions for us or our guests, please email what the health tech at radarhealthcare.com I've got it right this time. Thank you.