East Suffolk and North Essex Foundation Trust, commonly referred to as ESNEFT, was formed on the 1st July 2018 through the merger of Colchester Hospital University Foundation Trust and the Ipswich Hospital NHS Trust. As one of the largest trusts in the UK, ESNEFT now provides hospital care and community health services for areas in or around Essex and Suffolk.
As the NHS looks for ways to consolidate and digitise health services, it has rolled out initiatives to enhance patient outcomes. Alongside this, the ‘Paper switch off’ programme starts on the 1st of October 2018, meaning all healthcare services within the UK have had to switch all GP referrals to be processed via the electronic referral service (eRS). Given these priorities, ESNEFT wanted to ensure it was on the front foot and make that digital change away from paper-based activities. The switch over to eRS was performed without hindrance, but this did not resolve the underlying problem. The process structure around referrals at ESNEFT was both manual and laborious.
After a patient had visited their GP and been referred to the trust, up to 15 pieces of data on information such as scans, blood tests and other results were manually downloaded and printed by hospital staff. Once printed, the information was collated by staff members, scanned into one PDF document and uploaded as a single PDF into the Kainos Evolve administration system. The time taken to perform this laborious process was considerable (around 20 minutes per referral), and when combined with the volume of referrals to the trust this created an administrative avalanche which detracted the medical secretaries from supporting consultants and patients.
Not only was the manual process slow, but the maintenance costs were around £220,000 per year. This was a culmination of direct costs such as ink and paper as well as time spent by staff on this task. ESNEFT identified that it needed to find a way to resolve this, for essential enhancements to patient experience.
ESNEFT had started working with Thoughtonomy on a pilot automation programme based around the accounts payable back office process. ESNEFT saw the potential of the Thoughtonomy Virtual Workforce platform to automate the GP referrals process, across all specialties. The aim was to make the pre-grading part of the referral process fully automated and, in parallel, exceed expectations on the NHS digital switch over initiatives. Working in partnership with ESNEFT’s automation team, Thoughtonomy specialists set about deploying Virtual Workforce to automate the 2,000 referrals that typically came into the trust each week.
Virtual workers now actively monitor incoming eRS referrals from GP patient appointments in real time, 24 hours a day. When received, the virtual workers trigger the automation process to immediately begin. They then extract the reason for referral, referral data and supporting clinical information and merge the information into a single PDF document. The virtual worker is provided with highly secure access to upload the PDF into the trust’s administrative systems using virtual smart card technology – all completed within minutes. The virtual workforce is able to update all systems, including Kainos Evolve, instantaneously and extract critical information, which it passes on to the lead consultant for review and grading.
Since its recent creation, the trust has taken guidance from a new philosophy ‘Time Matters’; a principle that is clearly represented in this project. With a flick of a switch, virtual workers have sprung into action to deliver automation of the GP referrals process, reducing the time taken from 25 minutes to just five minutes. The virtual workers have also released medical secretaries’ time to perform more value added and vocational tasks, such as patient interaction or driving forward internal improvements. In the first three months of launch across five clinical specialities, ESNEFT released 500 hours of time, reduced spend on agency staff, cut paper usage and more importantly increased job satisfaction for hardworking administrative staff; all of which makes for a happier workforce.
“Our trust has a philosophy that time matters,” said Darren Atkins, deputy director of ICT, ESNEFT. “Using Thoughtonomy’s Intelligent Automation platform has released time for our medical secretaries, freeing them up from simple and time-consuming tasks. This gives them more time to speak with patients on the phone or solve problems for doctors, nurses and other team members. All of this means our staff have more time to make a difference, which improves our patients’ care and experience. This is how we make time matter.”
The time saved for the trust, in combination with other materials needed for the previous process, means that the overall saving for the project is estimated to be £220k a year. Additionally, the process now means that the trust can reduce paper and be a role model for the NHS’ digitisation and automation efforts.
The team at ESNEFT already have ambitious plans beyond the transformation of the Neurology department processes and are planning to roll their Virtual Workforce solution out to other clinical specialties and departments. The Thoughtonomy Virtual Workforce is becoming an integral part of transformation plans and is consistently referenced as a way to make ‘time matter’ within clinical and corporate areas of the trust.
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