Shift Organiser (#2885)

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Idea Description
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Innovation 'Elevator Pitch':
An app designed by a Midwife, with the aim to help healthcare professionals manage their tasks and workload whilst on duty.
Overview of Innovation:
The idea stemmed from working on the wards during the 12 hour busy shifts. At handover, you are informed of all the tasks required for your patients and the only way of knowing what needs doing is by memory or writing things down on scrap peices of paper. During the 12 hour shifts, I found it easy to forget all the tasks as call bells would be ringing and many questions asked by patients. The fear of forgetting led to my idea, Shift Organiser. It is an app designed to act as an alarm system stating what is due and at what time. For example, bed 2 is due antibiotics @ 14.00.

The app provides a clear and systematic digital way of all that needs doing during the healthcare workers shift, anything overdue (if they are too busy) will appear in one column and everything complete in another.

My aim here and being a healthcare professional myself is to try and help healthcare workers such as nurses and midwives manage their heavy workload. With the growth and inovation in digital health I have come across new ideas and concepts with the aim to help the public and patients. Whilst I am all for this, I thought I would try to do something for the healthcare workers themselves. I also have the aim of keeping it simple. I have had first hand experince on the wards with being introduced to new 'tech - heavy' ways of working, which some nurses have found hard to use. The whole purpose of Shift Organiser is to be simple, quick and helpful.

I am now seeking any advice in the world of digital health which can further develop the use of my app. I am very open and appreicative of any ways in which help can be offered.



Stage of Development:
Evaluation stage - Representative model or prototype system developed and can be effectively evaluated
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Innovation 'Elevator Pitch':
LASSO utilises disruptive 'Uber style' technology to introduce a unique approach in nurse recruitment. It enables the immediate supply of higher quality, temporary nurses to the healthcare market at half the current cost. 
Overview of Innovation:
LASSO is an innovative technology solution aimed at addressing the crisis in healthcare recruitment. A unique, mobile-centric platform has been created to allow healthcare workers the ability to directly interface with hospital providers through a simple, user-friendly, free smartphone app. This eradicates the need for third party agencies and gives workers full control back in terms of managing their own lives, at their own convenience. The same technology can also be utilised to manage hospital temporary staffing 'banks,' without the need for employed bank administrators and managers.
 
This disruptive technology enables immediate supply of higher quality, temporary staff to the healthcare market at significantly reduced cost. Currently, £3.6 billion is spent on NHS agency staffing pa with this spend recognised as one of the most significant causes of deteriorating hospital finances. Unfortunately, this spend sits alongside a noticeable decline in the quality of temporary staff, traditional recruitment agencies knowingly making excessive margins, aging IT platforms resulting in inefficiency and declining productivity, and antiquated, manual paper-based processes operated by teams of administrators.
 
LASSO utilises ‘Uber’ and ‘TripAdvisor’ style technology to eradicate unnecessary manual intervention. Its unique and dynamic system and simplicity of process are offered for instantly seeking/booking temporary work and immediately receiving feedback/rating on the service provided. This responsive approach not only increases productivity and removes un-necessary waste,  but it also  delivers millions of pounds of savings to healthcare organisations. LASSO’s pledge is to re-invest a proportion of any profit back into training and education to increase and incentivise its future partnership. LASSO believes its approach and value proposition will not only drive up quality but also support the retention of UK trained nurses, Allied Health Professionals (AHPs) and doctors.
 
With an annual 28% increase in NHS agency nursing spend and NHS organisations now fined for agency overspending, Introducing such a unique product with significant customer/user value proposition into a sector that has experienced little disruption in 15 years, will result in rapid time to value. 
Stage of Development:
Close to market - Prototype near completion and final form may require additional validation/evaluation and all CE marking and regulatory requirements are in place
WMAHSN priorities and themes addressed: 
Education, training and future workforce / Wealth creation / Digital health / Innovation and adoption
Benefit to NHS:
Economic- LASSO will provide significant direct and indirect savings to NHS providers. In terms of direct savings, LASSO recruitment fees will be at most 50% of the current fees charged by the traditional recruitment agencies with an instant realisation of benefits as the savings are shift related.  Initial projections highlight this equates to millions per annum (pa) for most Trusts.. More efficient automation will result in indirect savings through increased productivity with the release of workforce time and the introduction of a paperless framework.
 
• Social- one of LASSO’s major aims is to instantly improve its partners' quality of life and give back direct control of working life. Staff are empowered and able to immediately post when and where they wish to work rather than wait for third party intervention. Equally, providers have the opportunity to post shifts immediately and choose who fills the shift in a more responsive way informed by staff rating. Receiving feedback through the rating system, makes staff feel valued and appreciated at work and provides motivation to 'be the best.'
 
• Educational - LASSO believes, with a 20% reduction in applications for nurse training, investment in future partners is critical. Once financially stable, LASSO will therefore invest in the training and education of new and existing staff. This investment will be in the form of free extra placements/courses and costs are built in.
 
• Political– recognising the NHS is 'publicly' managing the largest deficit it has ever faced, there is now a strong political imperative to reduce spending. Agency staffing cost accounts for one of the largest contributors to this deficit with most trusts spending millions pa. This scenario is compounded by the fact that the quality of temporary staffing is falling resulting in the potential for patient safety to be compromised and for trusts to face reputational and regulatory pressure. With no market transformation  or alternative approach, trusts are struggling to comply with the new targets. LASSO will address this.
 
• Environmental - transforming the recruitment and placement approach from a traditional administrator-led, paper-based process to one delivered through innovative technology offers real, tangible benefit that can be instantly realised. A paperless system removes any waste associated with documentation and waste disposal.
Initial Review Rating
2.60 (1 ratings)
Benefit to WM population:
The LASSO project aims to commence its implementation in the West Midlands region as the first roll out area. Projections across the West Midlands region calculate the potential NHS saving to be around £10m pa. LASSO has already partnered with Worcester Hospitals NHS Trust to act as the pilot Trust. It will therefore be Worcester that work directly with the LASSO team to refine the project and make it individual for their nurses and ‘shift bookers.’ They currently spend £7.7m pa on agency nursing fees of which £1.2m is recruitment agency costs. LASSO will therefore save the hospital up to £600k pa on agency spend.
 
Worcester currently have a contract for their ‘bank staff’ with NHS Professionals (NHSP). This contract is due to expire, and as the service provided is of poor quality (less than 28% of shifts filled) and expensive, the Trust have  also agreed to work with LASSO to develop a bank product. They will serve notice on the NHSP contract and once the LASSO bank product is developed they intend to purchase bank nurses from LASSO, which will not only provide savings but offer a significantly higher quality of service. Once both LASSO products are embedded in Worcester, they will be rolled out across the West Midlands and then other regions nationally.
Current and planned activity: 
Engagement with the NHS can be challenging, based on the complexity of the organisations and the political agenda. This challenge has been simplified with several of the LASSO leadership team are already known to the NHS and well regarded. As such LASSO has already undertaken engagement with a number of NHS organisations including NHS Trusts and NHS Improvement. St Bartholomew’s Hospital (a LASSO partner) worked with the development team to help scope and create the LASSO prototype, through a number of user workshops. Nurses and ‘shift bookers’ engaged to describe the challenges they faced, inform the team of the flows associated with existing process and then redesigned these flows and the associated requirement to inform the prototype design. LASSO has shared its aspirations and work directly with NHS Improvement to get their full ‘buy-in’ to the programme and the team have now commenced engagement with a number of West Midlands Trusts to prepare for the first regional roll-out. 
What is the intellectual property status of your innovation?:
As the technology itself is not new, Intellectual Property does not apply in this instance. The innovation comes from the use of this technology to transform temporary nurse recruitment. LASSO has protected this innovation with robust Non-Disclosure Agreements (NDAs) being agreed with all organisations prior to formal engagement.
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
2 years
Ease of scalability: 
3
Regional Scalability:
The Business Case and associated Implementation Plan propose the roll-out of the product across the West Midlands over a 24 month period. This allows for lessons learnt to be understood and embedded for every new site, to ensure the technology is highly responsive to users, potential future partners and other commercial opportunities. Positive conversations have already commenced with Trusts who are due to be targeted after the pilot site.
 
Measures:
LASSO will provide direct and indirect savings for NHS organisations with an 'increased volume/reduced cost' model seeing providers paying a baseline cost which is 50% lower than the current commercial rate and as the volume of LASSO shifts posted and filled increases, so the costs of buying LASSO shifts fall. This saving, along with fill rates and speed of shift fill will be monitored and reported on a monthly basis to all Trust Boards as part of the project.
 
The Trip Advisor App embedded within LASSO provides the opportunity to instantly measure and feedback on the quality of the temporary workforce being utilised. This unique system offers both nurses and providers the opportunity to rate each other and provide feedback - something both parties expressly requested in the workshops. This information will be utilised by LASSO and the organisations to monitor and check quality and inform required changes as necessary.
 
In line with all healthcare providers, LASSO will ensure all regulatory and compliance standards and requirements are met, with the use of technology being utilised to simplify this protracted process and also ensure that all appropriate checks are undertaken and recorded electronically for reference. 
 
Within the individual nurse profile sits a full training and education profile which will need to be reviewed and updated to support ongoing LASSO compliance/registration. This information is then stored in the form of an electronic 'training' passport which nurses can share with Trusts and other organisations. This information can also be utilised to assist in training and development programmes. Once a 'swell' of nurses are registered on the LASSO system, LASSO has agreed to share regional and national workforce information to support workforce planning and education programmes.
Adoption target:
There is a proposed detailed phased roll-out plan of all the West Midlands Trusts highlighted with the Business Case. This has been designed to ensure early adoption within less complex organisations followed by an ability to scale up at pace and market the opportunity to numerous customers, once the implementation model is proven.
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Innovation 'Elevator Pitch':
MedsMinder is designed to help people improve their medications taking with behaviour change principles so that they can fully benefit from the medications their doctors prescribe for them. Reducing wastage, facilitated by pharmacists and SBRI

 
Overview of Innovation:
MedsMinder is designed to help people improve their medications taking so that they can fully benefit from the medications their doctors prescribe for them. The NHS works hard to help people improve their health, yet much of the drugs budget is wasted, and people’s health deteriorates when people forget to take their medicines correctly, and we want to help patients and the NHS to improve.
medsminder is being developed by ADI in Saltaire, Bradford, under the SBRI-Healthcare programme funded by NHS England. Its purpose is to develop effective ways to help people improve their adherence to prescribed medication, which will both improve their health and help the NHS avoid waste.
It builds on the behaviour change work of Dr Ian Kellar, Associate Professor of the School of Psychology at the University of Leeds. For more information, contact Dr Kellar ati.kellar@leeds.ac.uk.
The programme is being facilitated by Prescribing Support Services (PSS)
Secure integration into clinical systems  and pathways. Allows trusted two-way flow of information between patients and professionals such as pharmacists and clinicians, that can be relied and acted upon.  Data on adherence, per medication dose, is available to clinicians/pharmacists via the clinical portal. Clinicians can message users individually or as a group.
 Much more impact on long-term patient engagement and  adherence than “free”, timer-based apps. The psychological basis is founded upon Behaviour Change principles supplied and guided by Prof Ian Kellar, University of Leeds: Essentially this aims to involve the user in creating and maintaining a routine that supports his/her personal lifestyle. 
Specifically:
  • Planning - the user decides when to schedule medication doses not based on clock time, but on routine event cues, such as meals or other daily activities. 
  • Logging - this is self-monitoring of medication taking, which is known to report actual adherence far more accurately than retrospective self-reporting.
  • Routine awareness - the app knows when and where you actually take doses, and adapts and learns what normal behaviour is over time, thereby allowing more appropriate reminders and prompts.
  • Multi-language support 
  • Digital ordering of repeat prescriptions.  ( which is flagged to clinicians and pharmacists). 
Stage of Development:
Close to market - Prototype near completion and final form may require additional validation/evaluation and all CE marking and regulatory requirements are in place
WMAHSN priorities and themes addressed: 
Wellness and prevention of illness / Wealth creation / Digital health / Innovation and adoption / Patient and medicines safety
Benefit to NHS:
Estimation only as under evaluation:
  1. Summary of  financialsnd your estimate of ROI for the CCG
    • Estimated ROI for CCG :
      • Meds Companion users show improved  average adherence >15% vs baseline, across a range of medications ( Ian Kellar).. Translates into  different benefits and savings for the CCG eg improved control of type II diabetes using monotherapy and concomitant reduction in more expensive dual/triple therapy. (see example). Estimate minimum £250,000 in-year cash savings to Bradford CCGs with 50% takeup of the Meds Companion service, as well as longer-term improvement in outcomes from better adherence.
      • Meds Companion users have increased and convenient engagement with the repeat prescription ordering process, synchronising this with actual logged consumption, thereby reducing oversupply and enabling instant switchoff of unwanted repeat ordering.   Estimate minimum £50,000 in-year cash savings to Bradford CCGs from unwanted or premature repeats based on 50% usage of Meds Companion
=> estimated total in-year savings of £300k.
Online Discussion Rating
6.00 (1 ratings)
Initial Review Rating
3.80 (2 ratings)
Benefit to WM population:
There a great need for prescription waste reduction across all CCGs, the AF Programmes of care with new drugs is also key.
With regards to AF, adherence 
Current and planned activity: 
We are keen to work with any CCG, NHS Trust which is looking to reduce wastage, has an AF or Diabetes programme that needs some adherence tools for patients or has programmes which suite the MedsMinder app.
What is the intellectual property status of your innovation?:
ADI own the IP
Return on Investment (£ Value): 
medium
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
2
Regional Scalability:
Please describe how the innovation could be scaled across the WM region. Have you implemented at scale in any other regions?
Measures:
What outcomes are you hoping to achieve and what are the measures that you will use to gauge the success of the innovation and how will these assessments be made? Please ensure that you have quality, safety, cost and people measures.
Adoption target:
What are the targets for adoption across the WM and what are the minimum viability levels?
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Innovation 'Elevator Pitch':
Patchwork is an award-winning solution built by doctors and HR managers, that connects NHS organisations to a growing pool of healthcare workers, reducing the reliance on locum agencies and improving the experience of flexible bank working.
Overview of Innovation:
Patchwork is an award-winning solution built by doctors and HR managers, that connects NHS organisations to a growing pool of healthcare workers, reducing the reliance on locum agencies and improving the experience of flexible bank working. 

Patchwork’s mission is to completely revolutionise the way temporary staffing is currently managed; helping NHS organisations save money, free up time and improve patient safety. 

Firstly, Patchwork helps NHS organisations save money and gain financial control by connecting staff banks directly to healthcare workers without agencies. Secondly, Patchwork frees-up time and reduces stress by automating complex and repetitive tasks. Thirdly, Patchwork improves patient safety by increasing bank fill rates to ensure safe staffing levels with compliant workers. 

Patchwork does this all via its mobile app for bank workers, and a cloud-based software for hospital managers. The solution is entirely tailored and flexible to each Trust’s unique challenges, and is implemented by Patchwork’s team of specialist temporary staffing advisors.

Patchwork is built in partnership with Chelsea & Westminster Hospital NHS Foundation Trust. It has been appointed as a Crown Commercial Services supplier for Flexible Resource Pool (RM6158) and is co-owned by the British Medical Journal; reaching over 72,000 doctors every week.
Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
WMAHSN priorities and themes addressed: 
Wealth creation / Digital health / Innovation and adoption / Patient and medicines safety
Benefit to NHS:
 
Example of Patchwork’s impact at Chelsea and Westminster Hospital NHS Foundation Trust:
  • Since the launch of Patchwork’s first pilot at Chelsea & Westminster NHS Trust, the Trust has seen:
- £1.2 million saved annually on agency spend
- >90% fill rate Bank vs Agency
- 500% increase (1490 doctors) on staff bank
- 84% of shifts booked 4 weeks in advance
 
Patchwork primarily targets hospital efficiency & reduction of agency spending but could equally be used by smaller clinical establishments.

Reduced Reliance on Agencies
  • Major Efficiency of spend - Cost benefit of £15,000 and £20,000 per mth for every 10% conversion of doctors and nurses respectively from agency to bank staff. Est. saving of £750,000+ per year in costs (from junior doctor shifts alone).
Recruitment Support
  • Increase of clinicians in staff pool – Flexibility, personal control & transparency
  • Competition for available shifts – leading to early booked shift vacancies
  • Competitive adjustment of hourly rates – Staff selecting their own pay-rate (in Confidence)
  • Real-time data - Increase in proactive planning – Wards, Departments and Locums selecting their preferred shifts - Gamification
 
Automated and Streamlined Service
  • Reduction in Workload of HR by reducing the administrative burden of managing the bank. Removal of inefficient and unreliable methods of communication, such as interrupting clinicians with numerous cold calls and emails to establish availability and firm up bookings.
Morale Increased
  • No high Staff turnover 
  • Ability to take on other productive tasks e.g. recruitment drives
  • Greater Cross-cover for unfilled gaps in the rota – ability for staff to gain new experiences and insights
  • Minimum Admin Stress – reduction of time pressure
  • Reduced Workload for staff bank – reduced chasing and changes to information
     
 
Quality
  • End to mistakes due to human error & associated costs.
    Paperless Timesheets and payroll outputs for finance, meaning fewer errors and reduction of Admin & Finance time dealing with queries & disputes
  • Increase of full shift coverage – leading to less stress for HR staff stress and clinical/ward staff stress
  • Increasing the Choice for HR staff due to large pool of Trust staff being available
  • Better Management oversight on locum activity and spend
  • Consistent and trusted locums – Staff who know the hospital systems, procedures and protocols
  • Fewer opportunities for errors due to unfamiliarity with the hospital or insufficient induction
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
Within the Management Function, Patchwork facilitates:
  • Better Recruitment Support - The platform has a recruitment tool to manage candidate applications - onboarding and verifying new locums.
  • Efficiencies of a Streamlined Service - Platform streamlines the entire shift booking cycle & improves adherence to operating procedures and policies.
  • Insights via Feedback and Rating System - Clinicians can be scored on their care quality, communication and punctuality. To ensure quality control and rehire-ability.
  • Informative Powerful Dashboards - Data is presented in dashboards, providing management with real time insights into all locum activity.
  • Finance / Operation Service Improvement:
    • Reduction in delayed staff payments due to removal of paper timesheets not arriving with finance in a timely fashion.
    • Reduced the time it takes to process weekly payrolls.
    • Captured escalations and virtually eliminated unwarranted and unauthorized escalations in participating departments.
    • Department managers have more visibility over the locum activity in their areas by accessing real-time and department-specific dashboards.
 
For other benefits please see previous sections.
See http://patchwork.health for further information
 
In early 2019, the NHS published its Long Term Plan which set out how “improved technology will mean that services are organised and delivered more efficiently, which will contribute to improved productivity.  One of the key areas for improvement is in delivery of temporary medical staffing where the national picture suggests medical banks are on average used less effectively than for other staff groups, with less than 1 in 4 temporary staffing shifts being filled by a bank worker rather than agency.

In order to maintain patient safety, it is imperative to have adequate ward cover of medical staff.  Patchwork streamlines the recruitment and onboarding of bank staff to join York Teaching Hospitals and helps to improve overall fill rates.  Patchwork empowers these (often substantive) staff who are familiar with the patients, policies and procedures of NHS organisations to work additional shifts rather than relying on agency staff who often only work on a very short term basis.  As reported by a study in the King’s Fund (2018), patient experience is negatively associated with “higher spend on agency staff and fewer doctors”
 
Current and planned activity: 
Patchwork is currently live in twelve NHS Trusts. Plans are to continue to expand into other NHS organisations, development of collaborative banks and movement into other staffing groups. 

Requests: 
Opportunities for:
  • Links to relevant stakeholders and acute Trusts
  • Promotion of the benefits Patchwork can bring to their organisations – reduced reliance on premium agencies, improved patient care, huge cost savings, ensuring safe levels of medical cover, increased morale.
  • Accelerate adoption of Patchwork innovation
  • Bringing data-driven decision making to organisations and collaboration (e.g. control centre)
What is the intellectual property status of your innovation?:
The software is copyrighted.
The system and  App is password protected and has basic encryption
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
0-6 mon
Ease of scalability: 
Simple
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