SPACE e-magazine (#2508)

Idea Description
Overview of Innovation:
We are pleased to launch the first edition of our SPACE e-magazine. Click here to view the magazine featuring the latest news from the SPACE programme including:
  • Care home managers participating in Appreciative Inquiry training
  • Two housekeeping staff who 'braved the shave' for MacMillan Cancer Support
  • A new project launched in Walsall to improve wellbeing of residents, staff and visitors
  • Interview with a new apprentice who has joined the Walsall SPACE project.
Hope you enjoy the e-magazine and if you have any questions about the programme, please feel free to get in touch.
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Innovation 'Elevator Pitch':
A modular university accredited programme which builds the skills, understanding, tools and confidence of NHS junior and middle managers to implement innovations leading to greater efficiency and rapid improvement in services for patients
Overview of Innovation:
The gap between research evidence and practice is significant for healthcare organisations.  Healthcare interventions which we know to be effective can take a long time to enter common practice, whilst others which we know to be ineffective can take a long time to be discarded. The implementation rates of quality improvement (QI) initiatives, for example, are believed to be lower than 50%. Implementing innovations is demanding of employees and organizations--cognitively, emotionally, and physically.. When attempting to implement innovations, organizations face challenges such as misaligned incentives, professional barriers, competing priorities, and inertia.
Studies of innovation implementation in health care settings have shown that middle managers can play an important role in enabling innovation, and supporting healthcare innovation implementation as information brokers - communicating, diffusing and mediating information flow between senior leaders and frontline staff. Middle managers with the capability and confidence to innovate and to lead service improvements are therefore essential if the NHS is to deliver radical and transformational change across whole healthcare systems. But evidence suggests that middle managers are often slow to adopt innovations, whether through generating ideas for improvement or creating opportunities for spread of good practice across departments and organisations.The enablers for junior and middle managers to become improvement leaders have been identified as:
  • proficiency with management skills and tools, (including financial, HR and workforce, programme, operational and strategic management),
  • skilled use of improvement science and quality methods,
improved personal impact on the wider system, through understanding how to influence, motivate and engage effectively with other practitioners at all levels. 

This new programme seeks to bridge the research/practice gap through combining academic theory and conceptual frameworks with practical skills-based learning and behavioural development approaches to support junior and middle managers to become confident improvement practitioners. The programme combines classroom-based learning with application to identified improvement projects, ensuring that academically-rigorous teaching is linked to work-based practice and is grounded in the needs of managers, their organisations and the people who depend on health services. 
Stage of Development:
Evaluation stage - Representative model or prototype system developed and can be effectively evaluated
WMAHSN priorities and themes addressed: 
Mental Health: recovery, crisis and prevention / Long term conditions: a whole system, person-centred approach / Advanced diagnostics, genomics and precision medicine / Wellness and prevention of illness / Education, training and future workforce / Wealth creation / Clinical trials and evidence / Digital health / Innovation and adoption / Patient and medicines safety / Person centred care
Benefit to NHS:
Every £1 spent on management development in the NHS needs to  be  justified.  Research   suggests   that   the   financial   benefits of   effective  programmes  are  potentially  hugely  significant:  equivalent  to  up  to  £15,000 per programme participant due to staff retention, innovations and  improvements  which  lead  to  cost-benefits  and  better  patient outcomes.   This   is   set   against   an   average   programme cost per participant of <£5500.
The development of junior and middle managers with the confidence and capability to lead and support innovation and improvement will have multiple benefits for the NHS. For instance, the swifter adoption of improvements in process efficiencies will generate cost benefits; innovations in support to patients will lead to improvements in patient experience; adoption of new technologies will lead to innovative ways of working across multi-professional teams; the spread of good practice will be enabled.
The programme will be relevant to acute, community and mental health organisations across the West Midlands.Relevance to primary care and general practice will also be key, and longer term to social care providers potentially.  It should also be noted that these organisations are small and medium enterprises and by coming together on this programme may generate opportunities for collaborative improvement efforts.
Through the development of a cadre of peer-evaluators the programme will also support the building of a critical mass of junior and middle managers in the West Midlands health system, aiding succession planning and ensuring that the business of innovation and improvement is not confined to senior leaders or to specialist practitioners.
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Initial Review Rating
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Benefit to WM population:
Managers will come to the programme with ideas for a change they want to implement, or recognition of a problem to resolve. These could include a focus on the adoption of new technologies, introducing new skill-mix to service delivery teams, developing fast-track surgical pathways, developing whole system approaches to improving long-term conditions pathways of careasset-based approaches to person-centred care, improvement in the management of mental health problems in A&E, home-based exercise for older people to prevent falls, opportunities for cost-saving through better sharing of data. Since most, if not all, of these issues will call for multi-professional involvement, we will encourage participants to come on to the programme in pairs, trios and small teams. This will aid the rapid spread of ideas for improvement, and have immediate impact on services.
The programme will also enable junior and middle managers to swiftly assess and select between competing opportunities for improvement, develop workable project plans and compelling business cases, secure engagement of key supporters and manage resistance, and develop appropriate metrics to measure progress towards anticipated benefits.
The programme will be constructed as a proving ground: a space in which participants can test their ideas for improvement, learn from experience of application and develop the learning, skills and competencies they need to be influential managers. As such the participants will develop their skills as innovators and entrepreneurs.

The programme will use peer-evaluation of progress as an element in the assessment of the Certificate, recognising that one test of managerial skill is the impact on others. In this way participants will become skilled evaluators and assessors of innovation, developing skills which are immediately transferable to the workplace. Finally the design of the programme will enable participants to build relationships across professional and organisational boundaries, one of the key enablers for more effective and productive system-level  innovation
Current and planned activity: 
In 2017 the HSMC undertook research work on behalf of the University of Birmingham Health Leadership Group. This involved meetings and interviews with the most senior leaders in health and social care across the West Midlands to ascertain the learning and development gaps in their workforce. A key theme emerging from this research work was the need in the NHS for further development of the practical skills needed by junior and middle management in order to properly and effectively improve services; implement innovative practices; lead people; manage resources; and enable change. Aligned to this feedback was a request to support team development and multi-professional education and training. We have continued to work with NHS organisations and leaders to develop the ideas which underpin this programme proposal, which now includes opportunities for peer challenge and support, shadowing and developing system sightedness amongst junior to middle managers.
What is the intellectual property status of your innovation?:
The IP resides with HSMC at the University of Birmingham.
Return on Investment (£ Value): 
Return on Investment (Timescale): 
3 years +
Ease of scalability: 
Regional Scalability:
Please describe how the innovation could be scaled across the WM region. Have you implemented at scale in any other regions?
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?
Rejection Reason:
Board decided not to support - feedback provided and innovator decided not to pursue
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Overview summary:
The film was developed by Wessex AHSN and will support practitioners with discussions with patients on anticoagulation but also be a tool that patients can return to after discussions in clinics. 

Anticoagulants are prescribed to prevent harmful blood clots that can lead to stroke.  They are designed to prevent or treat clots, but can increase the risk of bleeding. Patients and carers need advice and information about how these medicines work, and their potential side effects. To view the film in full please click here
Challenge identified and actions taken :
Many people taking anticoagulants don't fully understand what side effects to look out for, or when to seek help.  Starting Anticoagulation with Jack has been created to prevent people becoming unwell while on anticoagulant medicines, and avoid unnecessary admissions to hospital.
Impacts / outcomes: 
Anticoagulants are prescribed to prevent harmful blood clots that can lead to stroke.  They are designed to prevent or treat clots, but can increase the risk of bleeding. Patients and carers need advice and information about how these medicines work, and their potential side effects and to help them to improve adherence to prescribed medication.
Which local or national clinical or policy priorities does this innovation address:
Reduction of unwarranted clinical variation in Atrial Fibrillation
Supporting quote for the innovation from key stakeholders:
We’d like to share our new anticoagulation film with you and ask you to share it with your networks.
It would be really helpful if you could consider how it can be made easily accessible to patients to support them with anticoagulation treatment.
Plans for the future:
The West Midlands AHSN is working on an Atrial Fibrillation, (AF), programme to support clinicians, patients and their carers in the detection and treatment of AF.  We have an Advisory Group and plan to launch the first part of our project in May.  We will be developing a toolkit to support clinicians, patients and their carers.
Tips for adoption:
This film has been developed after significant research into what patients and their carers want to see.  It can be used to support clinicians explaining about the treatmen they are prescribing.
Contact for further information:
For information about our West Midlands programme contact:
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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): 
Return on Investment (Timescale): 
2 years
Ease of scalability: 
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.
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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