Impact review 2021-22: transforming lives through innovation

Medicines safety

211,362 patients have moved to electronic Repeat Dispensing

173 delegates attended our QI for Pharmacy series

In the last year, our work to improve medicines safety has continued to evolve and progress. New projects have focused on medicines compliance aids and quality improvement for pharmacy teams.

Quality improvement for pharmacy

The quality improvement for pharmacy series has been a brilliant five weeks; it has been fun and informative.

Training attendee

In recent years there has been a step change to make pharmacy professionals a first point of call for healthcare information alongside more traditional settings, such as general practice or emergency departments.

Pharmacists and pharmacy colleagues, as experts in medication management and optimisation, are ideally positioned in the healthcare system to improve current processes and reduce avoidable medication-related harm. Despite playing an integral role in preventing and managing drug-related errors, pharmacists often lack the basic tools required to lead or participate in quality improvement (QI) initiatives.

That’s why our Medicines Steering Group identified QI in pharmacy as a priority focus area, recognising that improving awareness, and use of QI methodology and techniques in pharmacy would also have longer-term benefits for our wider opioids and polypharmacy programmes.

To support the development of QI skills we held a Pharmacy Showcase in January 2022, attended by 26 delegates. This support package was further developed into the first West of England Academy QI series, specifically tailored to pharmacy teams.

Across five sessions in March 2022, 173 delegates learnt the basic theory of QI, gained practical knowledge of applying techniques to pharmacy and were equipped with resources to help their teams embark on QI projects. 100% of attendees said they would apply the learning to their role and would recommend the series to others.

Read more about QI for pharmacy

Reducing reliance on medicines compliance aids

Working with an active steering group made up of 13 organisations and trusts, in the last year we have progressed our work to reduce the reliance on medicines compliance aids (MCAs), commonly known as dosette boxes. MCAs are often perceived as the ‘go to’ reasonable adjustment when patients are struggling to take their medication(s). Promoting alternative reasonable adjustments – following an assessment by a pharmacy professional – has been identified to be important in improving medicines compliance.

MCAs are not always used appropriately, and evidence shows they can actually increase risks to patient safety as people become unsure which medication relates to which condition. MCAs can also lead to increased waste as prescriptions change and are time consuming for pharmacy teams to package.

Building on our community pharmacy research during 2021, we are developing a suite of resources for healthcare professionals in primary and secondary care alongside an educational animation for patients and carers. These include a standardised assessment form based upon the Equality Act (2010) and an accompanying explainer poster and video.

Read more about our work around medicines compliance aids

Medicines Safety Improvement Programme

I was amazed at the difference in interruption numbers between the different round times. Some of these were avoidable, and some are not or at least less avoidable. The data we collected helped us see this, and that the simple changes we tried can make big improvements.

Vicky, St George’s Nursing Home in Worle

The Medicines Safety Improvement Programme aims to reduce medication-related harm in health and social care, focusing on high-risk drugs, situations and vulnerable patients.

The programme contributes to the World Health Organisation’s ‘Medication Without Harm’ challenge target for 2023 to reduce severe avoidable medication related harm globally by 50% over five years.

The first ambition of the 21/22 programme was to reduce medicine administration errors in care homes.

To support this ambition, we have focused on working directly with two care homes to develop interventions to reduce interruptions during medication rounds. Read more in our blog by our Programme Manager. Data collected demonstrated a reduction in the number of interruptions in one home and increased consistency in days without interruptions.

The second ambition of the programme is to reduce harm from opioid medicines by reducing high dose prescribing for chronic non-cancer pain.

We have been working with regional stakeholders to gain a better understanding of high-dose opioid prescribing at a local level. Together we contributed to the NHS Improvement-commissioned real-world study to find best practice interventions, alongside supporting field testing to inform the national programme’s approach. Our regional scoping will inform the next phase of this programme in 2022/23.

Read more about the Medicines Safety Improvement Programme

Polypharmacy: getting the balance right (STE)

On behalf of the AHSN Network, we have led the scoping of a new national polypharmacy programme, which is now being commissioned by NHS England as an adoption and spread programme by all 15 AHSNs in England.

The programme launched in April 2022 and aims to support local systems and primary care to identify patients at potential risk of harm through the taking of multiple medications and support better conversations with patients about medicines by promoting shared decision making.

One of the core principles of the programme is population health management. To consider how best to understand and utilise available data, alongside the AHSN Network and NHS Business Services Authority, we organised two webinars in March and April 2022 attended by 366 delegates. A third webinar was held in May 2022.

Read more about the polypharmacy events

Transfer of Care Around Medicines

Since 2018 we have supported the AHSN Network’s national Transfer of Care Around Medicines (TCAM) programme, and all acute hospital trusts in the West of England have implemented a TCAM approach.

During the last year, our focus has pivoted to supporting patients discharged from mental health settings, and we are working with working Avon and Wiltshire Partnership Mental Health NHS Trust and Avon, Swindon and Wiltshire Local Pharmaceutical Committees.

TCAM identifies patients upon discharge from hospital who may be at risk from adverse effects from medication or need help with their medicines and refers them to their usual community pharmacy for advice and support. As one of the few AHSNs who have rolled out the TCAM approach into mental health settings, we are sharing learning with colleagues from across the AHSN Network to inform the national approach to supporting patient discharge.

Read more about TCAM

The West of England Academy

This has first class content delivered by genuinely well poised experts. The raw content is an unbeatable overview of the key aspects of healthcare innovation.

Academy delegate on our new innovation course

903 delegates attended Academy events in 2021/22

Supporting health and care professionals and industry innovators gain knowledge and develop essential skills for innovative thinking and working, our popular Academy continues to deliver a wide range of events, training and resources.

Last year’s events and training programme included two quality improvement (QI) series, including our first tailored to those working in pharmacy. We also held a theory of change evaluation webinar in partnership with NIHR ARC West, two skills to lead change sessions, and a course on human centred product development and design. In May, we offered our first small group face-to-face learning since the pandemic on Coaching for QI and Psychology for QI.

Last year all our Academy courses were run successfully online with 903 delegates attending. For the first time, our QI series are now CPD accredited.

Introduction to innovation in healthcare

In the last year we have developed and launched our second massive open online course (MOOC) in partnership with the University of Bath. The introduction to innovation in healthcare course, hosted by Future Learn over four sessions, is available to learners across the globe all year round. To increase engagement with the course and embed learning, we facilitated three cohorts of learners, enabling participants to ask questions and received feedback from the lead educators.

Since launching in July 2021, 827 delegates have signed up to take the course. Our previous MOOC, focused on QI in healthcare, continues to support hundreds of learners every year through the Future Learn platform.

Free online recourses

Our West of England Academy also provides a range of free online resources. In the last year we launched a Creative Problem-Solving Toolkit (accessed by more than 530 users), a guide to creating QI posters (viewed 690 times) and most recently a workbook which takes project teams on a QI journey through structured exercises and activities. Our Academy webpages continue to provide users with high quality information and resources with more than 9200 users this year. All resources are freely available on our website.

To support the healthcare workforce, following a resilience for managers workshop in March 2021, the Academy developed a suite of free video-based resources to help healthcare professionals learn about and practise techniques to grow emotional resilience. These videos offer simple techniques to support personal wellbeing whilst encouraging self-reflection. So far, our emotional resilience resources have been watched by 700 people and continue to be shared across social media.

Supporting the innovation journey

The Academy is for all health and care professionals, frontline, support services and commissioners, plus academics and innovators living, working or planning to work in the West of England.

We cover the full innovation journey, from gaining a greater understanding of specific opportunities, developing creative ideas, prototyping and testing of solutions through to gathering evidence to support implementation and evaluation. Free resources to support the four-stage innovation journey are available on our website.

Read more about our Academy

Evidence Repository

That staff member who requested the search commented that ‘I found the local projects identified in this the most beneficial in our future planning as they were practical in application as opposed to purely hypothesis and small studies.’ After this initial success, our Knowledge Specialist Team have now incorporated the Repository into our list of resources for evidence search requests.

Katie Barnard Knowledge Specialist, Library and Knowledge Services, North Bristol NBT Trust

Our Evidence Repository offers a FutureNHS workspace for the safe sharing of non-peer reviewed documents not published elsewhere. The repository promotes a culture of shared learning and collaboration and aims to reduce duplication. We set up the repository in partnership with colleagues from our local integrated care systems, hospital libraries and the University of the West of England.

With 142 registered users, representing at least 49 organisations, the Evidence Repository continues to grow. In January 2022, 72% of users said they would recommend the repository to a colleague. Based on user feedback, this year we have since expanded the content to include surveys and supported all users to be able to upload their own documents.

Find out about our Evidence Repository

Supporting industry and innovation

£7.3 million leveraged by innovators through grants and private investment with our support

124 innovators supported by our industry and innovation team this year

7 jobs created or safeguarded by companies we’ve supported

5 evaluation reports published on pilots testing innovations in real-world settings

124 innovators have attended our Health Innovation Programme (HIP) since 2015

Despite the continued challenges of the Covid pandemic, we have provided essential guidance and a signposting service to healthcare innovators developing products and services with the potential to improve patient outcomes.

Through its support to innovators over the last year, our industry and innovation team has helped companies to leverage £7.3 million through grants and private investment.

The successful culmination of our Future Challenges programme, despite all the projects suffering disruption due to Covid, provided valuable data to support innovators in building their evidence bases, as well as providing insight to our local partners. One of our programmes, Keeping Active during Covid, was shortlisted as Most Promising Pilot Programme at the Leading Healthcare Awards.

We continue to refine and improve our offer to innovators, our innovation pipeline to accelerate the selection of the most promising innovations for expediated support to meet local NHS needs.

Visit our Innovation Exchange

Health Innovation Programme

The HIP provided us with a good introduction to business and operating in the NHS. It supported us to improve ideas and our business case and provided insight to improve strategy. It started a thought process that ultimately led us to pivot our business model to be more NHS focussed and integrated.

Carey McClellan Founder/CEO of getUBetter

Our Health Innovation Programme (HIP) is a healthcare innovation business development course, helping healthcare entrepreneurs test the validity of their business models and understand how to pitch their propositions to the NHS, amid a very complex NHS business landscape.

We have run the course in partnership with SETSquared, the global no.1 university business incubator, since 2015. Many of the innovators who join the programme are at the very early stages of their company’s journey and are still developing their proposition.

2021 saw our eighth cohort of HIPsters graduate, delivering ten new alumni. Innovations in development were wide-ranging and included a non-invasive blood glucose monitoring technology, a specialist provider of mental health and emotional assistance interventions for marginalised communities and a remote physiotherapy service provider who utilises 3D motion sensors.

To date, our programme in the West of England has supported 124 healthcare entrepreneurs across the region to develop businesses that improve patient care, generate savings for the NHS, create jobs and economic growth. We have supported the development of a wide range of innovations, including a breastfeeding support app, a digital platform for the self-management of pain, services that support mental health issues and promote wellbeing and a rehabilitation solution for patients with neurological conditions.

getUBetter, a pain self-management app founded by Dr Carey McClellan, is now deployed in the NHS and occupational health sectors across South London and South West England and is prescribed by clinicians (GP, physiotherapist, occupational health) during patient consultation. Dr McClellan has recently been announced as an NHS Innovation Accelerator fellow.

Find out more about our Health Innovation Programme

The Future Challenges: validating innovations in real-world settings

Our Future Challenges programme, which has been a ground-breaking new way to support innovators and local partners to pilot innovations and validate them in a real-world setting, completed its first round of projects and pilots during 2021-22.

The key aim of the programme, which commenced in 2019, was to generate evidence to support the wider introduction of promising new innovations to address an identified health and care challenge. The two themes for which innovations were sought and trialled were:

Under the Keeping Healthy at Home theme, two successful projects ran during 2020 and completed in 2021 and the full evaluation reports are now available: Replenish-ME and Moving to Better Health. Both explored the use of detailed activity tracking as part of a wider clinical approach to tackling chronic health problems. We added a further pilot in response to challenges faced during the pandemic, Keeping Active during Covid-19, to support maintaining physical activity levels amongst patients with a respiratory diagnosis who could not access pulmonary rehabilitation during lockdown.

As part of the Young People and Mental Health Resilience theme, we successfully ran two pilots in secondary schools: MiHUB and SmartGym Gloucestershire. MiHUB used an interactive avatar-based approach to help young people with self-reflection and coping skills. SmartGym Gloucestershire employed weekly physical and mental performance drills, led by trained staff, to explore topics surrounding motivation, focus and resilience.

Find out more about our Future Challenges and read the evaluation reports

Academic partnerships

The NHS offers significant opportunities for academic research ideas and innovations. Similarly, university academic research portfolios hold huge potential for the NHS.

To connect academia with the health and care systems in our region, we hold strategic partnerships with the University of Bath, the University of Bristol and the University of the West of England (UWE). As part of this programme, we co-fund two shared posts with Bath and Bristol.

Through these academic relationships we identify emerging research and promising innovation with the potential improve health and care. In return, we offer academic innovators support to help them prepare for and navigate the complex NHS as a marketplace.

We have also supported a programme between UWE’s Bristol Robotics Laboratory and North Bristol NHS Trust, exploring the potential applications of robotics and autonomous systems to support patient care and staff training. This has focused on the use of remotely controlled telepresence robots to support medical training, enabling doctors to carry out remote ward rounds.

Transforming with digital

Our team at Bath and North East Somerset, Swindon and Wiltshire (BSW) CCG have thoroughly enjoyed working with our colleagues at the West of England AHSN, who played a crucial role in securing regional funding from NHS England to scale up our work programme. They also helped us to shape our approach to the planning and delivery, which has made a real difference in releasing clinical time to care for patients within the care homes who have adopted the new system.

Jason Young Assistant Director of Digital Transformation at BSW CCG

2,820 hours of care home time saved on registering new residents through introduction of new electronic health records in Bath and North East Somerset, Swindon and Wiltshire

87% of GP practices in Bath and North East Somerset, Swindon and Wiltshire are now using a new digital system to access clinical advice and guidance

At the West of England AHSN, we have always advocated a joined-up, system-wide approach to embracing the opportunities and tackling the challenges around the digital transformation of healthcare.

The approach to using digital tools and services is undergoing a seismic shift across all our systems. Although many of the technologies adopted during the pandemic were already in use in some geographies, in many cases they were not widely implemented or evaluated in any depth and their impact on systems, services, workforce and citizens is only just emerging.

We recognise the vital importance of innovative digital tools and services to the future of care, but we also understand that the technology itself is only a part of the solution.

Our networks of clinical digital advisors, coupled with our intimate knowledge of the health and care systems we serve, helps us to understand our member organisations’ priorities for service transformation, their ambitions for new ways of working, and the unmet needs where digital enablers could support future service provision.

Through our knowledge of current infrastructures and digital programmes across the South West region and beyond, combined with our extensive stakeholder networks, we can identify opportunities for sharing best practice and broker relationships across our systems to support the adoption of proven digital ways of working using our expertise in quality improvement.

Where there is unmet need, we have supported our members to horizon scan for the best-fit technologies, seek funding assistance, and then transform the ways in which they work.

Where there are priority challenges to address, we have supported stakeholders with common needs and ambitions to come together and collaborate, enabling them to share best practice and collectively test potential future solutions.

Advice and guidance clinical communications

The West of England AHSN put us in touch with neighbouring CCGs, Gloucestershire and BNSSG, who are using the same digital platform. This has created strong working relationships and the potential for seamless advice and guidance support for border patients and future co-working.

Anna Field Deputy Director for Commissioning, BSW CCG

In 2020, Bath and North East Somerset, Swindon and Wiltshire (BSW) CCG reviewed its advice and guidance service for GPs accessing secondary care specialist knowledge. The service was being accessed and delivered in a number of ways across different specialities in the three hospitals and 89 GP practices. A system-wide clinical and management team decided to standardise the service with a common digital platform in every setting across the whole CCG.

We connected the BSW team with colleagues in Gloucestershire and Bristol, North Somerset and South Gloucestershire CCGs, coordinating a workshop to discuss their varied approaches to advice and guidance and referrals and to collectively look at ways to implement digital solutions with the potential for regional spread. The three systems were all at different stages of their clinical communications journey but agreed that working together to share knowledge on implementation would offer significant potential benefits.

We supported the development of the case for change and funding applications, and continue to facilitate joint working of the three systems to ensure shared learning throughout the delivery stages and beyond.

BSW CCG went live with their new advice and guidance system on 1 November 2021 and 87% of BSW GP practices are now using the system. This has been the one of the most extensive and complex digital transformations undertaken by the CCG and once fully embedded into ‘business as usual’ it is expected to change the way GPs and hospital specialists communicate, improve the quality of hospital referrals and refine referral pathways.

Read more about our support for BSW’s new advice and guidance system

Electronic health records in care homes

Over the last 18 months Bath and North East Somerset, Swindon and Wiltshire (BSW) CCG have, with the support of the West of England AHSN, trialled using an early ‘mobile’ version of TPP’s SystmOne electronic health record by introducing a new care home module across over 20 care homes. The system allows a significant time saving when registering new residents and contacting local GPs to discuss resident health problems; reorder prescriptions and arrange consultations.

It is estimated that up to 2,820 hours of staff time were saved on registrations alone in the latter six months of the project, when SystmOne was live in most of these care homes.

The AHSN and CCG have gained enormous insight into the difficulties faced by care homes when seeking to embrace digital ways of working. We are sharing this learning locally and nationally, which will be invaluable when considering further introductions of digital innovations into this and similar care settings.

Read more about our support for implementing electronic health records in BSW care homes

Telehealth to support remote monitoring of people in care homes

The follow-up survey has shown a clear improving in the confidence and ability our staff in using observation tools and identifying deterioration. Also, in one of our homes the local GP has also signed up to the trial and can access the same data we record, so that enables him to be able to diagnose more accurately and quickly.

Juliet Morris Registered Manger, Apperley House Care Home

We have completed an evaluation in Gloucestershire of use of the Baywater telehealth system to support annual health checks and remote monitoring of people living in residential care homes, in particular adults with learning disabilities.

In response to Covid, the system was developed to include the RESTORE2mini tool, while the scope was extended to include several additional residential homes.

Read more about the evaluation of the Baywater system

South Western Ambulance Connector Discovery project

At the request of the South West CXIO/Digital Leaders Network we worked with the South Western Ambulance Service and provider organisations across the region to build the foundation requirements for region-wide information sharing at scale with focus on the information needs of paramedics and urgent care professionals.

During her Topol Digital Fellowship, we supported Claire Lambie, Chief Nurse Information Officer for Gloucestershire CCG, to investigate how information for direct care is shared and accessed at local, regional and national levels, particularly across organisational boundaries.

This has resulted in extremely thorough discovery work following a user-centred design approach to fully understand the problem, which involved engagement with multiple stakeholders to explore the issues from different angles. The subsequent report has led to this work being adopted and taken forward as part of the regional ‘One South West’ Shared Care Record in 2022/23 and will also support the new national ambulance digital strategy.

Robotic process automation

In 2021/22 we supported NHS colleagues to understand the opportunities offered by robotic process automation (RPA) and develop skills and competencies, by running a series of popular seminars to connect local leaders to national exemplars and creating information resources.

RPA is where automation is used to perform administrative tasks such as filling in forms, extracting data, moving files and other similar repetitive tasks. RPA has the potential to transform clinical and back-office administrative functions, which are vital to effective healthcare provision.

In February 2022 our Digital Transformation Manager, Jo Bangoura, presented on RPA at the HSJ’s Digital Transformation Summit and had a piece published in the Guardian on the subject of RPA in March 2022.

Find out more about RPA

Workforce

The NHS Long Term Plan recognises that our greatest strength is our people. As demand for healthcare continues to grow, it is essential that NHS staff get the support they need to do their jobs effectively.

We are working closely with our health system colleagues to understand the challenges staff face and where our expertise in innovation and improvement can add value to addressing these needs to ensure staff get the support they need to continue delivering the best possible care, while improving the working environment and helping them do their jobs more easily.

Electronic Repeat Dispensing

6,312 hours of GP practice time saved following the move to electronic Repeat Dispensing in the West of England

77% of all prescription items are repeat prescriptions. Electronic Repeat Dispensing (eRD), when deployed successfully, can free up significant GP capacity and enable community pharmacy to manage the medicines supply chain. eRD enables GPs to authorise up to a year’s worth of repeat medication for patients whose medicines are relatively stable. Community pharmacists can then carry out a number of checks and dispense the medicines at regular intervals, usually monthly.

Since the start of the Covid-19 pandemic, primary care systems have been encouraged to increase rates of eRD to reduce the number of patients visiting GPs for repeat prescriptions and to reduce the administration burden on primary care. Since April 2020, 211,362 patients in the West of England have been moved to eRD, resulting in 6,312 hours of practice time saved.

To support our colleagues, the West of England AHSN has been working across systems to drive adoption of eRD by collating and sharing resources. These resources have been accessed by more than 240 users since launch in late 2021.

Read more about electronic Repeat Dispensing

Domiciliary Care Workforce Challenge

The Domiciliary Care Workforce Challenge, run in partnership with South West AHSN and Health Education England, is using innovation to help ease the pressure on domiciliary care workers and providers.

We ran a nationwide call to identify innovations that could support the domiciliary care workforce. Potential solutions covered communication, rostering, care management, wellbeing, training, and remote care. From these we selected Procomp Limited, a Finnish company with a background in logistics planning and optimisation.

Their service will be trialled in Bristol and Cornwall between March 2022 and May 2023. The aims of the pilots are to reduce travel times, increase the capacity of the workforce and improve the working lives of care workers by using artificial intelligence (AI) logistics technology to improve the planning of care workers’ schedules.

Find out more about the Domiciliary Care Workforce Challenge

Sharing learning from Ashton Gate Vaccination Centre

Thank you to our friends at the West of England AHSN for helping us to document these experiences and to each and every one of the 1,107 members of the Ashton Gate Vaccination Centre team. Your contributions have been extraordinary, and I feel very proud of all we have achieved together.

Anne Morris Chief Nurse for the Bristol, North Somerset, South Gloucestershire Vaccination Programme

To capture and share the learning and experiences of the staff and volunteers involved in setting up and working at the Ashton Gate Vaccination Centre in Bristol, we carried out a research project resulting in the launch of a special publication in January 2022 to coincide with the first anniversary of the centre opening to the public.

The opening of the centre on 11 January 2021 was an incredible achievement, having taken just three days to transform the Ashton Gate stadium into a large-scale Covid vaccination centre with the help of a military team. During the next seven months, a team totalling 1,107 staff and volunteers from the NHS, St John Ambulance, Ashton Gate Stadium and many other charities and community organisations worked together to give a total of 235,048 vaccinations before the centre moved to UWE Bristol in early August 2021.

Working with all the organisations involved, we reached out to staff and volunteers at the centre to share their memories and insights with us. Themes of friendship, diversity and teamwork shine through in their recollections, as well as stories about the individuals and characters who helped to make a difference when times were challenging. Volunteers and staff also shared their thoughts on leadership, communications and logistics, as well as many lessons learned to pass onto future teams involved in similar work.

Read the Ashton Gate Vaccination Centre publication here

Connecting and collaborating

72% of people with a learning disability in our region had an annual health check in 2021/22

103 patients were prevented from developing a surgical site infection since the start of the PreciSSIon project

230+ members of our South West CXIO / Digital Leaders Network

250+ academics, health professionals and service users have taken part in our UK-Canadian innovation exchange programme

We work hard to build supportive relationships with all those in our region who seek to improve and innovate healthcare.

Our priority is to work across organisational and geographical boundaries, involving our entire network in development and delivery of transformation that is based on genuine need, is successfully embedded and sustainable.

Below we take a look at the work and achievements of some of our collaboratives and networks during the last year.

Patient Safety Collaborative

The West of England Patient Safety Collaborative is one of 15 across the country, each hosted and coordinated by its local AHSN.

Our Collaborative is made up of all the NHS providers and commissioners across the West, including hospitals, mental health and community organisations, the ambulance service, primary care and clinical commissioning groups. It brings together local patients and healthcare staff, all driven by a collective ambition to bring about system-wide improvements to patient safety.

This work programme is informed by the NHS Patient Safety Strategy, and the National Patient Safety Improvement Programmes (known as NatPatSIP), which are led by NHS England and Improvement.

In 2021/22 the Patient Safety Collaborative Board oversaw five safety improvement programmes: managing deterioration; maternity and neonatal; medicines safety; mental health; and adoption and spread.

Read more about our work to improve patient safety

Learning Disabilities Collaborative

300+ members of our Learning Disabilities Collaborative

2,840+ views of our annual health check videos

On average, people with a learning disability die 20 years younger than their peers. Many of these deaths continue to be from avoidable causes, such as pneumonia and sepsis.

We established the West of England Learning Disabilities Collaborative (LDC) in early 2019, and our main areas of focus have been increasing uptake of annual health checks and flu vaccinations, and use of the National Early Warning Score (NEWS2) and soft signs tools for early identification of physical deterioration.

The LDC provides a space for collaboration, cross-system working and sharing of good practice in a way that did not previously exist in the region. NHS England most recently reported a 57% uptake of flu vaccinations in our region which is higher than the national average of 50%.

The collaborative now has over 300 members, including representatives from primary and secondary care, social care providers, commissioners, charities, community learning disability teams, and people with lived experience.

In 2021, NHS England South West commissioned us to create a suite of videos to increase the uptake of annual health checks for people with a learning disability. We produced these with Misfits, a local theatre and social group led by people with learning difficulties and collaborated with a number of experts by experience. Launched in October 2021, the videos have so far been viewed 2,840 times.

72% of people with a learning disability in our region had an annual health check in 2021/22.

We were invited to present our work to support uptake of annual health checks at the HSJ Patient Safety Congress in September 2021, and our speakers featured Andrew Bright, Head of Development for Thera Trust, an expert by experience.

In 2021 our LDC continued to host webinars on topics such as mental health capacity assessment and oral health, with more than 140 delegates joining us. The collaborative has also continued engaging with the community through regular newsletters and the launch of new resources, including a toolkit for promoting oral healthcare for people with a learning disability.

In 2022/23 the West of England collaborative is expanding to cover the entire South West region. The new South West LDC will be funded and delivered in partnership with NHS England South West. The expanded collaborative aims to share learning and best practice across the South West and focus on the adoption and spread of tested diagnostics, products and technology that supports both people with, and those who care for people with, a learning disability.

Read more about our Learning Disabilities Collaborative

PreciSSIon: reducing surgical site infections

£509,574 saved costs to NHS through our PreciSSIon project

PreciSSIon (Preventing Surgical Site Infection across a region) is our award-winning collaborative project to reduce the incidence of surgical site infection (SSI) after elective colorectal surgery. It involves all five hospital trusts in the West of England.

Through the introduction of an enhanced bundle of evidence-based interventions, we successfully reduced rates of surgical site infections after colorectal surgery by 50%. Interim data showed we prevented an estimated 103 patients from developing an SSI since the start of the project, with a cost saving to the NHS of around £509,574. Trusts have continued to collaborate to ensure long-term sustainability.

At the 2021 HSJ Patient Safety Awards, PreciSSIon scooped the Infection Prevention and Control Award, as well as being shortlisted for Perioperative and Surgical Care Initiative of the Year. PreciSSIon was also awarded the Quality Improvement Team of the Year at the 2021 BMJ Awards.

In March 2022, the Journal of Hospital Infection published a study by surgeons and trainees who formed part of the PreciSSIon project team. This evidenced the value of SSI bundles to patients and the NHS.

Looking ahead to 2022/23 we will be adopting and spreading a similar bundle in caesarean section surgery where we will utilise and report on patient-reported SSIs.

Read more about PreciSSIon

Tracheostomy community of practice

It has been great to get the multidisciplinary team across the newly merged trust working together on such an important project. Tracheostomy care has needed streamlining for a while now, so far we’ve written new care plans, discharge documentation, incorporated videos into our training, and identified emergency boxes and bedside trolleys to facilitate the best care.

Isabel Barfield Patient Safety Improvement Nurse at University Hospitals Bristol and Weston

To support healthcare staff caring for patients with tracheostomies, we worked with the region’s five acute trusts to establish their use of three evidence-based tracheostomy safety interventions including a standardised tracheostomy daily care bundle.

Through a community of practice of staff involved in tracheostomy care, we facilitated shared learning to improve the consistency of the bundle elements as well as identifying areas for improvement.

Our focus on tracheostomy care was one element of the nationally commissioned Adoption and Spread Patient Safety Improvement Programme.

Read more about the Tracheostomy Community of Practice

Patient Safety Culture Club

In October 2021, we launched the West of England Patient Safety Culture Club to bring together all of those working in the safety culture space in the region. The club is helping participants to collaborate, share experiences and dive deeper into topics such as psychological safety and unconscious bias.

Most importantly, the aim of the Culture Club is to foster a sense of community, given the persistent restrictions on in-person meetings and the extraordinary pressures clinical colleagues have continued to face.

Following a successful pilot of four sessions to identify the most effective way to engage participants virtually in this space, we decided to offer informal networking sessions of ‘Coffee and Culture Club’ in between the more structured formal workshops. This allows for relationships to develop and gives space to dive into personal experiences.

To date 57 delegates have attended Culture Club sessions, with participants noting: “This was one of the best workshops I’ve ever been on and am already doing the ‘coming into this space’ breathing whenever I am leading on something” and “I really want to tell the world about them as the first session alone blew my mind!”

Voluntary, Community, Faith and Social Enterprise (VCFSE) Partnership for Better Health

We created the VCFSE Partnership for Better Health programme to explore and support capacity building within the VCFSE community, helping to facilitate partnerships with care and health providers and support the delivery of services.

In the scoping phase we explored the stakeholder landscape and engaged with commissioners and voluntary sector leads to showcase successful local and national partnerships.

This was followed by a discovery phase, which focused on understanding the individual needs and priorities of each of the local health and care systems.

In the final delivery phase we have developed an online resource hub for anyone in the VCFSE sector interested in working with health and care providers, as well as hosting a series of bitesize ‘insights’ training events for VCFSE organisations, helping them get ‘ICS ready’.

Take a look at our VCFSE resource hub

Improving safety and transparency in surgical innovation

The first in a series of national online events was held in November 2021, exploring safety and transparency in surgical innovation. The aim of the series is to facilitate collaboration across the sector to design more consistent policies around introducing innovative procedures in surgery.

Chaired by Anne Pullyblank, consultant colorectal surgeon at North Bristol Trust and West of England AHSN Medical Director, we are hosting the events on behalf of the AHSN Network as part of its innovation exchange programme. Other partners include the Bristol Biomedical Research Centre, NICE, the NIHR Surgical MedTech Co-operative and the Royal College of Surgeons.

Around 140 people attended the first event, including surgeons, medical directors, governance leads, patients, researchers, regulators, innovators and industry representatives. The second event is planned for summer 2022

Read about our first surgical innovation event

South West CXIO / Digital Leaders Network

With over 230 active members from across our healthcare community, we continue to coordinate the South West CXIO Digital Leaders Network, hosting quarterly meetings and a dedicated FutureNHS workspace and discussion forum.

This network provides an ideal space for chief information officers (CIO), chief clinical information officers (CCIO), chief nursing information officers (CNIO) and emerging clinical digital leaders to connect with colleagues across the region to discuss and share best practice on the local challenges they are facing.

It provides us with direct intelligence of the rapidly emerging clinical and care priorities, and also gives voice to those digital practitioners who are critical to the successful identification, delivery and sustainability of the region’s digital future.

The network has been instrumental in moving forwards many key digital enablers with support from the AHSN by creating region-wide task and finish groups focusing on specific urgent challenges.

In 2020/21 one such group enabled the change control notice to support Summary Care Record Additional Information being rolled out for all adults across the UK to help with more detailed visibility of patients’ information during the pandemic.

In 2021/22 two more task and finish groups supported the South Western Ambulance Connector Discovery Project and the Digital Health and Care Skills Development Network (see below).

South West Digital Health and Care Skills Development Network

With rapidly increasing data and digital-driven change, we need to ensure digital health and information professionals have access to learning and development opportunities to help equip them with the skills they need for the future.

In response to this we have worked with Health Education England to develop a new regional Digital Health and Care Skills Development Network, which launched in April 2022. The network aims to support professionals working within informatics and digital (including clinicians) at all stages of their careers. Free learning events will be offered alongside learning resources.

Find out more about the Digital Health and Care Skills Development Network

South West Clinical Safety Officers Network

We established the South West Clinical Safety Officers Group towards the end of 2021 to support health professionals responsible for overseeing the clinical risk assessment of health IT products. Clinical safety officers do receive training to help them in this statutory role, but informal feedback suggested they can feel isolated.

Chaired by our Digital Clinical Adviser, Dr Shanil Mantri (himself a Clinical Safety Officer), the group meets monthly as an informal support network. Engagement from officers across the whole of the South West has been excellent and feedback shows they value the chance to share experiences with peers and feel the group is helping to raise the profile of digital safety across the wider region.

Future of Care lectures

After a Covid-enforced hiatus, our Future of Care lecture series resumed in November 2021. In our first event, delivered in partnership with the University of the West of England, Professor Maggie Rae, President of the Faculty of Public Heath, outlined some of the ways that she sees that Covid will have the greatest impact on future delivery of care.

In March 2022 at our next event with the University of Gloucestershire, Professor Shafi Ahmed (a multi-award-winning cancer surgeon, teacher and entrepreneur) explored the impact virtual reality technologies might have on the delivery of health and care, as well as the training of professionals employed in these fields.

Find out more about our Future of Care lecture series

Healthy ageing innovation exchange

With people in England now living longer than ever before, ageing well is high on the NHS agenda.

On behalf of the AHSN Network’s Innovation Exchange, we have been hosting a UK-Canadian innovation exchange programme, with the Canadian network, AGE-WELL. The aim of the programme is to support the adoption and spread of new health technologies in both countries, through shared learning and networks, and the facilitation of collaborations across health, academic, industrial and third sector organisations.

To date, we have hosted five virtual exchange events on topics such engaging older adults in research and innovation, robotics, and the longevity economy. During this time, over 250 academics, health professionals and service users have taken part in the programme.

Find out more about AGE-WELL

Looking ahead

In the context of the significant challenges faced by health and social care partners both locally and nationally, the core mission of the West of England AHSN to speed up the pipeline for health and care innovation has never been more relevant.

2022/23 marks our 10th year since first being licensed by NHS England and we have a full and busy work programme planned for the year ahead, working with our member organisations and local integrated care systems to support the discovery, development, and delivery of innovation.

Highlights for 2022/23 include:

  • Local delivery of three new national AHSN Network programmes – Polypharmacy, Wound Care Strategy and Blood Pressure Optimisation
  • Developing a PreciSSIon bundle of care for caesarean section surgery
  • Completion and evaluation of our ground-breaking Black Maternity Matters project
  • Supporting regional colleagues to develop a South West Primary Care GP Exemplar Laboratory
  • Domiciliary care workforce pilots in Bristol and Cornwall using Procomp’s AI logistics technology
  • Work with NIHR ARC West on a potential cerebral palsy register
  • Discovery events to explore the potential of innovation in primary care.
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