What was the aim/problem?
Northumberland, Tyne and Wear NHS Foundation Trust (NTW) provides mental health and disability services across the North East of England. The Trust employs over 6000 staff and operates out of more than 60 bases including six dedicated hospital sites, covering a geographical area of over 2,000 square miles.
Working with patients who are often high risk and highly vulnerable, the Trust’s staff are dependent on good quality, up to date information when attending an appointment where presentation and situations may be hazardous. Staff are also frequently required to travel to multiple appointments and contacts each day, often with no ability to return to base to seek information prior to meeting patients.
With users from all care settings reliant on the system, NTW needed to find a way to keep its patient records constantly up to date while ensuring staff could access the system wherever they were working, quickly, reliably and above all securely. NTW’s Mobilising the Workforce (MtW) project was established by the Trust’s Informatics team to allow all users secure access whenever and wherever it was needed.
What was the solution?
NTW’s Mobilising the Workforce project has seen both technology and culture change progressively implemented throughout all of NTW’s clinical and corporate services.
At the heart of the MtW project is NTW’s ‘mobile kit’ – Trust laptop computer equipment giving staff constant access to services such as patient records whether they are working from a hospital in Newcastle, their own home in Sunderland or a patient’s home on the Scottish Borders.
NTW uses Direct Access technology to provide all staff who need it with an ‘always-on’ connection. This means that wherever there is any sort of Internet access, staff can connect using the best available method to reliably and securely access patient records.
Connectivity can be securely achieved via corporate Wi-fi or Ethernet, public Wi-Fi or even a staff member’s own home broadband. If none of these are available staff can still achieve a connection wherever there is a mobile signal using each mobile kit’s built-in SIM card.
This all means that staff can access clinical records wherever and whenever they need to, with no need to return to a central base.
The Trust’s mobile technology also brings other features which all staff can benefit from, not just the teams who are accessing patient records. For example all staff with the mobile kit can use video-calling to save travel time and reduce environmental impact, and all users can access shared network drives wherever they are working.
There are also entire teams whose work would not be possible without constant secure access to patient records. NTW’s Street Triage service is delivered in partnership with local police and aims to provide the highest quality of care for people who come into contact with police and need mental health support… The service works across the entire region and requires immediate access to up-to-date current and historical information on the individuals it sees. Without NTW’s mobile kit technology this just wouldn’t be possible.
What were the challenges?
The sheer size of the project and the large size of NTW as a Trust, with hundreds of different services spread across many different sites, presented a challenge in itself. The Mobilising the Workforce project has included extensive planning throughout to ensure the significant changes to behind-the-scenes technology were as seamless as possible.
Cost was also an issue, but in this area the Trust’s size has in some ways been a benefit, as cost per device or staff member has been greatly reduced by taking advantage of economies of scale.
One unexpected challenge became acutely apparent with the extreme weather conditions in early 2018. But as the ‘Beast from the East’ battered the region, even when staff struggled to travel to service user’s homes or team base they were still able to work from home to contact patients with full access to patient records and other relevant information. NTW estimates that nearly half of their corporate services staff provided a seamless service during this period, despite travel being difficult or impossible.
What were the results?
NTW’s Mobilising the Workforce project has had a truly transformative effect for staff across the Trust, saving thousands of hours of unnecessarily travel time, increasing security, improving user experience and reducing support costs.
Since being established NTW’s Street Triage team has significantly reduced the number of patients being detained by police under section 136 of the Mental Health Act, and was specifically cited as an example of good practice in Sir Simon Wessely’s 2018 independent review of mental health legislation.
Access to NTW systems remotely has also supported the Trust’s compliance with standards of data security. For instance, staff are now able to easily access information governance training and resources online, with no need to travel to a classroom environment.
What were the learning points?
There have been learning points at every stage of the project. One key lesson has been around culture change: as the project advanced the Trust realised that achieving buy-in from all staff and not just those directly delivering the project work was essential to its success.
Good communications have also been key, and the Mobilising the Workforce team carefully planned communications with staff at all stages of the project to support the transition to using mobile kit.
Support for staff is also provided on an ad hoc basis by email or phone throughout the working week from the Trust’s Informatics helpdesk, where the MtW technology allows Informatics professionals to quickly control a user’s computer remotely, solving problems there and then and letting staff get on with work rather than having to wait for IT to come to them.
NTW treats its Mobilising the Workforce project as a constant process of innovation, and looks constantly at ways in which mobile working technology can continue to further help its staff do their jobs better while saving time and resources.
Want to know more?
To request access to the blueprint of this project, please email: firstname.lastname@example.org.