Case Study
Warrington and Halton Hospitals NHS Foundation Trust
Integrating NHS111 First Direct Appointment Booking Services
with Lorenzo
The NHS Long Term Plan
The NHS Long Term Plan sets out how patients requiring Urgent & Emergency Care (UEC) will be supported to access the most appropriate service so that treatment can be offered closer to the patient’s home with a clear intention to avoid unnecessary trips to A&E.
In support of this, NHS 111 maintains its place as the ‘first line of defence’ for the UEC system together with increased utilisation of UTCs to ease the pressure on Acute services, leaving other parts of the system free to treat the most serious cases. The UTC offering will result in decreased attendance at A&E, or, in co-located services offer the opportunity for streaming at the front door.
The first stage of this plan was introduced in December 2020 under the banner of “NHS111 First”, where patients are encouraged to call NHS111 instead of presenting unannounced at A&E. NHS 111 discuss the patient symptoms, undertake clinical triaged and direct the patient to the most appropriate service for their condition.
If the patient needs to be seen in an UEC setting, the patient is offered an appointment that is directly booked in to the Provider service and the referral details forwarded to the Provider in preparation for the patient’s arrival.
Warrington and Halton Teaching Hospitals NHS Trust
Warrington and Halton Teaching Hospitals NHS Foundation Trust (WHH) offers ED services at the Warrington Hospital site and less serious injuries treated at the Urgent Care Centre (UCC) at Runcorn.
Direct Appointment Booking (DAB) services can be booked through NHS 111 (NWAS) and NHS111 Online, but additionally referral emails can be received from the Regional Clinical Assessment Service (CAS) run by PC24.
Drivers for Integration
Prior to the recent upgrade, clerical staff were required to check multiple systems to ensure they managed incoming referrals and then manually transfer patient details to Lorenzo and any referral documentation was printed and physically attached to the CAS Card to be scanned later into the patient record.
Solution
WHH chose to work with WASP Software to replace all extraneous booking and referral services and to ensure all referrals (irrespective of their source) and NHS111 DAB is integrated into Lorenzo.
Our customers said:
We have simplified clerical processes significantly by introducing a range of background checks and clever messaging services that ensures patient data is available where it needs to be – in the patient record on Lorenzo. This makes a huge difference to our administrative staff and clinicians who don’t need to waste time trying to find important referral information.
Dr Roy Bhati
Associate Specialist, Emergency Department and CCIO, WHH
The Deployment
At the end of November 2021 WHH went Live with the WASP UEC Provider Scheduling service and now administrative staff only need to check the WASP Expected Patient Screen to see any patients that have been referred and/or booked. This is accessed through Lorenzo using Dedalus Desk Top Integration services.
The integration with Lorenzo results in a single clerical screen for Expected Patients, referral documentation within the Trust’s ePR and automated DNAs. More importantly, the integration service utilises standard HL7/FHIR Messaging services supported by every PAS/ePR system and so this integration can be rolled out extremely quickly to any Provider site.
Michael Brett
Managing Director, WASP Software
UEC availability at the Trust is published on Schedules within WASP’s Care Connect Compliant Provider Service and booked by NHS111 and NHS 111 online. If a referral is received from another service, WASP process this referral and allocates it the next available appointment slot.
When a patient is referred/booked, WASP undertakes background checks against Lorenzo to see if the patient is known to the Trust and if so, updates the referral with the patient’s Hospital Number. This allows any clinical triage prior to arrival to include details held within the Trust’s electronic Patient Record (ePR).
When the patient presents, WASP is triggered to process the referral documentation and delivers it in a format that allows it to be filed against the correct episode within the patient record. This means that clinical access to the referral information is online and within Lorenzo without the need to search for paperwork.
If a patient does not present, WASP automatically DNAs the patient and, after some minimal clerical work to check the patient’s registration, sends an email (including referral information) to the patient’s GP and records the DNA against the patient record. This is done for NHS111, NHS111 Online and PC24.
I am very proud of the UEC Scheduling Service we have collectively delivered to WHH, and it builds on the work we have done with Meditech at Alder Hey Children’s Hospital and Allscripts at Kent & Medway.
The “Warrington Method” will become our standard approach for system-to-system integration as it is instantly transferrable to all PAS/ePR systems including all Dedalus and Cerner systems.
Michael Brett
Managing Director, WASP Software