Impact Report 2020-21
The advancement and rapid development of digital technology is undoubtedly opening up more opportunities across every aspect of our lives.
Healthcare has been traditionally slow to adopt new technology, but the COVID-19 pandemic has highlighted how digital can be used to solve urgent and emerging problems.
During the past year, HInM has continued to accelerate and advocate for digital solutions, working in partnership with Greater Manchester Health and Social Care Partnership and the Greater Manchester Combined Authority. A vital part of this has been continuing to build a solid foundation of trust and collaborative partnerships across the system.
HInM has been part of the GM COVID-19 Health and Care Digital Coordination Group, established to set digital priorities and oversee the work taking place. This included resolving information governance challenges to enable data to be shared at the point of care, supporting primary care with digital access to care and how technology could support residents with long-term conditions or in the care sector.
HInM has also continued to look beyond the digital technology itself throughout the pandemic, focussing on the people, process and cultural factors involved in implementing and embedding digital solutions within the health and care sectors. Digital programmes are having a vital impact in the response to COVID-19 and through the pandemic, enabled by agreed priorities, clear governance and engagement across the system, including with clinicians, patients and technology experts.
Our Digital Response to COVID-19
Working closely with our health and social care partners across Greater Manchester we have delivered:
- GM Care Record: Accelerating Data Sharing, pathway transformation and research
- Digital Primary Care: Outcomes framework
- Digital Care Homes: Symptom tracker and signs of deterioration
- Digital Mental Health: Optimising deployment of remote monitoring support tools
- Support for staff: Remote working at scale
- Remote monitoring: Secured £1.67m bid to support creation and development of remote monitoring tools in heart failure, COVID and Maternity care
- COVID-19 Vaccination: Deployment of an online booking system in GM to facilitate health and care workforce appointments. 331,000 bookings made via tool
- Digital transformation: Engaged with 120 people across the GM system to develop future digital investment priorities to support service transformation
- Urgent Care by Appointment: Call before you go digital system and clinical triage at the front door of A&E deployed in GM
Case study: Accelerating vital data sharing through the GM Care Record
As part of the COVID-19 response, it became vital to accelerate work already underway to deploy a single joined-up record for all citizens in Greater Manchester to ensure no matter where patients were being treated, clinicians had the information they needed.
Until recently, this information was held locally in existing borough-based care records and not shared across the locality boundaries. Instead, the system relied on patients
repeating their medical history to each professional they encountered within the health and care system, creating risk and inefficiencies.
The GM Care Record project has been overseen by HInM and the GM Health and Social Care Partnership, working on behalf of GM’s devolved health and care partners. Rapid progress to rollout the shared care record was made in weeks rather than months at the start of the pandemic as part of the city region’s COVID-19 digital response plan and collaborative effort.
In total, 3.1 million patient records from 443 GP practices in GM and data feeds from all mental health NHS Trusts and all NHS acute trusts are now flowing into the GM Care Record. It also includes information about when a patient has been tested or diagnosed with COVID-19, allowing GM to track and understand the impact of COVID-19 and to develop programmes of work to counter the pandemic. The system has been developed by tech company Graphnet, which specialises in developing health and care IT solutions.
Since launching in May 2020, the number of unique users per month has grown from 4,599 to more than 10,000 and more than 100,000 patient records are being accessed each month.
The ability to share data through the GM Care Record is backed by a GM-wide approach to data protection and information sharing in accordance with national guidance, such as defining under which circumstances professionals can access the record. It is also underpinned by collaborative engagement and strong governance across GM.
The GM Care Record has become a major digital asset with significant potential to support programmes to tackle health inequalities and transform care. It is now being taken beyond the basic ability to share information, to supporting innovation, research and the transformation of care and citizen outcomes. The care record is now also being used to support the transformation of care pathways through new use case development, including COVID-19 virtual wards, heart failure, and
dementia and frailty.
“The GM Care Record will have a direct impact on the quality and precision of care we are able to provide patients, particularly those with complex needs across multiple specialities. Sharing this information has never been more important as it will greatly aid clinical decision making and will reduce the burden on both patients and clinicians.” – Karen James OBE, Chief Executive of Tameside Integrated Care NHS Foundation Trust and member of the GM Provider Federation Board
“As a person with multiple co-morbidities, it would certainly benefit me if patient information was shared. For example, the hospital I see my specialists at is Salford Royal, but my nearest A&E is Stockport. If I need A&E and I am not conscious, how will they know what meds
I am on and the possible side effects of mixing meds?” – GM patient
How is the GM Care Record making a difference?
Supporting end of life care
The GM Care Record is supporting healthcare professionals to provide the best possible end of life care for patients. In one case study, a patient was in the terminal stages of cancer and was being looked after by her family who contacted the hospice-at-home coordinator one Friday evening or more advice on how to care for her over the weekend and to avoid a hospital admission. Neither the on-call doctor or the hospice doctor had any prior knowledge of the patient, but using the GM Care Record via their EMIS Web system, they were able to gain an in-depth understanding of the clinical situation and enable a safe plan to be made for the patient that allowed her to remain at home, as per their wishes.
Approved COVID-19 related research using deidentified patient data from the GM Care Record
As well as being able to access information for direct care, deidentified data in relation to COVID-19 can used for research and planning purposes to gain a greater understanding of COVID-19, how best to tackle it and the type of services that needs to be in place. All 10 GM localities have approved that the COVID-19 Expert Review Group (ERG) can consider and authorise requests for COVID-19-related secondary uses and university research using GMCR data during a rigorous review process. During 2020-2021, six studies were approved by the ERG, with a further fifteen in the pipeline. Approved studies include:
- Healthcare utilisation across GM during the COVID-19 Pandemic – To study how the healthcare system in Greater Manchester has been used throughout the pandemic. This will give important insights into bottlenecks in the system that will help with planning for subsequent waves and future pandemics.
- The equitability of the UK government’s COVID-19 vaccination strategy – Using GM Care Record data to test whether the government vaccination plan meets the goal of giving equal priority to people with equal vulnerability to COVID-19.
- COVID-19 incidence, hospital admission and death in cancer patients in GM. – The GM Care Record will be used to determine the risks and factors associated with COVID-19 diagnosis, hospital admission and death in cancer patients and will help inform individual management decisions for cancer patients.
Case Study: UK-first COVID-19 tracker supporting care home residents
As cases of coronavirus began to rise dramatically at the start of the COVID-19 pandemic, the ability of the virus to rapidly spread within care homes and put some of the most vulnerable in society at risk became an urgent issue to solve. Care home staff needed support to track outbreaks among their residents and coordinate care with GP practices, social care, and hospitals to optimally support vulnerable residents.
HInM worked with health and care professionals from across Greater Manchester and tech company Safe Steps to solve this issue, creating a UK-first digital innovation in the process. The COVID-19 tracker allows care homes staff to input information about a resident’s COVID-19 related symptoms into a digital platform, which can be shared directly with the resident’s GP and NHS community response team to ensure that a swift assessment and response can be put in place. It also meant that the NHS could more closely monitor how care homes are doing thanks to a visual dashboard that displays the information at an aggregate level.
After a successful rollout in Tameside and Glossop in April 2020, the COVID-19 tracker has been adopted by 151 care homes across 7 localities. In total more than 4,200 residents
are being supported through the tracker, with over 360,000 assessments taking place since April 2020.As the pandemic progressed, the digital tracker was adapted to also be able to record COVID-19 vaccination consent and when a vaccine has been given to a care home resident. It allowed a real time dashboard view of each care home and their vaccination status, contributing to national efforts to vaccinate the most vulnerable and care home residents. The approach taken has garnered national and international interest for adoption and spread, and HInM has brokered a commercial incentive model to ensure GM benefits from any further growth and development.
“The care homes data dashboard provides invaluable information to GPs about the most up to date status of their patients allowing proactive management and care for the most vulnerable in our society. By empowering carers, who know their residents best and can spot symptoms or signs of deterioration, we can easily identify those patients who need advanced care planning by picking up signs of deterioration as soon as they start to happen.” – Dr Saif Ahmed, GP and Clinical Lead for the project.
Case Study: Reducing the admin burden on midwives with the smokefree pregnancy digital platform
The Greater Manchester Smokefree Pregnancy Programme is now using a digital platform which enables specialist midwives to spend more time helping pregnant smokers to quit smoking and less time on time-consuming admin tasks.
HInM has worked with Greater Manchester Health and Social Care Partnership and digital transformation specialists Objectivity to develop the digital platform, which has been rolled out across Greater Manchester during the COVID-19 pandemic.
The platform enables midwives to view information about the pregnant women in their care, including information about their pregnancy, progress in quitting smoking and record their carbon monoxide levels. Midwives can also use the platform to schedule appointments and send motivational text messages and appointment reminders to support women on their quit journey. Individuals on the pathway are also provided with carbon monoxide monitors which link to smartphones, allowing them to complete screenings at home, rather than attending a clinic in person, and report their readings to the specialist midwives.
It aims to reduce the amount of time spent inputting and collating information, creating more time for midwives to provide care. It also standardises data collection across GM, enabling a clearer picture of the programme’s impact and where improvements can be made.
Smoking in pregnancy exposes developing babies to carbon monoxide, a poisonous gas which significantly increases the risk of stillbirth, premature birth and cot death. Since the Greater Manchester Smokefree Pregnancy programme began in 2018, an additional 510 babies have been born smokefree.
“This new digital platform is providing benefits to our maternity teams across Greater Manchester, releasing more time for them to care for individuals and increasing capacity. It is also allowing us to engage with more pregnant individuals and their partners, advise them about the dangers of smoking while pregnant and give them personalised support to quit.” – Jane Coyne, Strategic Lead for Smokefree Pregnancy programme at GMHSC Partnership
Read the rest of the 2020-2021 Impact Report
Use the image links below to move between the different sections of the report.