Ekta Mehta, Author at CACI

Torbay and South Devon NHS Foundation Trust

Posted on: 20 June 2022

Highlights

• One version of the truth instead of diverse standalone solutions
• Insight for decision-making, financial measurement and forecasting
• Local customisation to keep pace with change
• Fully maintained solution to reduce in-house IT burden
• Supports latest statutory reporting and ongoing change

About Torbay and South Devon NHS Foundation Trust

Torbay and South Devon NHS Foundation Trust provides acute health care services from Torbay Hospital, along with community health services and adult social care. It was the first Trust in England to integrate hospital and community care with social care.

The Trust has around 6,500 staff and 800 volunteers. It runs Torbay Hospital as well as five community hospitals and other local clinics. It provides health and social care to the local population, with around 500,000 face-to-face contacts in patients’ homes and communities each year, serving a resident population of approximately 286,000 people, plus about 100,000 holiday visitors at any one time in the summer season

I’d be happy to recommend this product to any other NHS Trust. InView gives us the flexibility to work around a stable core product — and the support from CACI is outstanding.
Stephen Judd, Informatics: Head of Data Engineering – Strategy and Improvement, Torbay and Devon NHS Foundation Trust

The challenge: Inadequate legacy systems and disparate, incomplete data

South Devon and Torbay has used InView for many years, with the original solution implemented in 2006. More recently, the Trust has experienced challenging times in its IT division, with tight budgets limiting staff and resources. This led to key systems becoming outdated, through lack of investment in upgrades and system replacements.

The resourceful IT team used workarounds and in-house development to bridge gaps and connect systems, to draw essential clinical and financial insight from the Trust’s data, stored in disparate sources.

Head of Data Engineering Stephen Judd says, “On top of this, since Covid, there have been big organisational changes in the Trust, including new wards, which affected the data we work with. And a lot of our lookup tables were based on old national standards. Although we had a made series of updates to the standards and data dictionary, our Patient Administration System (PAS) and InView hadn’t caught up.”

In 2020, Torbay and South Devon received funding to upgrade their SQL server and jumped at the chance. Stephen Judd says, “We knew we needed to upgrade the InView system as well and seized the opportunity to present a business case for this. It was accepted – but we needed to implement by the end of the financial year – less than four months away. Normally, we would have planned twice as long for this type of data warehouse project.”

The solution: A new, fully functional InView database and support to prepare and migrate

CACI agreed to work with Stephen and his team to deliver a new InView data warehouse against the tight deadline. Stephen explains, “CACI provided overall consultancy to plan the data warehouse migration. With many vacancies in our data team, we also used CACI consultants to backfill. Due to time and resource constraints, we didn’t have as much engagement with the information team and data team as we wanted. Moreover, some of our old source systems and extracts didn’t have an Information Asset Owner or anyone who understood the data architecture fully. We had to do a lot of interrogation analysis to bridge this knowledge gap. We wouldn’t have been able to deliver the project without CACI’s support with this.”

CACI’s consultants worked with Stephen’s team to implement the latest version of the InView data warehouse for healthcare organisations. It brings together feeds from in-patient, outpatient, critical care, the old maternity system, neo-natal and paediatric and some community and extended data (from InfoFlex) that adds richness and detail to patient records – for example, information from GP discharge letters.

Torbay and South Devon’s core project embraced the core data feeds they knew best. Stephen’s team set a stretch goal to bring some of the Trust’s community data in. This was particularly challenging, as it was poorly defined and spread over eight systems.

Stephen says, “Some of the services had started setting up their own booking systems outside our main PAS and using InfoFlex. Drawing on CACI’s expertise and resources, we were able to merge these in, which has made our data more complete and accurate again.”

To improve outputs and reporting, the team replaced a daily, fixed format export routine originally written in the 1980s. They built new feeds for demographic, inpatient and outpatient data from the SWIFT bed management system.

The benefits: Data best practice from a proven solution and trusted partner

Torbay and South Devon NHS Trust could have chosen to build its own custom solution. But InView has a powerful advantage. Stephen explains: “If we create anything bespoke, we have to support it. And we don’t have capacity.”

There has been a big shift because of Covid – the NHS is moving towards a more standardised national view of income. “InView means we can accommodate national SUS calculations and keep pace as our obligations increase each year, because it uses a recognised best practice approach. With InView, we have a proven, standard platform and can make local adjustments for a perfect fit to our organisation,” says Stephen.

For ongoing support, CACI’s team is responsible for upgrades and loading new tariffs. Stephen can focus his own engineers on getting the data right. This is key, because some of NHS England’s payment to the Trust relies on it. Stephen gives an example: “We discovered that a percentage of our outpatient activity had the wrong consultant speciality, which potentially reduces our national NHS income. With CACI maintaining InView, I have the resources to investigate and rectify that type of issue.”

“The beauty of working with CACI is that they take ownership of everything they promise in the scope of the agreement, and fix it. They provided excellent project management. I didn’t have to chase up work or check every detail – you can only do that with real trust in the team’s capability and judgement to escalate when needed.”

“The InView data warehouse is a product that will last us ten or more years – it’s our one source of data for all key reporting so it’s a critical solution for the Trust. Amongst the many programmes I’m responsible for, it was a relief not to have to worry about this one, because CACI has earned our trust and confidence throughout a long working relationship. CACI’s engineers are extremely experienced and were able to jump in, ask intelligent questions, and deal with unfamiliar and unusual data feeds and systems! The project manager provided excellent communication throughout, so I didn’t need to intervene and always knew the latest status and progress.”
Peter Sheard, IT Programme Manager, Torbay and South Devon NHS Foundation Trust

Why England’s farm inspectors are launching a war on duplication

Posted on: 7 July 2020

Ensuring that England’s agricultural sector complies with national and EU regulations is a complicated task – but smart technology for inspectors could revolutionise the process

FARM INSPECTIONS

Farm inspections are complex, costly and time-consuming. From controlling animal epidemics such as Bovine TB and swine fever to protecting woodland and checking up on animal welfare, England’s agricultural inspectors have a wide-ranging remit.

They carry out some 150,000 visits a year [pdf] at tens of thousands of sites to check that farmers are complying with agricultural rules laid out in a thicket of 172 Acts of Parliament.

Farmers complain that inspections are sporadic and uncoordinated. They face visits from five separate bodies that are part of Defra, as well as from local councils, and they are subject to a range of punitive fines for rule breaches.

FINDING BETTER WAYS

The search is on to find better ways of running the inspection regime. One solution could be to implement an overarching software system to coordinate visits, where data about farms is stored centrally and farmers can be advised electronically on the steps they need to comply with regulations. Sweeping changes to the inspection regime are imminent. A new report commissioned by environment secretary Michael Gove recommends a wholesale shake-up of farm regulation.

SINGLE FARM REGULATOR

After a year-long investigation, Dame Glenys Stacey published the Farm Inspection and Regulation Review [pdf] in December. She proposes creating a single farms regulator to replace the work of the five Defra bodies and local councils. This single watchdog would carry out more streamlined inspections and offer farmers support and guidance rather than fines.

Her report reveals the complexity of the farm inspection regime as regulators with overlapping duties all carry out their own checks. Environment Agency inspectors check on how farms protect and enhance the environment. The Animal and Plant Health Agency controls diseases and pests in animals and plants, while the Rural Payments Agency supervises the EU’s Common Agricultural Policies in England. Natural England looks to ensure the preservation of the natural environment and the Forestry Commission seeks to protect trees and woodland. Local authorities are responsible for checking on animal health and welfare.

No wonder inspections often duplicate previous visits. An analysis carried out by Defra of farm visits in the north of England found that an inspector travelled for two hours to undertake a 30-minute inspection. But he was unaware that four other inspections were carried out that day within a five-mile radius. Stacey argues that with better coordination, inspections could be carried out in a more cost-effective and efficient manner.

AUTOMATED WORK SCHEDULING AND CASE MANAGEMENT SOFTWARE

One way of greatly improving the inspection regime is through central, automated work scheduling and case management software. Using such a system, a regulator would store a list of all the farms that need to be inspected, the regulatory aspects that need examining and the history of inspections for each farm. The system would also carry data on the entire workforce of inspectors, where they operate, where they travel from, their expertise and the areas of regulation they specialise in. An algorithm would schedule inspectors’ visits in the most efficient way. This would help avoid overlapping inspections and uncoordinated visits in the same area.

Ollie Watson, a director at the technology and consultancy company CACI, which offers the Cygnum work scheduling and case management system, believes agricultural regulators could be transformed through an automated inspection regime. “Defra and its agencies rely on inspectors, officers and assessors in the field to make sure farmers are complying with ever-changing rules,” he says. “A joined-up, centralised digital strategy could provide real benefits. Farm inspectors could adopt a technical solution in the same way that the market they inspect is adjusting to rapid technological change.”

An automated system can be programmed to advise when a further inspection is needed based on business rules. Inspectors could access details about farms and their inspection record through mobile apps. “There is a lot of scrutiny on how public money is spent, so being able to demonstrate transparency of process and improved efficiency should be important.” He believes that automating the process would reduce the chances of failures and errors considerably, for instance, by generating a schedule to make sure the right inspections are carried out when they are needed. “There may be rules about how often checks should be made on different aspects of farming based on results of previous inspections that need to be accounted for. Programming these into a scheduling engine means they are never overlooked”. Additionally, at some organisations case data can be quite disjointed with information stored in different locations and in some cases individuals’ heads. “This can lead to human error, wasted time and to not getting the right information or outcomes even though the data is available,” he says. “A software workflow system can be programmed to match the exact processes casework needs, alerting and prompting, and presenting the tasks and data an inspector requires at the right time, which can really help when you are dealing with lots of complex cases.”

There is clearly a quality and consistency benefit with this approach the more it is adopted, with actual outcomes being analysed against historical recommendations made, which helps assess quality of the regulation itself.

UK agricultural rules will change as we leave the EU, and along with them the rules and systems governing agricultural inspections. Bringing on board new technology to coordinate and make visits easier would go a long way to improve the regulatory regime.

Find out more about Cygnum, our work scheduling and case management system.

Mobile working has never been more important – is your company ready?

Posted on: 25 March 2020

The ability to work from home, or work remotely, has been brought sharply into focus by the outbreak of Coronavirus (COVID-19). Most firms across the UK have been forced to shut their offices and instruct their workforce to operate from home following a government lockdown put in place to reduce the spread of the virus. So, how are you and your workforce coping with the requirement to work remotely?

The answer to that question lies in the quality of your technology infrastructure. Equipping everyone with laptops and smartphones is merely a start. How does your back-end technology function? Perhaps alarmingly give the situation in which we find ourselves, in a recent survey we conducted with Surveys in Public Sector, we found that 57% of organisations are still relying heavily on paper-based and spreadsheet methods of managing their workforce.

The pitfalls of such reliance are obvious and will become glaringly so to the 57% of organisations in that bracket during the onset of COVID-19. Not only are such methods time consuming, they often result in a lack of integration across a business, with no single source of truth. There is then the problem of Chinese whispers occurring, with misinformation, inconsistent data keying and a lack of efficiency across the entire process. With all the moving parts based in different locations, this will prove incredibly difficult to manage for some firms.

We also see in the report that organisations are already struggling to plan and manage their mobile workforce without the addition of a global pandemic, with 76% saying that they find the task difficult. Again, this is a scenario that will be exasperated by forcing even more of the workforce into a mobile situation. If it’s difficult to manage tasks during periods of normality, the stress scenario posed by COVID-19 will multiply this.

This seems to be something that most organisations are aware of, too. Responding to the question; What to do you believe are the biggest benefits when digitising resource management for your organisation? 68% replied, increasing flexibility and scalability of resources, whilst 67% replied, enable more efficient mobile or remote working.

What this shows us is that organisations have been aware of the need for change. That change isn’t just about technology, either, but about working culture, too. This has been slowly happening with advancements in technology, with laptops, smartphones and broadband making it possible to be connected 24/7.

Now that we find ourselves in the unusual position that COVID-19 has thrown up, aligning available technology with a short to medium-term culture shift is the key to business continuity.

Since flexibility sits at the heart of the process, workforce management software is designed to be just that, which means it isn’t too late to implement new software in your organisation. It has never been more important to rely on a mobile workforce and to effectively and efficiently manage them. Are you ready?

For our full report, The Future of Mobile Working in the Public Sector, please visit: https://pages.caci.co.uk/future-mobile-working.html