Seven health care project teams have each been awarded £0.5 million by the Health Foundation to take proven health care interventions and approaches and deliver them at scale across the UK.
Over the next two and a half years, as part of the Health Foundation’s Scaling Up Improvement programme, the project teams will scale their projects regionally or nationally and aim to deliver direct improvement to patient outcomes.
To effectively promote, spread and embed change across NHS the project teams will work together with a range of organisations such as clinical commissioning groups (CCGs), health boards, royal colleges, academic health science networks, and voluntary sector organisations.
A previous example of success from the Scaling Up Improvement programme is the pharmacist-led PINCER project to reduce medication errors in general practice. Around 2.9 million patient records were analysed for prescribing errors, with pharmacists working together with GP practices to build action plans to protect patients at risk of prescribing errors. PINCER exceeded its original aim of scaling up to 150 GP practices and has now been implemented in 362 practices in 12 CCGs.
The long-term aim is that improvements will be sustained beyond the life of the original project and have wider adoption across the UK.
The projects are:
1) PReCePT2: Reducing brain injury through improving uptake of magnesium sulphate in preterm deliveries
Lead organisation: University Hospitals Bristol NHS Foundation Trust
The PReCePT project aims to increase uptake of magnesium sulphate to protect babies’ brains during premature births and will be scaled up to 10 maternity units. Evidence shows that magnesium sulphate reduces the risk of cerebral palsy, but currently many premature babies in the UK do not receive the benefit of this highly cost-effective treatment.
2) Scaling up virtual consultations across the NHS – implementing, evaluating and sustaining improvements
Lead organisation: Barts Health NHS Trust
To spread the use of outpatient video consultations, this project will create a virtual consultation unit within Barts Health and form a national network of sites working together to learn about implementation. They will aim to develop a standardised national-level policy for the practice. The use of video consultations in the NHS has been shown to increase patient attendance rates, improve outcomes and provide more patient-centred care.
3) Scaling up a clinical effectiveness approach for Southwark to drive up quality and reduce unwarranted variation in general practice
Lead organisation: NHS Southwark Clinical Commissioning Group (CCG)
Working in partnership, Southwark’s CCG and GP federations will adopt a tried-and-tested clinical effectiveness model to meet the challenges facing primary care. Using a package of aligned quality improvement interventions, a clinically led delivery team will support practices to improve outcomes for patients by making the right thing to do, the easy thing to do, for busy GPs.
4) Improving surgical care for patients and their families in Greater Manchester – ERAS+ GM
Lead organisation: Manchester University NHS Foundation Trust
ERAS+ is a pre- and post-surgery training programme proven to improve recovery following major surgery, and has been shown to reduce post-surgery respiratory complications by 50% resulting in a three-day reduction in length of stay and annual savings of over £0.5m within a large acute hospital. This project will involve implementing the programme in six other NHS Trusts and evaluating this process to disseminate the programme further within the NHS.
5) Telemedicine for adults with cochlear implants in the UK: empowering patients to manage their own hearing health care
Lead organisation: University of Southampton
People with cochlear implants need lifelong follow-up, which can be done at one of only 18 centres in the UK. This project will improve access to care and increase patient empowerment by scaling up a successful remote care pathway so patients are offered a personalised online support tool, home hearing test and support to adjust devices.
6) Pressure reduction through continuous monitoring in community settings (PROMISE): reducing and preventing avoidable and unavoidable pressure ulcers
Lead organisation: Cornwall Partnership NHS Foundation Trust
Many people with high levels of frailty and underlying health conditions develop pressure ulcers and these can be difficult to manage in community settings without access to specialist support. This project will explore whether monitoring and adjusting pressures using mattress and chair sensors in patients’ homes, and in residential and nursing homes, can alleviate discomfort and reduce pressure damage.
7) Implementation of Redthread’s hospital-based Youth Violence Intervention Programme in the Midlands to care for young people affected by violence
Lead organisation: Redthread Youth Limited
Redthread Youth is a charity that supports vulnerable young people in crisis. This project will implement the charity’s Youth Violence Intervention Programme in Nottingham and Birmingham, and bring learning from previous experience of embedded youth worker teams in major trauma centres in London. The approach supports young people who attend hospital because of a violence-related injury and is based on the idea of the ‘teachable moment’; a moment of crisis at which a young person is most receptive to change.
The new projects are currently subject to contracts being finalised with the lead organisation of each project.