The HETT Unexpected Innovation Awards returns in November 2022 to celebrate the very best in experimental design, collaboration, and leadership in digital healthcare. 

The event showcases champions of digital health innovation and highlights some great stories of transformation. The awards bring together the health and care ecosystem and highlights best practice examples to inspire more to do the same. 

The Best Designed Virtual Service Award showcases teams who deliver to exceptional standard and demonstrate user-centred design at a practical service level. The service supports patients to be seen in a virtual setting that meets the needs of the patient, practitioner and the system. 

The three shortlisted submissions for this category are: 

Cush Health Digital Platform (NHS Clinical Entrepreneurs) 

 The Cush Health Digital Platform is a web app designed by NHS clinical entrepreneurs. The app, designed to help empower active living and improve mobility and social wellbeing, provides personalised recovery pathways and links to community activities and social events to older users. 

Users access videos (such as strength, balance, breathing and pilates exercises) from the platform, both while in hospital and at home. Recovery data (both user inputted and smartwatch data) allows the clinical team to remotely monitor progress and change regimes and targets accordingly. 

Grants from the Small Business Research Institute and the Zinc Catalyst enabled patient user testing via focus groups, who were engaged in all elements of production to ensure the platform was directed to users’ needs rather than becoming just a clinical tool to monitor them. 

Results indicated a reduction in length of hospital stay by two days when compared to a control group, as well an improved mobility score on the EQ5D-5L questionnaire. Readmissions were 25% of the control readmission rate, with fall related injury dropping substantially. Users up to the age of 94 engaged with the platform. 

An independent report by Consult Climate found the app resulted in a 53% cost saving and 53% carbon emission saving due to reduced readmittance, improved community care and a reduction in the need for repeat appointments. 

The V.FND Service, St George's University Hospitals NHS Foundation Trust 

In the UK, access to appropriate and timely inpatient interdisciplinary rehabilitation for patients with Functional Neurological Disorder (FND) is constrained. There are long waiting list times (+1 year) and in some geographical areas there is no local inpatient provision at all. v.FND, a fully digital service comprising of neuropsychiatry, clinical psychology, physiotherapy, occupational therapy, and speech and language therapy, was developed to address this unmet need.  

The virtual service, which provides assessment and treatment to patients via video-conferencing appointments in their own home, was developed in collaboration with key stakeholders, including clinical specialists, hospital managers, charity groups, and service users (current and past patients).  

The service evolved following reviews at key milestones and continues to mature in response to ongoing qualitative and quantitative feedback. 

The clinical pathway involves offering the digital service as an alternative to patients who meet certain criteria. Multidisciplinary assessments are completed in three weeks and a collaborative team formulation informs whether further digital rehabilitation will be provided. Nine patients have received an eight-week tailored rehabilitation programme with a minimum of four sessions per week. 

Evaluation against key deliverables after one year found:  

  • Significant improvements in rehabilitation outcomes. 
  • Change was comparable to patients receiving inpatient rehabilitation. 
  • On discharge 70% of patients rated their condition as much improved or very much improved on the clinical global impression scale. 
  • The cost per patient was 10% of inpatient rehabilitation (£5,000 vs £50,000).  
  • A 90% reduction in referral to treatment time 

Medway Foundation Trust - SMART Service 

The SMART (Surgical Medical Acute Recovery Team) virtual service consists of a nurse-led 30-bed virtual ward. SMART is an expansion of an existing virtual pathway in Medway Maritime Hospital.  

The H@H (Hospital@Home) service was designed in 2009 to cater for a small number of nebulised patients, some oxygen-wean, and for the administration of IV antibiotics in the community. Capacity was an issue so in 2018 the virtual pathway was amalgamated with the enhanced recovery pathway in the Trust to expand the service. The service was renamed SMART to encompass all adult specialties and include vascular access as part of the service. 

The challenge was to utilise the SMART workforce effectively and efficiently. Remote Patient Monitoring (RPM) was introduced. Current Health’s RPM kits were identified as the most suitable following research of similar solutions across neighbouring hospitals. 

Utilising Current Health’s kits, it was possible to reduce the number of face-to-face visits for respiratory patients. The service enabled certain patients to continue acute care in an outpatient setting. All surgical, orthopaedic and cardiology pathways are supported by the various admitting clinicians. 

Staff are trained to use clinical assessment and examination skill to pre-empt clinical deteriorations, to commence investigation, and obtain treatment via the hospital front door units and outpatient clinics.  

The RPM technology allows continuous vitals monitoring, which is shown on a dashboard. The device identifies clinical deterioration that can be escalated and acted on immediately by the assigned healthcare professional (HCP). Clinicians contact patients via the device video to conduct assessments. Virtual visits between the MTD, the patient and carers at home are conducted via Zoom. 

A 2020 patient satisfaction survey found that monitoring was efficient, and that patients felt reassured to be monitored, have a nurse call them every morning, and have access to help at the press of a button.  

Visit the HETT Unexpected Innovation Awards 2022 website for more information about the categories and the upcoming awards ceremony. 

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