eSAP at Tower Hamlets

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e-SAP at Tower Hamlets
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Tower Hamlets

• Strong history of joined up working
• Inner NE London Care Community
• Co-located / funded
• Leading Partnership in innovation service
  development in SAP
• One of the most culturally rich and diverse
  boroughs in the UK

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The Partnership

• London Borough of Tower Hamlets
• Tower Hamlets Primary Care NHS Trust (PCT)
• Bart's and the Royal London NHS Hospital Acute
  Trust
• East London and the City NHS Mental Health Trust

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SAP in Tower Hamlets

• Project team created in June 2004
• Representation from
• LBTH Social Services
• Tower Hamlets PCT
• East London City MH Trust
• Bart's the Royal London Acute Hospital Trust
• Older peoples reference group
• 5 Workstreams
• The workstreams had a lead officer from one of
  the agencies

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e-SAP project

• We had an existing N3 connection
• We wanted a computerised system to support
  information sharing for the Single Assessment
  Process across the Partnership
• London Programme for IT e-SAP solution provided
  us with the opportunity to try out a system which
  authenticated to the NHS spine and allowed us to
  quickly and easily attach existing SAP
  documentation

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eSAP Deployment

• We went live on 05 June 2006
• System deployed to 228 users across the
  partnership

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Lessons Learned

• Do not underestimate the complexities and
  difficulties in managing a project across 4
  organisations.
• We provided floorwalkers to supplement user
  training.
• The need to duplicate entry of data.
• Because we were the first partnership to try out
  the system we had good support from the London
  Programme and BT to identify issues promptly, and
  these have been fed through and used to modify
  future deployments.
• A good deal of work has been undertaken to
  understand and to optimise the RA process in each
  of the organisations.

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Benefits of the e-SAP system 1

• The system is web-enabled. This speeds up the
  referral process
• The system is relatively easy to deploy and to
  roll out to additional teams
• Overheads are minimal
• Workflow is organised within the system
• Confidentiality of patient records is enhanced

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Benefits of the e-SAP system 2

• The system consolidates the SAP process
• Data quality is enhanced by providing access to
  NHS spine database
• Key information such as GP, allergies and basic
  personal information is made accessible to staff
• Risk alerts are accessible to staff prior to
  initial visits
• Smart cards control access to patient information
  and provide an audit trail
• Referrals across organisations are better managed
  and easily accessible

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Benefits of the e-SAP system 3

• Individuals needs can be viewed holistically
• Work can be managed at a team level
• Information can be quickly and easily updated.
• The system provides secure messaging across the
  partnership
• Coordinated care can be managed better

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Benefits of e-SAP to older people

• Not being asked the same questions by a range of
  people
• An individual is empowered
• An assessment is proportionate to an individuals
  needs
• A single assessment summary is produced in a
  prescribed form
• Full information in accessible formats is
  available to them about access, assessment,
  services, charges and complaints

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E-SAP Case Study - Mrs A

• Mrs A was admitted to an in-patient ward at Mile
  End Hospital and died shortly afterwards.
• Staff carried out the normal procedures in this
  event and a death certificate was issued.
• Two days after Mrs A had died a flag was
  automatically generated on her e-SAP record.
• This is because formal notification of death (by
  generation of a death certificate) triggers an
  alert on the NHS spine which automatically flags
  any patient records held on the patient
  demographic service (PDS file).

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E-SAP Case Study Mrs A

• As a result, all the professionals involved in
  Mrs As care were able to see the updated changes
  to her e-SAP record and were able to update their
  own client records quickly.
• Staff were able to close down their involvements
  with Mrs As care quickly and appropriately.
• Mrs As relatives were not needlessly contacted
  and professionals could be sure that they did not
  cause any unnecessary distress to them.

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E-SAP Case Study Mrs B

• A Mrs Bs daughter contacted her mothers GP to
  express concerns about Mrs Bs current situation
  at home.
• The GP passed the concerns to his practice team
  and a district nurse did an assessment of the Mrs
  Bs needs.
• Within hours and as a result of that single
  contact to the GP a care alarm and commode had
  been delivered to the Mrs Bs home.
• Mrs B now has her care managed through the e-SAP
  system and the full range of services available
  to her can be brought together as and when
  required.

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E-SAP Case Study Mrs B

• Mrs B was able to continue living at home, with
  appropriate support and services brought to her.
  
• This demonstrates how services can be brought
  together seamlessly, and unnecessary admission to
  acute care (hospital) can be avoided.
• Because professionals had access to the e-SAP
  system, they were able to co-ordinate the various
  parts of Mrs Bs care quickly and easily create a
  cross-organisational care team which focussed on
  both the patients social care and health needs.

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A closer look at Benefits Realisation

• A single benefits register was created to
  identify organisational and community level
  benefits
• These benefits were prioritised and agreed by the
  e-Sap project manager and BT
• Owners were assigned to 5 priority benefits and
  base lining commenced
• BT supported the project office in the reporting
  and presentation of the benefits post go-live to
  promote lessons learnt and knowledge share

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5 Priority Benefits

• Reduction in number of inappropriate referrals
• Real-time access to patient records 24/7
  (Improved access to patient data)
• Care professionals spend less time chasing
  patient records (Improved access to patient data)
• Improved workforce performance
• Improved access to services

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Reduction in inappropriate referrals
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Care Professionals spend less time chasing
patient records

• Average time reduced by 6 hrs 21 mins

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Variance in Processing Time for SAP Requests

• Average time reduced by
• 6 hrs 21 mins
• Variance reduced by
• 25 hrs 10 mins

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What next for e-SAP at Tower Hamlets?

• E-SAP seen as the key IT solution for Adult
  Services across the partnership
• Increase the numbers of staff to whom e-SAP is
  deployed
• Links made to GPs system
• Investigating the use of Section 2 and Section 5
  documentation

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What next for e-SAP at Tower Hamlets?

• We are looking at ways in which we can utilise
  the application more fully
• By piloting mobile technology
• By developing further the SAP documentation we
  currently use
• By developing the way in which information is
  passed from our core applications across to e-SAP

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Thank you Polly WicksAdults Project
Manager Adults Health Well Being London Borough
of Tower Hamlets polly.wicks_at_towerhamlets.gov.uk