Supporting service providers to evaluate innovative ways of working in real world settings
Black Maternity Matters
Black women are four times more likely to die during pregnancy or in the postnatal period than White women. Stillbirth rates of Black and Black British babies are over twice those for White babies.
We’ve developed the Black Maternity Matters project in partnership with Representation Matters, BCohCo and Black Mothers Matter to deliver meaningful, actionable improvements to reduce inequity of outcomes for Black women within maternity systems through a collaborative quality improvement (QI) approach.
In 2022 we ran an eight-month pilot with midwives and maternity support workers from North Bristol NHS Trust and University Hospitals Bristol and Weston NHS Foundation Trust, who took part in
training examining unconscious biases and the role of the individual in perpetuating unsafe systems of care for Black women.
Evaluation of the pilot phase of Black Maternity Matters shows the project has successfully helped to improve their knowledge and skills associated with cultural competency.
Informed by the evaluation of the pilot phase, we will deliver three further programmes of the Black Maternity Matters training in 2023/24.
Read more about Black Maternity Matters.
Non-invasive ventilation
Mortality rates for patients in England requiring acute non-invasive ventilation (NIV) for type 2 respiratory failure is higher than in many other countries.
In December 2022 we launched a new project to reduce mortality rates for patients who require acute
NIV. We are collaborating with all six acute hospitals across the West of England to implement an
evidenced-based care bundle known as ‘NIV 5’. The project also aims to improve staff knowledge of NIV care, alongside supporting a positive patient experience through more effective communication.
An evaluation exploring this project will be completed by December 2023. This will inform the potential
for adoption and spread of the care bundle and collaborative approach beyond the West of England.
Read more about our NIV project.
Working together to reduce caesarean birth infections
Building on the success of our award-winning PreciSSIon project to reduce surgical site infections (SSI) after elective colorectal surgery, we launched a new collaborative focused on preventing SSIs following caesarean births.
Since October 2022 we have baselined data and designed the new care bundle. During 2023/24
we will embed the bundle across our six trusts and evaluate our progress. We are also working with our local Maternity Voice Partnerships to coproduce materials with mothers and their families.
Find out more about PreciSSIon.
Domiciliary Care Workforce Programme
We are leading an evaluation programme to test the potential of artificial intelligence (AI) logistics technology to transform planning for providers of domiciliary social and health care and improve the working lives of their staff – and ultimately, the quality of service provided to patients in their own homes.
Delivered in partnership by the West of England and South West AHSNs, Health Education England, Bristol City and Cornwall Councils, the Domiciliary Care Workforce Programme is running two pilot schemes in Bristol and Cornwall.
Following an open call, Finnish company Procomp Solutions was selected as the innovation partner for the programme. Procomp has a strong track record in logistics planning and optimisation, and around 75% of retail food distribution in Finland is organised using their systems. In 2011 they spotted the potential of their systems for the home care sector, and now support around a third of the Finnish home care workforce.
Early findings show there is an opportunity to reduce mileage by up to 65% and improve utilisation of the workforce by 30%. We are undertaking a real-world evaluation to assess to what extent the opportunity can be delivered by councils and home care providers.
The pilots will run in Bristol and Cornwall through to autumn 2023, with a full evaluation report due to be published by early 2024.
Find out more about the Domiciliary Care Workforce Programme.
Speeding up clinical diagnosis of cardiac arrhythmias
Zio XT is a complete and clinically proven ambulatory ECG monitoring service, utilising
powerful AI-led processing and analysis to support clinical workflows and improve the diagnostic yield and timeliness of cardiac monitoring.
We have been supporting iRhythm, the digital healthcare company behind Zio XT, since 2018 to get their product market-ready. It is hoped this technology will help to reduce waiting list time, prevent unnecessary journeys to and from hospital, release staff capacity and reduce the number of repeat tests performed.
We are working with North Bristol NHS Trust on a ‘proof of value’ project to assess the impacts of their use of Zio. Our support focuses on pathway transformation and a retrospective analysis of trust and company data to confirm impact and if applicable, inform a case for future potential commissioning within their cardiology pathway.
Read more about this proof of value project here.
Evaluating a new frailty service in South Gloucestershire
Research suggests that housebound and frail patients are less likely to access the care they need despite having higher rates of co-morbidity, functional impairment, and mortality than their non-housebound counterparts.
Yate and Frampton Primary Care Network (PCN) have implemented a new frailty pathway to better support frail patients through use of a more holistic and person-centred approach. The West of England AHSN supported the development of the frailty pathway and coordinated a service impact evaluation by
Unity Insights.
The evaluation shows patients feel less isolated and better able to manage their health as a result of the service.
The PCN will keep delivering the frailty service through to March 2024. Further evaluation will be carried out (available in early 2024) to inform the potential continuation of the service. As there’s lots of interest in this model, findings will be shared from both this initial evaluation and the next phase with other localities to help inform their approaches.
Read more about the pilot evaluation.
Reducing restrictive practice
As part of our local delivery of NHS England’s Mental Health Safety Improvement Programme, we’ve focused on the national ambition of reducing restrictive practice incidences by 25% in inpatient mental health, learning disabilities and autism wards.
We have worked with two mental health trusts, Avon and Wiltshire Partnership and Gloucestershire Health and Care, to develop and test a range of change ideas with patients and experts by experience. This has included reviewing and reducing or removing unnecessary blanket restrictions in mental health wards, developing new discharge processes for patients with a learning disability, and positive behavioural support ‘scenario’ training for staff.
Read more about our work to reduce restrictive practice.
Innovation for Healthcare Inequalities Programme
We’re working with project teams and local communities across the West of England to reduce healthcare inequalities through two new projects designed to improve access to the latest health technologies and medicines.
NHS England’s Innovation for Healthcare Inequalities Programme (InHIP) seeks to address local healthcare inequalities experienced by deprived and under-served populations. It is a unique collaboration between the Accelerated Access Collaborative, NHS England’s National Healthcare Inequalities Improvement Programme and the AHSN Network, and delivered in partnership with
integrated care systems.
In our region we are working with Bath and North East Somerset, Swindon and Wiltshire and Bristol, North Somerset and South Gloucestershire integrated care systems on innovative projects focused on reducing cardiovascular disease through lipids optimisation, a clinical priority within NHS England’s Core20PLUS5 strategy.
Find out more about InHIP.
