Challenge

It’s essential for all hospital and care staff to have personal protective equipment (PPE) to care for others safely. The COVID-19 pandemic has created shortages of PPE across the UK.

North East London is striving to keep all medical and care staff as safe as possible as they respond to unprecedented levels of demand in a crisis. Managing emergency PPE stock for hospital trusts, GPs and other community providers in the area, they have an urgent need for visibility of all equipment levels to manage supplies, assess equipment allocation and sharing decisions.

North East London invited FutureGov to help redesign their PPE reporting system. Working together to create a digital tool, we could identify supply levels and better enable decisions around the provision of emergency supplies while reducing time spent on reporting to the wider PPE coordination efforts in London and nationally.

Approach

Currently, hospital sites collate PPE stock levels using a spreadsheet which is then emailed to the North East London team to coordinate the delivery of supplies. This data was then consolidated into a master spreadsheet before it could be sent off to a central team for further spreadsheet consolidation. The process resembled a ‘Russian doll’ of spreadsheets which was both time consuming and increased the likelihood of data input errors. For primary and community providers, a lack of regular reporting to the North East London PPE team also made it difficult for decisions to be made around allocating emergency PPE supplies and the use of ‘mutual aid’ between providers.

North East London needed an effective and time-saving digital tool that could incorporate PPE management needs, whilst recognising the immediacy of delivering support to their COVID-19 response. Through a combination of remote working, virtual tools (Google, Figma, Slack, Trello) and user research/proxy user research, we worked with North East London to co-create a digital tool that was both fit for purpose and ease of use. We wanted the tool to be simple to use but also easy to scale, with the future opportunity of low-cost replicability at a regional and national level.

Recognising needs

The North East London PPE team required the ability to visualise all hospital, GP and community provider stock levels in real-time to make decisions around allocating emergency stock accurately and supporting ‘mutual aid’ amongst primary and community providers. It’s essential to enable staff to send timely reports of stock levels to the team coordinating PPE supplies that support London and national PPE supply efforts.

Hospital trusts are required to record PPE stock levels for regional, London-wide and national PPE coordination efforts. However, little consideration had been given to how they were balancing this process against the pressures of supporting COVID-19 response efforts on the frontline. To support them, teams needed to be able to enter stock quantities and information (including how long until stock runs out) in a way that was simple, clear and flexible to the different areas of a whole hospital, e.g. ward, substore, hospital site, whole trust, etc.

Primary and community care providers (GP practices, out of hour services, urgent treatment centres, pharmacies and community care services) required support from North East London in coordinating their emergency PPE provision. Whilst their requirement to report PPE stock levels was not mandated, they needed a simple way to report stock levels and request emergency supplies and/or mutual aid. With over 1000 potential providers, it was important to ensure the process for onboarding, stock level collection and PPE need identification was as streamlined as possible. In addition, consideration needed to be given to the multiple potential sources of support for primary and community providers, including GP Federations and Primary Care Networks.

Data collection

It was essential that PPE data collection recognised the pressures that providers are under and ensure that all data collected will provide real value in the management of PPE. The London PPE team initially set requirements for data collection at a trust level. During the month of April, these requirements changed on a near-daily basis.

North East London have therefore established PPE data requirements needed to manage their emergency stock for trusts, primary and community care sites which includes London data requirements but takes a proactive approach to their own PPE management.

Creating a digital tool

Looking at needs across the system, we identified opportunities to improve the process of recording and assessing PPE stock levels, incorporating them into a digital tool that reflected the real and urgent needs of a health system response to a global pandemic, making it easier for users operating in stressful and time-sensitive conditions.

Using a smartphone or tablet, users can review and record stock levels in real-time following clear instructions on how to measure stock (e.g. individual vs. pairs vs. boxes vs. palettes of gloves) to minimise ambiguity and make the process as easy as possible and define the granularity or scope of data collected, providing the flexibility to record for individual wards, a whole hospital, etc.

To date, we’ve developed and implemented two versions of the PPE digital tool to support the varied, important and individual requirements of hospital trusts and primary/community providers.

PPE management for hospital trusts

The PPE management tool for hospital trusts works by allowing providers to use their own smartphone or tablet to collect information on PPE. If this is not possible, they can use the internet on a computer. There is one account/individual per hospital to avoid conflicting updates.

The site has easy access and guidance on what information is being collected on PPE and how it should be collected. Staff can enter information each day using an online form, submit it and receive feedback on the information they’ve collected.

PPE management for primary and community sites

In addition to the requirements for hospital trusts, community providers require a way to register their interest in submitting their PPE stock levels and being eligible for emergency PPE and mutual aid. It was essential for this version of the tool to capture site location to understand proximity for consideration of mutual aid. This version also prompts providers to encourage the daily return of PPE numbers.

PPE management for North East London

To support the management of PPE across the system, the PPE team in North East London can use their own smartphone, tablet or computer to view stock levels as they are submitted in real-time.

Registering through a dedicated link, staff can view the information for all submissions in one place and understand PPE levels across North East London. There is added functionality to change the level of permission of staff, so more than one member can access certain information. From a central dashboard, staff see a prioritised view based on which stock is at greatest risk, allowing them to understand and prioritise need. This information can then be exported and shared for input into wider data analytics.

Impact

During a time of restricted movement and inability to be physically together, we utilised a host of digital collaboration tools, project rhythms and rituals to ensure we could work effectively and collaboratively with North East London and care providers.

We’re still in the early stages of the management tool and already seeing an impact:

• reducing time spent collecting and disseminating data by care staff
• improving data accuracy
• promoting conversations across the system

Next steps

It was important to build a digital tool that could extend this solution to support consistency in PPE decision-making across a wider network, whether that be the region, London-wide or nationally. The next steps will see North East London expand the use of the PPE tool and process to other areas that are vital in managing the ongoing COVID-19 response, including testing kits and mortuary management.

Further development will automate functionality, allowing us to open-source the code and scale it further across London and other geographies. The tool will be considered for London and nationwide efforts to track PPE and other vital supplies required as part of the ongoing COVID-19 response. This was an objective kept in mind during the development stages, and as such the tool is easy to scale and simple to use which contributes to low-cost replicability at a regional and national level.