Meet the Rewired Speaker: Dr Caroline Pritchard

At Rewired 2024, Dr Caroline Pritchard, Consultant Anaesthetist and Perioperative Service Clinical Lead for Buckinghamshire Healthcare NHS Trust, will be taking to the Integrated Care stage on Wednesday 13 March (12.15pm) to discuss how BHT has recently created a novel and intuitive 'population health dashboard' for managing the preoperative care pathway.

The dashboard, which is integrated with the Buckinghamshire Shared Care Record, surgical waiting lists, and primary care records, allows early identification of patients on the waiting lists who have chronic conditions such as hypertension, diabetes, or obesity and those with co-morbidities.

We spoke to Caroline about her upcoming presentation, and what she is most looking forward to sharing with the audience.

Q: At Rewired, you will be speaking about how Buckinghamshire has combined surgical waiting lists with the Buckinghamshire Shared Care Record. This is believed to be a UK first. What was the motivation?

A: We saw an opportunity following the Combined Intelligence for Population Health Action (CIPHA) programme to better understand our surgical population. We have limited resources in line with most other areas, and we want to be sure - when planning how to get patients fit for surgery – that we spend our resources where it is needed, and not where it is not needed. 

Q: What changes have been made to the perioperative pathway due to the dashboard? What are some of the key modifications?

A: The incorporation of primary care data has made it possible to easily identify patients who need information on how to prepare themselves while waiting for surgery. It is also supporting surgical teams to understand the co-morbidity implications for theatre and helping them book the right patients at the right time.

On top of that, candidate lists for cancellations are helping fill cancelled slots. The dashboard automatically stratifies patients, which enables the instant identification of low-risk patients that can be booked in to available surgical appointments straightaway, filling cancelled slots immediately.

Q: How has the population health dashboard transformed how you approach perioperative wait lists in Buckinghamshire?

A: It has been truly transformative. We have thousands of patients on our surgical waiting lists - but prior to this work with Graphnet, we didn’t know how much work was needed to get people ready for surgery. We had no visibility when it came to the number of hypertensives and diabetics we had and how many were having major or minor surgery. Now, we can see the population, and we can understand their needs for the first time. That means we can target our resources in the right place.

Q: What benefits have you seen so far? 

A: We are still on the journey, but one of the main benefits so far has been the collaboration with our public health and primary care colleagues. Also, an understanding of the scale of the work we need to do, to improve the pathway for surgical patients.

The time savings have also been extremely valuable. For example, previously, all pre-operative patients would have filled a 45-minute clinic appointment. Now, manual triaging by a senior nurse has been completely removed, and 20 out of every 100 patients will avoid a pre-operative assessment (POA) completely. This will save a minimum of 15-hours of nursing time, meaning they can spend more meaningful time with their patients, along with the cost of previously associated unnecessary investigations.

Q: What are the key priorities for yourself and the work in Buckinghamshire this year?

A: Our priority is to deliver the NHS England Core requirements for perioperative pathways in an efficient and sustainable way. We also want to support and connect to the preventative health programmes running in our communities.

Q: How would you like to see the technology and its use evolving over the coming years?

A: We have only just connected the GP data in Bucks, and there is loads more to do digitally to have data flowing across services in a way that is useful clinically. We want a complete source of data for patients, ideally in the GP record. We would also like to make this information available to patients themselves. Ongoing digital development is going to be key over the coming years.

This year, Digital Health Rewired will take place from 12-13 March 2024 at NEC, Birmingham. Several of our customers will be speaking, and Graphnet Health will also have a stand at B20, just inside the entrance. We’re looking forward to seeing you there!