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Royal Papworth / Case Study 18.08.21

Royal Papworth builds data confidence with Trust-wide elective care management solution

Royal Papworth Hospital NHS Foundation Trust, the UK’s leading heart and lung hospital, implements Insource’s Patient Pathway Plus (PP+) to drive waiting list automation and deliver:

Key Benefits:

  • Reduced errors in waiting lists and patient pathways
  • Automated data collection, consolidation, and validation
  • Automated Referral to Treatment (RTT) and Patient Treatment List (PTL) reporting
  • Operational staff taken ownership of data accuracy at input
  • Single version of the truth of the PTL across the Trust
  • Confidence in the data throughout the Trust and at Board level
  • Data quality helping with business practices redesign and training

Full case study

Based on the Cambridge Biomedical site, Royal Papworth Hospital is the UK’s leading heart and lung hospital treating more than 50,000 patients per year. The Trust was rated as ‘Outstanding’ by the Quality Care Commission (CQC) in 2019. With an international reputation for excellence, it now performs more heart and lung transplants each year than any other UK centre. Royal Papworth is a member of Cambridge University Health Partners (CUHP), a partnership between one of the world’s leading universities and three NHS Foundation Trusts. It was granted Royal status in 2017 in recognition of its commitment to excellence in cardiothoracic care.

The Challenge

Royal Papworth’s aim was to generate an accurate view of patients waiting for treatment and produce reliable daily PTL reports for service planning and reporting. To achieve this, data from their electronic patient record system, Lorenzo, was pulled through to the Trust’s Access database. Due to data quality issues, this needed to be manually corrected for external reporting which resulted in major discrepancies between the two systems.

Changes within patient’s RTT pathways between the weekly PTL submissions needed to be validated manually prior to submission, which took the central team approximately two and a half days to complete. The weekly PTL report could not be produced until this process had be completed, resulting in the PTL already being out of date. Due to the high error rates, producing regular reports was proving to be a challenge for the central team as there was no ability to audit changes and resulted in duplication of workload. Ownership of patient pathways and the correction of any data quality errors needed to sit with operational teams, and less with the central team. If data quality corrections were made directly in Lorenzo, PTL submissions could then be generated automatically without manual intervention.

The additional national dataset requested by NHSE/I in April 2021, which now incorporates Non RTT data, has reaffirmed the Trust’s commitment to create a single source of the truth where coding errors or broken pathways are easily identified and corrected, and national reporting is automated.

The Solution

Royal Papworth wanted a system that was fully auditable and refreshed the RTT PTL automatically on a daily basis. They needed a solution that the operational teams could access, so the ownership could shift back to the point of original data input.

The Trust installed Patient Pathway Plus (PP+) a powerful data platform that extracts and processes data directly from the Trust’s source systems automatically. Through these automated data pipelines and rule-based data validation processes, PP+ provides a single version of the truth and shows the precise status of 18-week pathways at any point in time.

Data standardisation and the need to automate disparate data sources and data flows is a critical foundation for a data-driven NHS. PP+ provides a transparent, evidence-based data platform that enables Royal Papworth to effectively manage their patient pathways and processes throughout the organisation.

Increased data ownership across the teams

The RTT PTL can now be viewed daily by the operational teams who are responsible for inputting patient data in Lorenzo. This increased visibility has created a greater focus on data quality, and enabled individuals to see the impact and importance of the correct administration of patient’s data. The audit trail produced by PP+ has enabled the team to highlight specific areas for data quality improvement, which has resulted in targeted training being delivered throughout the trust.

Of the original 2,000 data discrepancies between Access and Lorenzo, this rate has now decreased to 100-150. These errors are sent out to the business teams to correct at source, which is recorded and monitored within the solution. As PP+ gives a joined-up, continual gathering of data, it is enabling Royal Papworth to redesign business processes to make the best use of their data in the PTL.

“The availability of a daily PTL has improved the visibility of our 18 week pathways, which has reinforced the impact of data quality across the Trust. Staff are more engaged with the Trust’s principle of ‘Getting it Right First Time’, and the benefit that this brings to improving patient care.”

Adelaide Hough, Data Quality Team Leader


Royal Papworth – data confidence for a data-driven organisation

With increasing confidence in the Trust’s data, Royal Papworth is now using this validated information as a foundation for change in its move towards becoming a true data-driven organisation. Clinically at-risk patients are now easily identified, and breaches spotted quickly and dealt with urgently. Harm reviews are also clearly visible in the system.

“Following the deployment of PP+ we are now able to detect and correct RTT data quality issues far more effectively than in the past. With the audit and governance capabilities of the system, we are also able to detect emerging trends as they develop, enabling the central team to conduct targeted training to prevent these common errors reocurring.”

Craig Salmon, Head of Business Intelligence and Analytics

Next Steps – eLearning and Non RTT submissions

  • Implementation of Insource’s RTT eLearning training platform to improve staff knowledge of 18-week pathway guidance and administration
  • Following the update to national requirements regarding the submission of non RTT data, the Trust are working with Insource to implement non RTT pathways into PP+. This will enable the creation of a complete PTL in PP+, encompassing both RTT and non RTT waiters, including automated national submissions and reporting.