“The evaluation work conducted by KSS AHSN was really impressive – professional, agile and thoughtful from start to finish. We look forward to seeing the report we have co-produced driving transformation towards streamlined communication in the NHS.”
Dr Barney Gilbert, Co-founder of Pando
Overview

Pando (previously known as Forward) is a communications platform for healthcare professionals. It was created by NHS doctors to help NHS staff exchange patient information, make clinical decisions, manage their workload, and make collaboration easy, fast and secure. Pando saves healthcare professionals more than 40 minutes per shift and improves satisfaction at work, while saving NHS Trusts £6.9m over a five-year term.

The KSS AHSN Insights team conducted an in-depth evaluation to assess the impact of Pando in 2019, which found that an acute Trust adopting Pando could save just under £1 million (£922k) from in-year cash and non-cash savings, rising to £44 million should the application be rolled out across all acute Trusts nationally. The vast majority of savings are attributed to time savings for the workforce (non-cash savings). Less than 2% of overall savings were a result of avoiding potential fines from disciplinary action requirements (non-cash savings) and pager savings (cash-savings).

With contracts at eight Trusts and the British Army, Pando are ready to scale, working with AHSNs to achieve this. Pando has been able to create 20 jobs as a result of its growth and attracted £11 million of investment.

Challenge / problem identified

Communicating effectively and efficiently is of key importance in healthcare as the impact of such inefficiencies can lead to various negative outcomes affecting the overall continuity of care, patient and staff experience and resource misuse (Vermeir et al., 2015). Pagers still represent the traditional method of communication for urgent and non-urgent requests in the NHS in England primarily due to their reliability. Instant messaging applications are increasingly being used, but are often non-legally compliant with patient safety and data protection rules.

Research suggests that, by 2016, more than 95% of NHS healthcare professionals had switched to using a non-compliant smartphone app to share information at work (Schamroth et al., 2019).

The NHS Long Term Plan marks a change towards the adoption of a new generation of digital services; a key transition will be the phasing out of pagers by the end of 2021.

The challenge was to enable NHS staff to exchange information and communicate effectively over a secure platform.

[1] Vermeir, P., Vandijck, D., Degroote, S., Peleman, R., Verhaeghe, R., Mortier, E., Hallaert, G., Van Daele, S., Buylaert, W. and Vogelaers, D. (2015). Communication in healthcare: a narrative review of the literature and practical recommendations. International Journal of Clinical Practice, 69(11), pp.1257-1267.

[2] Schamroth J., Pettit, W., Yarlott, L., Scharff, L., Scharff, L., Gilmartin, M., Harris, R., Gilbert, B.J. (2019). Connecting the hospital using ‘Forward’, a smartphone application for clinical teams. Future Healthcare Journal, Vol 6, No 1: s67.

Actions taken

Before launching Pando, its founders verified their hypothesis of need for a new communication platform by surveying more than 500 healthcare professionals across 10 NHS Trusts (mix of acute/ community, tertiary referral/ district general, and in different parts of the UK). They also studied available research by the Center for Health Information and Decision Systems showing that poor communication costs US hospitals in excess of $12 billion per year.

The KSS AHSN evaluation included assessment of the economic, health and social outcomes of its solution and qualitative review to understand clinicians and users’ sentiment about the application. A cost-benefit analysis measured the technology’s impact in terms of real monetary cost, headcount, material reduction and productivity improvement standards relative to other current options of communication.

A budget impact model tool has also been produced to assess the applications implementation impact for a selected pilot site looking at different workforce population groups.

Impacts / outcomes

Since launching in 2018, Pando (Forward) has onboarded over 16,000 clinicians representing more than 10% of NHS hospital doctors, who have sent more than five million clinical messages, across 5,000 teams. Pando has contractual agreements with eight NHS Trusts.

Pando has been able to create 20 jobs as a result of its growth and attracted £11 million of investment.

Overall, findings in the KSS AHSN evaluation showed positive return on investment results under all scenarios. The scenario which looked at the overall clinical staff population (applying inter- and intra-department tasks to all groups) resulted in in-year cash and non-cash releasing savings of £922K for a trust-level roll-out and £44 million for a full national roll-out (n=135 acute non-specialist Trusts). On a broader timeframe, this results in a five-year net present value savings of £6.9 million at a Trust-level and £340 million nationally, should it be fully rolled out. Further scenarios reviewed the impact of the application looking at tasks realised within or across teams.

The largest proportion of benefits were NHS non-cash releasing outputs (>95%). From the cost-benefit analysis, the use of Pando highlighted the following:

  • Specific staff group populations experienced greater benefits than others e.g. nurses
  • Process time for intra-departmental communication tasks was improved significantly compared to inter-departmental communication tasks
  • Process time for specific tasks was faster than with current communication methods e.g. patient discharge, patient review, queries with respect to medication, nutrition or prescription.

The qualitative review brought to light additional indirect benefits from those monetised and showcased in the analysis. Such benefits included the improvement of patient management and experience, staff satisfaction and retention, patient safety and security, as well as learning opportunities.

Plans for the future

Pando has mainly been directed towards the acute setting with more than 200 pilot sites across the UK. KSS AHSN continues working with Pando to support continued adoption and spread. Whilst the initial focus has been targeted on clinical staff in acute settings, Pando will look towards allied healthcare professionals as well as administrative staff. The community care setting and primary care setting are also two areas to be explored in 2020.

As of April 2020, Pando is working closely with over 200 NHS organisations and is the only app listed in the COVID-19 section in the NHS Apps Library that is made solely for health and social care professionals. It is also has NHS Digital approval and has been widely used as part of the COVID-19 response.

Which national clinical or policy priorities does this example address?
  • Care and Quality
  • Funding and Efficiency
  • Driving Economic Growth.
Where did the innovation originate from?

Pando was created by NHS doctors.

Which AHSN Priorities does this example cover?

System enabler projects:

  • Data integration / interoperability
  • Digital health (including road maps and enabled care services)
  • NHS Innovation Accelerator
  • Workforce development (incl. capacity & capability building and patient & public leadership).
Start and end dates:

KSS AHSN evaluation

Start: October 2018

Finish: September 2019.

Project contact for further information

Marie-Anne Demestihas, Workstream Lead, KSS AHSN. marie-anne.demestihas@nhs.net

Media contact for further information

Rick Fell, Head of Communications, KSS AHSN. rickfell@nhs.net 07827 369797