Imagine if there were an app that reduced accident and emergency waiting times, ensured women are followed up after childbirth and even identified when hospital patients need to be transferred to intensive care.

These were some of the innovative ideas generated by more than 100 NHS doctors, dentists, technology developers, scientists and health economists at an unprecedented blue-sky thinking event that aimed to explore new possibilities in care in the digital age.

The task at the NHS Ideas Lab hackathon was to find 21st-century solutions to problems facing patients, doctors and the NHS. Issues addressed included long waits for A&E, paper records that can get mislaid and lengthy processes that slow down patient care and increase the possibility of human error. A new innovation fund worth £100,000 has been set up to support some of the best ideas.

Dr Umar Ahmad, an A&E doctor at the Royal London hospital, was part of a team at the hackathon that came up with the idea of an app to speed up A&E waiting times. He said: “We need to streamline processes by using new technology, while at the same time maintaining high standards of patient care.

“In 15 years’ time artificial intelligence will be part of the NHS, but there are things we can do now to make our jobs a little bit easier and better for patients too.”

Anaesthetist Dr Tim Knowles, who also attended the event, added: “The technology is moving forward but we have hundreds of legacy systems. This means everything gets patched together with the electronic version of Sellotape but it doesn’t work very well. Clinicians have ideas about how to improve systems but the hackathon gave us the opportunity to find out realistically what is possible and understand how apps work.”

The hackathon, which took place in London last month, is the first to be organised by the pharmaceutical company Boehringer Ingelheim since becoming a sponsor this year of the NHS clinical entrepreneur programme, set up by NHS England and Health Education England two years ago to offer doctors and other health professionals the chance to develop their entrepreneurial aspirations while continuing to work in the NHS.

Professor Tony Young, national clinical lead for innovation at NHS England, said: “It was a remarkable success, and directly supports our programme to support clinical entrepreneurs, which offers opportunities for doctors and other health professionals to develop their innovative aspirations.

“We are committed to finding new ways to improve care so patients can directly benefit from the creativity and talent of our workforce.”

Managed by the Apperta Foundation, a not-for-profit community interest company set up by health professionals in 2015 to improve technology in health and social care, the fund is open to social enterprises looking to improve health outcomes, address unmet needs and enhance the care and experience of patients with long-term conditions.

Sabine Nikolaus from Boehringer Ingelheim said: “By making the most of the intellectual capital in the NHS and technology sector, we can unearth new concepts which can make a difference to patients, the NHS and all those who deliver healthcare.

“We are thrilled with the ideas that emerged at the hackathon and can’t wait to see the best of these stand the chance of adoption in clinical practice.”

Three ways to improve patient care

Monitoring new mums

Around a third of women will have an epidural – a local anaesthetic administered into the back – to relieve the pain of childbirth. Although the treatment is very effective, there can be side-effects such as headache and nerve damage, so there should always be a follow-up before mothers are discharged from hospital. Currently, there is no national system for this.

According to anaesthetist Dr Tim Knowles, in some cases notes about patients are simply written in a diary for the next shift for follow up, or entered on databases managed by individual doctors. “There are lots of points of failure in the system; you might forget to put the patient details in the book because you are so busy, which means that patient doesn’t exist in terms of follow-up, or the diary can get lost,” he said. “This means follow-up is variable and that’s a problem because we don’t want to miss a serious complication that we could have done something about.” To improve patient safety and generate useful patient data on complications, he and the epidural anaesthetics team came up with the idea of an app that stores all information about epidural follow-ups to a central dashboard using the Ruby on Rails server.

Reducing A&E waiting times
Lengthy waits for A&E are commonplace in the NHS. With two million patients going through the system each month, the NHS target of treating 95% of patients within four hours has not been met since 2015.

According to Dr Umar Ahmad, an A&E doctor at the Royal London hospital, part of the problem is the delay getting medical test results back: it takes a lab about an hour to process a blood test. He and his team came up with the idea of an app that identifies which tests a patient needs as soon as they arrive in A&E.

The algorithm generates a barcode that the patient can scan using their mobile phone and this directs them to the right part of the A&E department to get tests done. The idea is that, by the time their turn comes, doctors have all the information they need to make a diagnosis. “It can take an hour-and-a-half or even longer for patients who are not immediately sick just to find out which tests they need to have done,” said Dr Ahmad. “If tests are done early, by the time the patient sees the doctor they will have the information they need to make a diagnosis, admit a patient to hospital or refer to a specialist.

“Even if we could apply this approach to 20% of A&E patients, it would have a huge effect on waiting times as well as helping medical staff.”

Early warning for deteriorating patients
When patients in hospital take a turn for the worse, their condition should be picked up by the national early warning score (NEWS) system. However, this mostly paper-based system relies on patients’ observations and the NEWS score being correctly calculated, and then finding appropriate medical staff.

According to anaesthetist Dr Jakob Mathiszig-Lee, even if every stage is carried out correctly, it can take more than an hour to get deteriorating patients to critical care.

“Identifying patients who are deteriorating from sepsis and other serious conditions and then flagging it up appropriately is a problem in the UK,” explained Mathiszig-Lee. “There are cases when by the time I get told about a patient, their condition is irretrievable.”

He and his team came up with the idea of VitalFlag – a real-time text alert system to warn critical care staff directly that a patient is deteriorating.

“Our idea was to find a way to speed up the process,” he said, “going directly from entering the patient’s data to flagging it up with the critical care team.”