From pagers to holograms: Digitisation and AI in the NHS
How Princess Alexandra Healthcare Trust uses AI and automation to transform the experiences of staff and patients
Princess Alexandra Healthcare Trust is demonstrating how to use AI and automation to improve engagement, efficiency and experience for staff and patients.
Deputy Director of ICT at Princess Alexandra Healthcare Trust (PAHT) Jeffrey Wood, acknowledges that when it comes to digitisation, the Trust is ideally placed because of its size relative to some other Trusts.
“We have about 4,200 staff” he says. (For context, some Trusts such as Manchester and Leeds Foundation Trusts employ more than 20,000.)
“We can turn on a dime. We can try proof of concepts. If it works, great! We can put that in, and others can learn from us.
“Nobody ever used to talk to anyone in the NHS, but things have changed since I put in NHS Mail six years ago. Our whole approach is trying to do something and then sharing everything we've learned.”
A smaller Trust is more agile, but it has its challenges. Wood thinks there are around 120 applications in play, and if you count multiple versions its more than 500. To manage that is a service desk of 5 and a second line support team of 4. Overall, Wood’s ICT Team is 67 strong but its remit includes enterprise technology, telephony and cybersecurity.
Service management transformation
Several years ago, the Trust was trying to find efficiencies and improve reporting and analytics.
“But I couldn't pull any of those reports from our previous service management tool,” says Wood.
“Someone would phone up with a problem, the team would type that information into the system, and if they couldn’t deal with it there and then it went round and round until we got to the right person. Most of the team were spending more time on the phones typing out details than they were fixing the problems.”
A solution was found in the form of Freshworks’ Freshservice platform which Wood deployed in 2023. The metrics delivered by the new platform are impressive. The Trust reduced open tickets from 1308 to 550 in just three months, cut SLA breaches from 629 to 13, and streamlined 210,000 monthly calls through automation, self-service portals, and AI-driven workflows.
There is also agentic AI platform which is designed to help staff fix common problems like password resets instantly, without needing to log a ticket.
The impact on staff efficiency is clear and the less time medics spend trying to resolve technical issues the more time they have to spend on patient care.
The Trust has also integrated another tool for proactive remediation. Wood [provides an example of how it works by means of a Microsoft Teams cache filling up. Remediation can now occur before the user experiences a problem. It’s a minor issue, but minor issues account for most service desk interactions.
“Last month, we had over 10,000 remediations run with automatic fixes so it didn’t hit the service team.”
Wood is also assessing voice AI directed telephony but has already embraced AI in a more advanced form.
“We have a virtual holographic receptionist that's able to speak to people coming into the Trust. we've got it programmed for six languages, of which, one of which is sign language.”
The extent to which visitors to hospitals will be happy to engage with a hologram is debatable. Wood has clearly thought about it.
“At the moment, we just use it for directions at the hospital or answering basic questions. What I really what to use it for is entertaining children. People coming into a hospital will have high stress levels so if we can reduce that stress, we can improve their experience.
“If someone is in with their child, because either they can't get childcare or it's the child that's ill we could have a virtual teddy bear for example that could read them a story, talk to them, play games with them and reduce those stress levels. We're playing around with that now to see how much we can do and how much we can take that pressure away from adults.”
Close to the edge – but not on it
The use of a childcare hologram sounds cutting edge, but Wood emphasises that the PAHT is not “at the bleeding edge” of innovation. The Trust looks at technology established in other industries and wonders if it could make the NHS better. The technology behind the hologram was first spotted in use in the hospital at Disney.
Holograms notwithstanding, attitudes to technology vary among those employed by the Trust.
“We've got junior doctors, and they come out of university having grown up with tech. They are so disappointed when they walk into a hospital and have use paper and clipboards. At the other end of the scale, you've got senior consultants, doctors that came back after COVID because we desperately needed people, and they're 70 years plus, and really don't want to get involved in tech.”
The need to adapt to different user communities and meet people where they are lies behind a COPE programme that the Trust has rolled out.
“We're starting to utilize Apple Watches, mobile phones, iPads, so that people use them for work, but then they can take them home and use them for personal life as well.”
There are good reasons for providing devices as a bit of perk, such as the fact that Harlow, where PAHT is situated, must compete with London – and weighted salaries - for clinical staff. But innovation is the driving force.
“The more you play with a device, the more you get used to it so they learn to do far more on it that they would if we limited it to work use only. “
Wood is also acutely aware of the cybersecurity risks facing the NHS. For him, empowering users with their own devices makes them less likely to expose the Trust to risks arising from Shadow IT, and increasingly Shadow AI.
“For me, it's about, how do we make it easy for our people to use the technology we can secure as much as possible rather than allow them to go outside of our control and try and find workarounds.”
Wood has essentially made a pragmatic compromise with device management. The NHS will always struggle to square escalating demand, pressures on funding and on staffing. But the thoughtful application of established technology is helping PAHT to keep the show on the road.