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Morecambe Bay Hospitals exploit low code


Industry Voice


The NHS trust has demonstrated how the technology can support the rapid development of digital solutions, writes Patrick Marren, business manager, NDL Software

Digital brain in lightbulb

A bolder approach to the development of digital solutions has been among the consequences of the Covid-19 pandemic.

Organisations in the NHS, local government and other public services had to react quickly in setting up systems to support the fight against the virus and protection of the vulnerable, and this made them more willing to take risks. They broke free of cumbersome processes for developing solutions to deliver in days or weeks rather than months.

Low code platforms have played a crucial role for some organisations, providing tools that can be utilised without the need for calling on in-depth skills from external experts. This has contributed to the change in approach, providing the ability to quickly reassess and correct the design of any services without a big investment of time and money.

University Hospitals of Morecambe Bay (UHMB) NHS Foundation Trust was among those that demonstrated the potential from the early days of the pandemic.

Speaking at the recent UKAuthority Digital Health and Care conference, head of digital services Marc Hadwin said it had already obtained relevant tools from NDL, notably the FX platform for developing e-forms and MX for mobile applications. Also, from 2019 it had been implementing an ‘e-hospital’ programme, under which its digital team had become proactive in developing solutions and offering them to other teams.

Demands in testing

The prime demands from the pandemic were to set up effective testing regimes, initially for antibodies then for swab tests and lateral flows, followed by a solution to support contact tracing.

“We took the low code approach to allow us to do things nimbly and change as the facts changed,” Hadwin said.

This became important around June 2020 when the volume of antibody testing increased sharply from a handful of tests per day to 80-90, requiring a system to handle the increase without needing a lot of administration. The team initially used FX to develop a staff booking form for the tests, then adapted this to one to handle the public demand using the approach of ‘understand, simplify, automate’.

These took into account the basic steps of taking the swab and getting the results to the patient, with considerations around reporting and audit. It involved an online booking form that captured good quality data – better than was possible through staff transcribing – along with a database, robotic process automation, reports and the ability to audit. The team also developed an automated texting and email service, including links to existing advice on what to do for anyone testing positive; and the latter group also received a phone call.

“We turned what was an admin heavy process into virtually zero admin for the staff,” Hadwin said.

Vaccination effort

Another big step took place just before Christmas with a service to support vaccinations for local NHS, care and other public service staff, with clinics running to Tuesday to Saturday at the trust’s three main hospitals. The team created a booking form, effectively tweaking those used for the antibody and swab tests, which it linked to the electronic staff record; then created another form for second appointments that people could use if they needed to shift the dates.

This was followed by the creation of an administration app. The trust had previously worked on but not quite completed an app for flu vaccinations, and it was able to adapt this to one for Covid vaccinations. This enabled the staff running the clinics to record people’s arrival and consent on a tablet computer along with the administration details, and pass all of it to the National  Immunisation and Vaccination System.

“It was quite a slick process, it hit the ground running and some stages we were vaccinating 700-800 people per day across the three sites,” Hadwin said.

A system has also been set up for lateral flow testing, with people able to log in and report their results to the trust’s system, and another to record staff signing in and out of the sites.

Flexibility factor

A big advantage of using the low code tools in this has been that they can be deployed flexibly around numerous processes. NDL has found that engaging with end users at an early stage helps to ensure the solutions are intuitive and reflect the way they work, and those that have already proved effective can be tweaked and adapted to other processes that run on similar lines.

There is also scope for integration with back office systems, analytics tools and technologies such as wearables, with the potential increased by other NDL tools such as SX for robotic process automation and QX for workflow.

Organisations have shown that new implementations can be achieved very quickly and effectively, and it has set a new standard across the sector. There is now a potential to push this further using the NDL suite of tools and the experience of public sector peers within its community who are ready to share what they have learned.

It amounts to a new approach and a new attitude that will help the public sector rapidly respond to changing demands on its services.

More great NDL case studies are available to read on their website here

You can also catch up with the whole UKAuthority Digital Health and Social Care event here and find out about UKAuthority's forthcoming events here



Image from iStock, ipopba

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