The Benefits and Challenges of RPA in the NHS
Robotic Process Automation is the technology that allows anyone today to configure computer software, or a “robot” to emulate and integrate the actions of a human interacting within digital systems to execute a business process. RPA robots utilize the user interface to capture data and manipulate applications just like humans do. They interpret, trigger responses and communicate with other systems in order to perform on a vast variety of repetitive tasks - without the need for a break.
Applications for RPA within a healthcare setting are numerous. For the NHS, who are really starting to build up momentum into this nascent technology, it’s been revolutionary. Most recently, trusts are using robots to register COVID-19 antibody testing, which has helped to save over 82,000 hours of time.
To understand the potential of RPA, and the scale of the challenge facing those implementing it, we brought together a handful of leading voices in the space to discuss.
The Benefits of RPA
We spoke to Rob Child and Richard Moyes from Leeds Teaching Hospitals NHS Trust.
Rob, who has spent his entire career in the NHS, is the Programme Manager in the Digital IT team. Heading up the project delivery office, Rob leads a team of 19 Project Managers, Assistant Project Managers & the Project Delivery Office function across a portfolio of 20 plus digital projects.
Richard, a former RAF fast jet pilot, joined the NHS in 2017 after a brief stint in the private sector. Now the General Manager for Outpatients at Leeds Teaching, Richard has about 600,000 patients per annum that he and his team are responsible for across a number of departments, with the Trust seeing about 1.3 million patients per year.
After hearing about RPA from a colleague who attended a conference, Rob started to conceptualise what RPA might look like at Leeds Teaching. Focusing on using it to integrate legacy systems, Rob built the business case with help from external experts who could demonstrate the value through existing RPA systems. With Richard’s arrival at Leeds Teaching, Rob was able to demonstrate the benefits of RPA in a live project. Between Rob and Richard we can see the full lifecycle of an RPA implementation from ideation to implementation.
RPA Can Bring Together All The Moving Parts
Rob’s mind while building a business case for RPA was always firmly focused on using RPA to integrate lots of different legacy systems.
Like most large organisations, the NHS has a lot of moving parts and systems that rely on manual entry. Unlike other large organisations, however, the NHS has systems that interface directly with the care of patients.
One of the key arenas for RPA and Automation within the NHS is the patient journey. Not all the systems within the NHS are agile enough to cope with the changing needs of patients. Cancelling and rebooking appointments is just one example where a seemingly simple task will involve many different systems and manual input from many parties.
With a career in technology spanning 20 years, Kevin Bell (Strategic Technology, AI & Automation Advisor at Alder Hey’s Children Hospital) has built up a wide and varied portfolio including business intelligence, data and automation across a number of industries, predominately healthcare. More recently, Kevin has been focused on leadership, strategy, and how to take organisations forward using technology and has been using RPA in a similar way to Rob.
“RPA plays a massive role in joining those systems and activities together seamlessly. You can then go one step further and create a better patient experience by incorporating something like Blue Prism Cloud that allows for automated interaction with the patient.”
It’s this seamless interaction with the patient and the back office that Kevin is most excited by. Bridging the gap for different departments and creating a single flow of patient interaction would be a massive achievement.
“It would release time to care for consultants. It would cut down all those conversations and make sure that people that using their time more effectively.”
It Was A Light in the Darkness
The COVID-19 pandemic has changed everything. For the NHS, it was and still is, a significant strain with almost all roles within the NHS feeling the pressure. For Rob, Richard and the team at Leeds Teaching Hospitals, RPA was somewhat of saving grace.
“It was a light in the darkness, something else to concentrate on, releasing staff time to care for our patients.”
With implementation starting in Summer last year, Blue Prism Cloud was procured for the first programme which promised to be a large one. With Blue Prism’s support, Richard was able to accelerate the implementation and ensure that they got what they wanted from the programme.
“We wanted a return on investment, but not a financial one. We wanted to enable our colleagues and our patients to have a better experience. So the first programme we wrote was to support GP routine referrals.”
When the GP refers a patient to the Trust, the bots pick that up and do several checks across the systems at Leeds Teaching and pull any data that's missing in terms of demographics before putting the patients onto the waiting list in the relevant clinic.
A process that, on average, can take up to 15 minutes each depending on the complexity of the referral. With the number of these referrals averaging at about 300 a day, it’s easy to understand why automation is needed here. With the automated processes in place, robots handle the 300 daily requests quicker and more effectively giving the team back 172 weeks in their 12-month working period.
“It is not about redundancy. It is not about that kind of ethos. It's about allowing colleagues more time to focus on the important things.”
We Can Have a 24/7 Working Remit
Jaki Allen-Free is Health Records & Transcription Digital Programme Manager at Alder Hey Children's Hospital. Currently working on a programme that involves using a mix of digital solutions including Blue Prism Cloud RPA to automate the dictation and then transcription of clinical letters.
The opportunity that technology like RPA represents is part of a vision of a truly integrated and ‘always on’ NHS that Jaki has held since she started her career with the NHS.
“What I envisaged years ago was for a patient to receive an appointment, decline that appointment and then be offered a new appointment by a bot. While all that is working, the bot is then looking for someone else to take the appointment that was just declined.”
Taking enough of the load off the people who are normally tasked with these very time-consuming requests means that more time can be put into care and move one step closer to a service that is accessible at all times.
“If we can release enough time for our clinical colleagues to be able to, you know, undertake that type of activity. It means we truly have a 24 seven working remit.”
The Challenges Facing RPA
As with all transformation projects, there will be bumps in the road and obstacles to overcome. We were keen to dive into the issues facing those working on these programmes.
The Fear Factor
As Kevin Bell, Strategic Advisor to AIHQ, which is a dedicated AI & Automation team within Innovation at Alder Hey Children’s Hospital agrees, there is a certain amount of anxiety involved in discussions around automation and robotics.
A technologist through and through, Kevin is confident that the technical side of implementing RPA won’t pose much of a challenge. As difficult as it might be to get every system connected and functioning, while maintaining business as usual, this challenge pales in comparison to the cultural and ethical challenges that come into any kind of robotics or automation debate.
“This is a source of anxiety for some people. But this isn’t about replacing jobs, it’s about aiding people and allowing them to fully focus on what they do best, which in our case is caregiving or thinking through problems and not manually adding data to a system.”
For Rob, who did a significant amount of foundation laying for his business case, it’s about addressing the perceptions around robotics instead of trying to hide from them. As part of his initial foundation laying, Rob socialised the idea across the trust and got the workers Union involved from day one.
“RPA is helping us be patient-centric. It’s taking time away from the mundane and allowing our teams to release that time into the patient care that truly matters. It’s helping us stay true to our values – which is key.”
The strong work Rob and Richard have done socialising and educating at all levels of the Trust has paid back in dividends with the teams not only embracing the solutions provided but even going to so far as to give personalities to the bots and, in an effort to humanise the new members of the team, decided to ask the department to name them.
“We've got six bots, one bot who takes care of back-office developments and five on the front line. We wanted buy in from the teams and for them to accept the bots. We got all sorts of responses back; however, we settled on naming them after the cast of Friends.”
Before we get Output, There has to be Input
Kerry Morgan, RPA Programme Manager at Alder Hey Children’s Hospital, is in the process of setting up and rolling out an RPA programme across Alder Hey while developing an RPA team structure and governance to ensure that RPA programmes are rolled out safely.
Currently, Kerry has two main RPA focuses. Firstly, looking at automating referrals received via the electronic referral system to help the booking and scheduling team. And they spend a lot of time processing referrals that come in. Secondly, Kerry is also looking at HR processes.
“We're trying to automate contract changes that come in and update the electronic staff record automatically.”
Identifying a process that needs automation is usually done it from a strategic point of view. The person or people who are currently maintaining that time consuming process are key stakeholders in the process as their input can be the difference between a system that works and a system that is rejected.
For Kerry, this is one of the key challenges facing effective RPA integration.
“If you want to improve something for someone, you need their help but they’re so busy. You do have to put the time in in the first place to reap the benefits in the long run.”
The Future and Potential of RPA
With the Foundation laid, Rob and Richard have a team of 3 with Richard as the Head of RPA to carry on the transformation projects. With 2 programmers who are double hatted as project managers who completed the Blue Prism Training, Richard is looking to the future with a positive and optimistic outlook.
“We have already started writing additions to our first process. We’re expanding into urgent GP referrals and then we’ll expand it further into fast-track. This will use the same process but in a slightly different model.”
Applications across the Trust are also on the table with Leeds Dental Institute signalling their interest in RPA solutions – a move Richard is supporting.
“We could say; ‘Oh, just go and get an external programmer.’ But how do you get the funding for one? How do you bring them in effectively? And how do you grow the expertise of your team?”
Richard is also looking outside of his Trust for applications of RPA. Previously at Yorkshire Ambulance Service, he’s had conversations about using RPA to automate the assurance process to confirm that a vehicle has a valid tax and MOT, which is normally a massively laborious task involving manually inputting registration numbers into the DVLA website.
The Sky’s the Limit
Rob and Richard have a clear pipeline for the continued development and support of the RPA solutions they’ve introduced. Outside of that, the sky is very much the limit.
“Everywhere you turn there’s another opportunity for automation. They don’t have to be big automations, they could be smart ones that work when no one else will.”
Louise Wall, Owner and Director of e18 Consulting. Louise has been working with clients from the public sector to help maximise the value of new technology solutions. She has noticed an increased interest from her NHS customers in RPA solutions and has been working to identify areas where RPA can benefit the organisation, staff and their patients. Louise has been working closely with the Automation team at The Royal Free London NHS Foundation Trust to increase adoption across the NHS and share best practice throughout the NHS community.
“The Blue Prism Cloud platform is the clear market leader in the NHS with a large number of NHS processes already embedded and working in over 50+ Trusts. The power of the community that has been created and the level of knowledge and expertise around specific clinical systems puts them as the preferred supplier in most cases”
For her, some of the most exciting applications of RPA that she has seen are the ones that really push the boundaries of what people In the NHS thought was possible.
“I am most excited about the NHS specific processes that have not been automated before. All of the core processes developed for the NHS are great and deliver a solid return on investment, but it is the ones that push the boundaries which are the most exciting. I have been working with Jaki Allen Free at (Alder Hey Children’s NHS Foundation Trust) and Darren Atkins (CTO at The Royal Free Innovation and Intelligent Automation Centre of Excellence) on a market first Transcription Process – working alongside experts in their field and exploring the art of the possible is something that is very exciting.”
Louise is also an advocate for the Women in RPA group. The Women in RPA (WIRPA) initiative exists not only to celebrate the contributions of women at Blue Prism, but also women who are succeeding in Robotic Process Automation and the wider technology industry.