‘It was everything we needed’: How a doctor is using his tech skills to help Northampton General Hospital
When Dr James Richmond spotted a missed opportunity at Northampton General Hospital, he started working with Kieran Jones from the hospital’s communications team to implement a new solution giving accurate and up-to-date information to patients and staff.
James: I’m a doctor and a coder, and I’ve developed a solution to help patients and staff while saving money for the NHS.
My journey to coding began when I was 15 or 16, and I was a Pokemon fan.
Nintendo introduced Digital Friend Codes where two people anywhere in the world were given a 16-digit code, you went online to find the other person with the same code and you battled against them online.
There were various messageboards where I made some friends and I thought it was great. At the same time I had IT lessons where I had to make a webpage.
So I made one relating to Pokemon that had a chatbox function. Curiosity started to get the better of me and I started to learn little bits of code.
The embed code for that chatbox was the first thing, then I realised you could add a bit of HTML so I could introduce some bold or italic. Then I got some free webpage templates and taught myself bit by bit until I had a fully-fledged Pokemon website with more than 20,000 members.
The time came when I had to turn my attention to my A-levels and then I started studying medicine at the University of Birmingham. In the third year of med school I found out the Medical Society was struggling to make sales of event tickets to legitimate society members, so I offered to code their website.
That went really well and we were dealing with £50,000 of sales every year.
The clinical commissioning group (CCG) in Birmingham had a piece of extremely outdated patient information screen software running on 60 or 70 very old TVs in GP practices, council offices and so on. The company that provided it wanted about £5m to renew for a couple of years. Someone innovative in the CCG said no and they wanted to find someone who could do it better.
They found me.
As a university student, I initially worked with the group but they merged with another CCG and the person headlining the project had to leave. Ultimately that left me to stand on my own two feet and they said to me 'you can do this on your own, this is a great product and you've developed something we've never seen before, which far exceeds our expectations'.
So I had to go commercial at that point and I set up ScreenStar. I found a federation of GP practices in Birmingham that really liked the idea of cost-effective public information screens to reawaken TVs that were switched off. The prices they were quoted by other companies worked out at about £3,000 per screen. I came along and did it for a couple of hundred quid.
As a doctor I understand it's important to advertise public health information to patients who are often sitting in waiting rooms, sometimes for ten minutes and occasionally for up to an hour. They get bored. The elderly population sometimes don't have phones to scroll away on so a TV screen provides some interest as well as being useful for advertising public health information or practice information.
I worked as a doctor at Northampton General Hospital in the second year of my foundation programme. One of the programme's requirements is to gain experience in different areas, so I worked in general medicine for four months, working under a great team on the Stroke ward. Then I moved over to Trauma and Orthopaedics in the winter months, which was an interesting and extremely busy experience.
In spring I moved to NHFT and did a placement in psychiatry which was very insightful, getting fresh experience on how mental health is looked after in Northamptonshire. From my experience in Northampton compared to other places, it was actually pretty good.
When I moved to Northampton I noticed a similar problem to Birmingham though - they had information screens dotted around the hospital, most of which were switched off. And I thought what's the point of having a screen here if it wasn't working? You had people sitting in waiting rooms and others walking past and there was a way of giving useful information to these people, so why not use it?
I enquired, got in touch with a few people and soon met Kieran, one of the communications leads at the time. He was very innovative and understood the problem and the benefits of the potential solution. We set about working together to implement it at Northampton General Hospital.
Kieran: One of the IT technicians here at the hospital had seen one of James's screens in an area in the head and neck ward.
We knew the previous screens weren't good for patients because the content was very static, but the process to update and manage the slides shown on the screens was also taking up a lot of our time and resources.
We were connecting by remote desktop to various screens around the Trust.
They each used a computer locked in a cupboard somewhere on a ward, and we had a PowerPoint presentation with the slides on. This was about a gigabyte in size, and the process could take maybe an hour or more at peak traffic time on the hospital network.
We were already looking at ways to improve these computers that were in cupboards. A lot of them were affected by dust and we were having to replace them quite often.
We looked at James’s solution and it was everything we needed. Now we can log into an online portal, so we don't even have to be on-site. We can do it at home on our mobile phones - everything is web-based so we can upload things without relying on the hospital network.
A lot of the other features he's developed along the way for us have been additional bonuses. It can connect with clinical systems now and we can broadcast special events like the Queen's funeral onto the screens. We weren't able to do these things before.
There were a lot of requests for the Women’s Euros football tournament to be broadcast in the waiting rooms last summer. We had one screen showing it in integrated surgery and one in outpatients. They were two areas where there are often waits to see clinicians. We've had good feedback about the RSS news ticker as well. People think it's refreshing to look at rather than the standard patient leaflets in those areas.
We're a veteran-aware hospital and we're signed up to the Armed Forces Covenant so it was a significant thing for us to be able to show the Queen's funeral and the Remembrance Day broadcast by the BBC on 11th November. They were requested by staff on the wards and by our Armed Forces representative at the Trust as well. The screens help enabled us to show that we're looking after veterans as much as we can.
James and I were trying to work out how we show some of these events, easily and affordably. We've got a TV licence across the site so we put an aerial on top of the IT department to bring in the digital TV signal and it's plugged into a screen by USB.
James wrote some custom code for us that encodes that TV stream into small MP4 files which get pushed onto the other screens. It was a way of honouring that request without having to spend thousands of pounds.
Now if you're in a GP office, it will call out the patient's name and direct them to the room they need to go to, and that's controlled by a receptionist. It draws that direct from the patient system, so it's one source of the information.
James: In 2018, we installed on one screen and then rolled out to 8 screens.
Obviously the pandemic hit and priorities had to move elsewhere in terms of managing patients.
As Covid has gradually become a more manageable situation, I've started working with the communications team at NGH to roll this out further across Northampton General Hospital and hopefully Kettering too.
We're looking at 48 more screens getting rolled out soon across the hospital site. We're hoping that a ward clerk in each area will be trained as a content editor so they can show health information specific to their area of the hospital on their screens.
As a doctor, the main reason for implementing this was to help patients. There are many thousands of GP practices dotted around the country, many of which don't have a solution like this - and the ones that do are usually paying huge amounts for it. Why spend £4,000 on a TV screen when that can go towards hiring a healthcare professional or getting specialist equipment?
The NHS is under a lot of financial strain at the moment. There are issues with staff leaving and information not being shared quickly enough, either to staff or to patients. The main two benefits of this system are that it's cost-effective, because I'm not really out there to make profit - I want to support the hospital and support patients - and it can be updated almost instantly through the app.
That saves a lot of time for the communications department to focus elsewhere and ultimately improve the way information is given to people. You can get accurate opening times and clinic availability as opposed to getting that from a paper handout which tends either not to arrive to the person, be out of date straight away or put in the bin.
By working closely with members of the team at the hospital to roll out these screens, it also ensures various wi-fi networks are available for patients in waiting areas so they can use their own phones. We've really worked together to improve the patient experience in different areas.
The idea is eventually to go big, to get everyone on board and solve a problem for the NHS while also saving money to be spent on staff and equipment.
Want to know more?
Find out more about Screen Star.