The document summarizes the Lancashire Care Innovation Agency Test Bed program which tests a combinatorial approach using technology and care models together to improve patient outcomes. The program recruited over 600 patients across 4 cohorts in 2 clinical delivery areas. It has faced challenges with recruitment, varied risk interpretations, and competing priorities between partners. The program addresses these challenges through close collaboration between partners and problem-solving techniques. It aims to continue recruitment, retention, and spread adoption of the technologies tested.

1. Testing a combinatorial
approach
Vanguards with their models of
care and technology working
together to improve outcomes for
patients and their healthcare teams
@LCIATestBed www.lciatestbed.org.uk

2. Size, range and number of
organisations collaborating
Innovators:
• Philips
• Speakset
• Cambridge Cognition
• uMotif
• Intelesant
• Simple Telehealth
• House of Memories
• Good Things Foundation
Clinical Delivery:
• Fylde Coast Vanguard
• Better Care Together
Vanguard
Evaluation:
• Lancaster University’s
Centre for Aging
Research (C4AR)
Governance:
• Lancashire Care NHS
Foundation Trust
• Lancaster Health Hub
• The Innovation Agency

3. Target Cohorts
Cohort 1
Cohort 2
Cohort 3
Cohort 4
>55 >25% COPD, Heart Failure
>55 >10-25% COPD, Heart Failure
>55 <10%
COPD, HF, Diabetes, CHD,
Hypertension
Mild Dementia MMSE 20-26

4. • 681 recruited across 4 cohorts
• 459 active using technology in their homes
• 69 have completed the programme (152 left the programme)
• Negotiation of 3 months extension to the recruitment period to
support a robust evaluation report June 2018
• Phase 1 and 2 of evaluation underway
• Use of control data negotiated and first set sent to University
• Spread and Adoption group in place and work started.
• Interim report produced by Lancaster University for Expo
What have we achieved?

5. • Test Bed Board reflects the uniqueness of the partners in the
programme. It meets monthly via Skype and face to face
quarterly. It is productive and offers challenge and support to
the programme
• Formal Clinical Operational Groups (COGs) are held
fortnightly in each Vanguard area to track recruitment,
problem solve and action plan
• Lessons learned report finalised by evaluation team
• The first case studies published
• Increasing presence on line (website and twitter)
What have we achieved?

6. The challenges are:
• Size, range and number of organisations collaborating (Over
70 individuals)
• 2 vanguards with 2 different models of care
• Different care pathways
• Recruitment into 4 cohorts
• Varied interpretation of risk
• Recruitment of Clinical Staff
– Availability / lack of
– Time taken
• Provider/commissioner arrangements
• Communication pathways

7. The Challenges are:
• Spread and adoption of Test Bed technology solutions
• Partners competing for the same contracts
• NHS procurement guidelines
• Operating systems e.g. IT
• Governance: including IG
PROCUREMENT AND
COMMISSIONING

8. Number of initiatives
The challenges are:
• Competing for resources
• Finding and agreeing common goals with individual values
and priorities
• Competing for patients / clients
• Managing evaluation protocols

9. • Built a programme based on an ethos of mutual respect
• Found common ground and built on it
• Find the right individuals to talk to
• Remember that there is usually a solution, we just need to
find it
• Listen and communicate with all involved
• Dog with a bone approach – never give up!
What have we done to
resolve?

10. • Development of the Clinical Operational Groups (COGs)
• Close liaison with the Vanguard Project Office (Fylde
Coast)
• Regular reporting into the Vanguard Delivery Groups
(Fylde Coast)
• Project team member spends 1 day a week in Better
Care Together Vanguard trouble shooting, consenting,
putting patients on to FLO and delivering mobile phones
• Project Team spent time in Fylde Coast
Vanguard consenting for Cohort 3 and supporting
patients to download the uMotif app
• Become proficient with the technology to be able to
support clinicians and problem solve together
What have we done to
resolve?

11. • Produced simple information leaflets regarding the technology
• Produced trouble shooting leaflets to help keep patients using
the technology
• Visited different teams to discuss the Test Bed and answer
any questions they may have
• Trained to fit SpeakSet in homes if required
• Liaised with the innovators on behalf of the Clinical Teams to
find solutions to issues as they arise
• Procured simple mobile phones to enable patients
without access to a phone opportunity to be
recruited to C2 for FLO
What have we done to
resolve?

12. • Share evaluation protocols
• Regular liaison with other project leads
• Thinking strategically across projects to find mutual benefit
• Asking “What If ?”
• Spread and adoption task and finish group
• Use the membership of the Project Board as ambassadors
• SRO is member of the Healthy Lancashire and Cumbria Board
• Link with the Healthy Lancashire and South Cumbria Digital
team
• Regular liaison with NHSE Account Manager
• Attend quarterly Test Bed events
What have we done to
resolve?

13. • Recruitment, recruitment, recruitment to end September
/October
• Work with partners on retention of consented patients to
ensure robustness of evaluation.
• Finalise demobilisation plan
• Spread and Adoption
• Planning for EXPO
• Continue to raise the Test Bed profile
• Continue to work in partnership with NHSE on the Test Bed
programme
• Publish evaluation reports
 Interim October 2017
 Final June 2018
Forward View

14. Lyndsey Pangburn
Specialist Community Physiotherapist
and AHP Lead
Central West Neighbourhood Team
Whitegate Health Centre
Fylde Coast Vanguard

15. Thank You
• Thank you to Lancaster University as our programme
evaluation partners for providing early insight into challenges
and lessons learnt.
• For more information about the LCIA Test Bed Programme,
please contact us on:
testbed@lancashirecare.nhs.uk
@LCIATestBed
www.lciatestbed.org.uk
01253 953159