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Developing the e-Red Bag

A case study with Sutton Council.

Sutton Council improved upon the successful Red Bag pathway by digitising and electronically transferring the residents’ records in the event of an emergency admission to hospital - improving both communication and information security.

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Background

Since 2015 Sutton Council has been operating the Red Bag pathway. This provides the borough’s homes for older people and those with a learning disability with a Red Bag in the event of an emergency hospital admission. The Red Bag accompanies the resident when attending hospital. Sutton has over 80 care homes which are home to around 1,300 residents. Along with medication and personal belongings, the Red Bag contains key standardised paperwork, such as ‘This is Me’ (a reference leaflet developed by the Alzheimer’s Society used to record social information about a person) and an Older Persons Assessment Form. 

To date, the Red Bag scheme has been successful in improving information sharing between care homes, ambulance services, hospital staff, residents and their family members, resulting in a reduced length of stay in hospital. In 2017 it was widely deployed across the country and by April 2019 it covered 80% of England.

The aim of this project

Sutton Council's aim was to digitise and electronically transfer the residents’ records for improved communication and information security. These electronic records became the ‘E-RedBag’. The E-RedBag pathway aimed to provide a cost-effective, simple and secure method to improve residents' care and flow, reduce medication errors and improve communication between and within agencies.

The E-RedBag information is generated by an electronic care management system (Mobile Care Monitoring, developed by Person Centred Software) in to a searchable PDF document, and then transferred, with some meta-data, directly to a resident’s health record on the hospital’s electronic record system. The physical Red Bag remains an important part of the pathway.

What the project involved

Two care homes have been involved in the pilot, both sharing digital information with Epsom and St Helier University Hospitals NHS Trust. Each care home began the project with a different level of digital maturity; one used paper records only, while the other used a combination of paper and digital records, stored on the Person Centred Software system. Correspondingly, the project’s approach to each care home was slightly different.

 

For the care home with access to digital records, further information was added to the digital hospital pack (such as residents’ medication administration records). The care home using paper records was provided with a mobile device for records to be photographed and uploaded to the software. Both care homes were supported to access NHSmail. The care home using paper records was supported to be able to publish at ‘Standards Met’ level on the Data Security and Protection Toolkit. The other home had already achieved this as it was part of a large provider.

Four fewer days in hospital resulting from the hospital transfer pathway

Savings due to reduced non-elective hospital admissions

Savings due to reduced length of stay

Benefits of the E-RedBag pathway

Care home residents, family members and carers benefit from:

  • improved Red Bag records, meaning fewer unnecessary assessments and interventions while in hospital  
  • reduced opportunities for paper records to go missing 
  • a better experience, and more reassurance that up-to-date reliable information is available for clinicians, leading to fewer complaints 
  • reduced length of stay in hospital
  • reduced avoidable A&E attendances

Care home staff benefit from:

  • reduced time spent on data entry and paper record administration
  • improved compliance and understanding of data protection and information security
  • reduced time spent on phone calls to/from hospital 
  • reduced use of faxes by having a secure method of transferring information through NHSmail

Hospital staff benefit from:

  • faster access to reliable patient data at the point of care, reducing clinical risk and improving efficiency 
  • reduced risk of data security breaches due to electronic record transfer 

Long term benefits

  1. Completing the Data Security and Protection Toolkit has caused the care homes to be more aware about data protection in general and has enhanced their overall digital maturity.
  2. Relatives have greater reassurance that the care home residents will get better care as those treating them will have a more holistic view of their condition.
  3. External review (by other health professionals) of the detailed records in the E-RedBag encourages care home staff to review residents more often and enables them to put measures in place to prevent unplanned hospital admissions.
  4. Shared learning amongst software providers due to the creation of Care Software Providers Association (CASPA) by Person Centred Software.

Lessons learned so far and the challenges during delivery

  1. Information governance for digital projects requires the agreement from multiple stakeholders, including all information governance leads, in respect of the documents to be used as there are a number of options available.
  2. Understanding the needs of individual care homes, and their staff and their processes, requires time, and a range of communication methods. Frequent face-to-face meetings and phone calls work well to keep up the momentum.
  3. Engagement with inter-agency stakeholders has to be top priority in order to deliver the solution.
  4. Completing the Data Security and Protection Toolkit to the appropriate level for data sharing between the NHS and social care providers requires multiple stakeholder input. Contribution is required from the owners or head office staff, as well as IT and HR, alongside care home managers, due to the range of answers required and the sign-off needed. Supporting independent care homes to publish at ‘Standards Met’ on DSPT requires a lot of resource.

For more information on this project, email: [email protected].

Download the case study

Last edited: 29 September 2022 4:18 pm