Implementation of Whzan Blue Box monitoring in Surrey Care Homes

Health Innovation Kent Surrey Sussex (Health Innovation KSS) has supported the implementation of the Whzan Blue Box in care homes in Surrey since 2018. The aim of the Blue Box project is to improve patient care through regular National Early Warning Score (NEWS) checks giving a baseline, from which any potential decline can be assessed. The system has been proven to reduce hospital admissions, 999 calls and ambulance conveyances, and unplanned GP visits.

Whzan Blue Box

The Whzan Blue Box contains diagnostic equipment to help care home staff take key measures on patients, to provide a NEWS score. This enables all staff to understand the patient’s base line and ensure that changes to the base line are dealt with appropriately. Each box contains equipment for monitoring residents’ vital signs, including body temperature, blood pressure, blood oxygen levels, consciousness, and respiratory rates. One box can be used to measure vital signs for 30 residents. Previously if staff had concerns about a patient’s health measurements, they might call an ambulance even if the measurement was normal for the patient.

Implementation in Surrey

A small pilot of the Blue Box scheme was originally started in primary care in 2018, with a view to reducing unnecessary calls to urgent care services and emergency GP visits to homes. It was also designed to upskill nonclinical care home staff to manage the health of residents confidently and appropriately, and help to avoid missing signs of deterioration by recording each patient’s base line.

63 care home staff were trained to use the Whzan Blue Box and early indications showed that there has been a positive impact on monitoring the health of care home residents as well as increased confidence in care home staff. This pilot scheme was interrupted due to Covid-19 before it had been fully trialed.

In March 2022, 120 more Blue Boxes were purchased using the Digitising Social Care fund from the NHS Transformation Directorate. In October 2023, 60 of these boxes had been set up in 40 homes, with 400 NEWS2 assessments submitted each month. A small team at Surrey Heartlands Integrated Care Board (ICB) support the roll out and staff training.

Health Innovation KSS support

Whzan has been supported by several health innovation networks. Health Innovation KSS have supported the company for around five years which has included helping them refine their remote monitoring offer and value proposition during the pandemic, supporting adoption within multiple sites in Kent, Surrey and Sussex, and in-depth support in deployment and evaluation work in Surrey since 2022.

They have also contributed to the project group which consisted of ICP representatives, Care Home representatives, Health Innovation KSS RESTORE2/Patient Safety leads and Whzan.

Health Innovation KSS has also worked with Whzan on other use-cases of their products regarding the co-design pilot and evaluation of a new app to support children’s continence services in a Sussex community setting.

Impact

The blue box is now in over 5000 homes across the UK. A recent independent study by Health Innovation NENC proved eight care homes saved more than £756,000 in emergency services costs over one year by using Whzan Blue Box.

• 22% Reduction in 999 ambulance requests
• 35% Reduction in unplanned GP visits
• 50% Reduction in 111 calls

Impact in Surrey

From six months before the Blue Box was implemented (22/06 – 22/11) to six months after implementation of the Blue Box (22/11 – 23/05) in Woking Homes Residential Care for Older People (52 residents), we saw:

• 41% Reduction in number of 999 calls
• 36% Reduction in uplanned GP visits
• 53% Reduction in hospital admissions (19 fewer residents)

(Note that the comparison months start with summer months before the Blue Box is implemented and winter months with the Blue Box, when need is likely to be greater.)

“The Blue Box is a must for every home. We’ve been using them for about a year, and they’ve really transformed things for us. We no longer need to contact the doctor every time we’re worried about a resident – we have the data to help us. The Blue Boxes give the staff confidence in what they’re doing and keep everyone reassured including the residents as they get to know what is normal for them. Our relationship with our GPs has improved because we don’t have to call them out so often.”

Paula Hook, Registered Manager at Woking Homes

Lessons learnt

There is a significant difference in how well the Blue Box has been adopted in each home, despite some homes being part of the same group with the same area manager. Engaging homes can be a challenge, although the box is easy to use and helps staff to assess patients in a timely manner. Users can be trained to use the Blue Box in a short time scale and each patient assessment takes around five minutes.

The Implementer Team are having great success in getting more care homes on board through a two-stage training programme which focuses on NEWS2 assessments. The Implementer Team are a dedicated resource provided by Surrey ICB who give a lot of support to care home staff to help familiarise them with the Blue Boxes so that they are used to their full potential. It is particularly important that there is dedicated support in the early stages of the project for care homes to access.

“Once the users start to see the benefits, there’s no looking back, though it can sometimes be a bit of a challenge to get to this point.”

Paul Summerton, Project Co-ordinator – Primary Care Digital, Implementer Team

Looking to the future

The Implementer team has put together a bid for further funding so that a Whzan Blue Box can be put in every single care home for older people in Surrey Heartlands.

The team are now the first point of contact for other digital projects within care homes and can signpost staff to additional services.

For more information: Contact jennypartridge@nhs.net

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