MKUH creates an end-to-end Clinical Correspondence Platform to transform patient care

Milton Keynes University Hospital NHS Foundation Trust (MKUH) is a recognised digital leader in the NHS, innovating and accelerating the adoption of technology across all departments and job roles to create a patient-centric, efficient and cost-effective system. Treating approximately 400,000 patients per year from across Milton Keynes and the surrounding areas of north Buckinghamshire, south Northamptonshire and north-west Bedfordshire, the Trust employs more than 3,000 staff who provide care around the clock.

This scale of both inpatients and outpatients means that efficiency is crucial to provide timely care that focuses on the patient’s best interests. In a data-led world, it is well documented that hospitals have often been left behind, working with paper-based formats and processes that prolong and sometimes delay the patient journey, with admin trails that are long, complicated and multi-tiered.

Digital Evolution

To counter this and drive innovation, MKUH embarked on a journey that started in 2011 with BigHand and has continued since, with integrations of BigHand Digital Dictation, Clinic Builder and workflow optimisation programmes, as well as an outsourced transcription module in 2015. Importantly, the Trust added Health Level 7 standards in 2019, to ensure that clinicians were able to access a live data feed, improving the availability of information. Furthermore, BigHand has worked collaboratively with MKUH to add a fully functioning Clinical Correspondence Suite, allowing demographic retrieval that enables automated formatting templates of letters, as well document export, document console and smart router systems.

These digital developments reduce the reliance on tapes for dictation and the administrative burden on clinicians; improve the processes around clinical correspondence, governance, and the turnaround time on items such as GP letters. The integration between BigHand Digital Dictation, Clinic Builder and MKUH’s EPR, for example, means that clinic lists are updated in real-time with the relevant patient details, so clinicians can dictate directly into the system with no additional time spent searching for the correct record.

BigHand also underpins the Trust’s process for exporting letters for external printing – and providing digital versions of those where appropriate – which has greatly increased the speed at which letters are accessible. This latest element of the Trust’s digitisation project has developed over the course of 18 months, with a brief stoppage during 2020 as a result of COVID-19, to now represent a fully automated system that has provided the hospital with £13,000+ in savings per month in admin, physical posting, and various other secretarial tasks.

It is now possible through the end-to-end digital pathway for registered patients to receive their documentation in their online patient portal, MyCARE, before they even leave the hospital.

Clinical Approval

The newly added Document Console allows clinicians to login and approve letters easily and virtually. Before this transformation, secretaries had to search the Trust’s Electronic Document Management system to find the correct letter template, type into that letter, save it and wait for approval for each individual letter. This new way of working has reduced the number of templates significantly, speeding up the process and bringing everything together into a simple, fast, single end-to-end digital platform.

Jacqui Page, Patient Access Digital Solutions Lead at MKUH, comments: “We wanted to transform the way patients received their letters and to make our patient portal much more effective and efficient, to save admin time, clinician time and patient time. We worked to upgrade our systems with BigHand, and Clinic Builder was a crucial part of coordinating everything, from printing patient letters to getting signed approval from consultants, into one single efficient, digital system. In particular, the Document Console function enabled clinicians to sign off letters one after the other, without the need for going into each letter individually, which gave us significant time-savings.”

“We worked very closely with BigHand to ensure everything was a success, and we had great support from key members of their team. The feedback from clinicians has been overwhelmingly positive; we’ve had emails thanking us for the work we’ve undertaken, which is testament to the difference it’s making.”

Robyn Norris, Digital Solutions Project Manager adds: “Ultimately, our patient journey is the most important thing and it was key for us to be able to drastically improve the speed at which this moved to improve patient wellbeing. By creating an end-to-end single digital model, supported by appropriate technology such as BigHand, it has given us greater control and efficiency of this system whilst providing utmost proficiency for clinicians, GPs and patients together.”

“We’ve been able to transform large scale MDT meetings too, through the use of templates and a single digital platform, to significantly decrease the usual timings it would take us to turn around letters and documentation that result from these. It’s been an altogether incredibly successful and efficient project that will continue to provide us with significant savings month-on-month, and it’s not something we could have achieved without the BigHand technology and their service and support.”


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