The Future of the NHS Estates Return Information Collection (ERIC) Submission Process?

The future of ERIC. EventMAP's Associate Technical Director, Chris White, provides a thoughtful step through an automated response.

Every year, every NHS trust in England must submit responses to a predefined list of questions. These questions range from the amount of money spent on certain services (e.g. cleaning, portering, catering, etc.) through to how records are processed (e.g. paper, electronic, etc.), and how much of the Trust’s estate is made up of clinical space and the usage of that space.

We often hear from Trusts about how the submission time is a frantic, fraught process, not only because of how complex and time consuming it is to gather data from multiple sources, but then having to pick through rows of data to ensure that the response is accurate, and that the processing of the data is correct.

Data is then posted to NHS Digital, who in turn consolidate the results into a set of 17 metrics which are published, and each Trust is ranked amongst their peers in a 'model hospital' report. This report finds its way to a ministerial level, and often the focus is on the last metric, ‘backlog maintenance costs’, and how the deficit can be reduced. The data acts as a precursor to benchmark against one’s peers, therefore it is critically important that the methodology used to collect the data,  is accurate, as a Trust’s reputation may depend on those figures.

The Estates Returns Information Collection (ERIC) Automation tool developed by EventMAP, in partnership with QTS, ensures this data accuracy, and gives the Trusts that use it, confidence when they submit their data. Our automated ERIC solution has recently seen the successful submission and revalidation of two Trust’s data.

Reflecting on what has made EventMAP’s endeavours into solving this niche NHS problem such a success, has been the first-hand engagement with existing NHS colleagues from an early stage.

‍Automation Journey – EventMAP is no stranger to creating successful products through partnerships. We believe this is a great way to deliver innovative products that meet the client’s needs first time. Read more on our approach here!

‍EventMAP took a 5-step approach to delivering ERIC:

1. Constant consultation with Subject Matter Experts and NHS colleagues over the workflows and designs
2. Wireframing and interactive sessions with the client to tweak everything from layout to button text and navigation system.
3. Granular approach to data storage – we appreciate the high-level output and the small data components that make this up. We opted to store information at a building level even though the data is reported at a site level.
4. Agile development – the core of our ethos. We understand that the client will want to rejig things throughout the process, and we are reactive to this.
5. Continuous enhancements to rationalise the application. Specifically, with the ERIC process, the NHS review and refine the ERIC capture, introducing and removing questions on an annual basis – we provide mechanisms for making this as painless as possible through the application as well as providing a consultancy led onboarding service that is always available

Automation meaning – we keep this simple:

1. Reducing time spent on tasks.
2. Let the systems do the hard work freeing up teams to concentrate on other areas.

Automation Benefits - Usually when EventMAP works with a client, there is a spreadsheet or five involved, and often many versions of the same spreadsheets that have been floating about the office for years. A “Single point of truth” is one of the major goals for any of our products, as spreadsheets exchanging hands multiple times over the years can introduce errors. This in turn brings with it a variable approach to version control, with multiple instances of the same document out in circulation (final report version 3, final report version 7, etc.).

‍Intelligence - Once the "static" data is collected our systems can make very powerful calculations in split seconds. Changing data at one point automatically updates at the other critical points - as an example, changing area or financial data that are subcomponents of an ERIC response will automatically recalculate the proposed 'answer' to the relevant questions.

‍Auditing and cleansing data - Over the years we have been adding in simple reports to aid the user. We take the standard Estates and Facilities Management report (EFM) and reproduce it at a granular building level, also supporting direct comparison of last years submitted values along with tolerance breaches and mitigations supplied as standard functionality.

Our reports identify subjective codes not in use in the system and indeed areas where a subjective code, overhead or analysis code may have been used more than once. The system helps eliminate the opportunity for double accounting.

‍QTS One of the primary precursors to developing ERIC was the relationship that EventMAP has with QTS, a wholly-owned subsidiary of Central & North West London (CNWL) NHS Foundation Trust. Since day one, EventMAP and QTS have worked together to develop a product based on feedback from those responsible for compiling the data.

‍NHS Digital

‍With ERIC we worked with our colleagues at NHS Digital to come up with a way to automatically send the rich collected data to the NHS ERIC portal. Over the series of a few months, we collaborated to refine the API and were able to develop an interface that not only transferred the results directly from our software to the portal (saving weeks of effort and manually entering response after response) but also identified any mitigations for data that required extra information.

Additionally, the Trusts who use our system were able to follow up any queries after the submission deadline by using the tool in a number of ways. The most valuable of these being that during the revalidation phase of the ERIC submission process, the Trusts can give a detailed breakdown of how each response value was arrived at. These can be very trivial, 'yes' and 'no' responses, that require no further elaboration right down to a detailed trace of subjective codes, overheads, and gross internal area metrics, combining and apportioning across multi building sites. The users were able to effectively audit their responses in seconds and then use the tool to transfer their explanations again in minutes - a task that in the past would have multiple people scrambling for spreadsheets and digging up month old emails with a lack of confidence that the explanation was robust.

‍The Technical bit - We built a service within the ERIC application to communicate with the NHS Digital API. As the data transfer for some trusts involved sending 48 Trust responses and 80 building responses for each of the 178 questions (close to 15k responses) we needed a way for the user to firstly be informed of how the submission was progressing, but also the ability to leave the submission and continue using the app to 'check back'.

The WebSocket API was used which allows 2-way communication between a user’s browser and the server. Together with ‘Hangfire’ (a background job and worker, allowing scheduling and execution of jobs) this allowed the server to send back 'progress' on where the submission was, and the percentage of completion.

At the end of the submission, the user is presented with details, any failures, and the reasons why (for example, when a value supplied was above the accepted limit as defined by NHS Digital) as well as any mitigation requests (where the value supplied greatly differed from previous years and a reason was needed to supplement the response).

‍Outcome and Future - Overall, the exercise has been a success, the Trusts that we work with have commented not only on how the ERIC automation tool has made the whole process quicker and easier, but also how it has made them feel more confident on accuracy of reporting and revalidating their responses - backing up figures with detailed audit trails of how each value was arrived at.

As ERIC submission relies on many external sources of data, EventMAP is already in talks with third party suppliers of critical data such as CAD and finance streams to help solidify the whole process further.

As the Company takes hold in the NHS market, the next logical step is developing the CAFM system - an estates management tool of sorts, that will talk to our automated ERIC solution...watch this space!

Chris White – Associate Technical Director and EventMAP Project Lead