Orlando Agrippa, Associate Director of Business Informatics National Health Service (NHS) Trusts, talks to Trustmarque about the challenges hospitals face and how dashboards can make a difference.

There are three major challenges, in my opinion that hospitals face: time, quality and finances.

Let’s start with finances – there is a £20 billion black hole that the NHS has got to plug in a couple of years, and it’s been predicted that there’s going to be a £60 billion black hole to plug by 2025. Every hospital has got to contribute to that financial shortfall. There’s been more of a drive – which is right – for different patient care, and with that hospitals feel that the first thing they’ve got to do is spend a bit more.

And quality: the recent Keogh review has highlighted there are a number of A&E departments that are falling over. Last winter the majority of NHS hospitals did not meet the A&E standard, and this winter we’ve had A&E departments falling over from as early as August, not being able to deal with demand. Some argue it’s the acuity of patients, some argue that there’s more demand in the system, some argue that A&E departments are not built to cope with this volume of tenancies. An example of that is  an Essex based  A&E department: was built to cope with 40,000 people a year and they see over 75,000 people every year now. There’s something there, and as a health economy, we have to figure out what that is.


Focusing on time for a second – I’ve worked in the NHS for a long time, or at least its feels that way to me  – and what I’ve seen is the people becoming more and more tired. The pressures of running a hospital, the pressures of delivering haven’t changed but are now amplified. Patients are a lot more tuned in to what they should get and what they can expect. Let’s say I’m one of those patients: I will Google my condition, I will Google my symptoms – I will do all that before I go to my doctor and say ‘but I’ve read all of this’. Now we challenge a lot more, because we have a lot more intelligence available to do so.

If you look at our hospitals, not a lot has changed in the NHS in 65 years, so we’re trying to do more, but the system on which it’s sat is still fragile, it’s still 65 years old. More and more we’re needing to deploy technology to help frontline staff – but I think there’s an issue with how we package it. One of the things that we’ve recently launched within our organisation, and across the country, is a suite of nine Clinical, Operational and Corporate applications built to target in-patient, out-patient and A&E functions within organisations. It gives you a number of straightforward measures so that you don’t have to scramble around in the data to understand it: you look at it, it’s right there, you know what you’ve got to do. You understand the volume of patients coming through, the age group, the time they come through and you can start thinking about how to do things differently. You can try to manage it in more of an informed fashion.

You’ve got it a lot more real-time, and I think that’s important, and it fits with the emergence of the iDoctors, as I call them. The doctors that are coming through now are younger, and they’re accustomed to using their iPads, their iPhones, their Android devices. They want to interact with data in the same way they interact with their data outside, as opposed to in a blocky, constrained way. They want that openness that you get in Twitter, Amazon or Facebook or Google or online dating. They want to interact with their data in the way that they feel comfortable. We have to give them that platform, and QlikView is something that we’re using in a number of the hospitals I now work with to do that.

There definitely needs to be an emergence, or a greater gravitation to the use of intelligence – not only to make hospitals deliver better patient care, but also hit that issue that we started with: financial efficiency. You cannot be financially viable if you don’t know the full picture within an organisation.

In addition to his role with NHS Hospitals, Orlando is a keen advocate of technological innovation globally, and works actively to promote its development by supporting events such as the recent Centre of Excellence for Healthcare Analysis Awards.