In Cheshire WIN (Warrington Innovation Network) PCN is aiming to capitalise on the efficiencies that digital transformation can bring. Here clinical director Dr Dan Bunstone and strategy manager Hannah Glyde explain their plans
WIN (Warrington Innovation Network) PCN's strategy is to bring in effective innovation. Digital optimisation when it will support; clinical automation where it is possible; AI where it will add value.
Before you commit to buying any of the digital solutions or tech that exists, you really need to create at least a rough plan of what you’re trying to achieve. This doesn’t have to be overly complicated, but you need a clear vision of where you want to head and why.
There are a host of effective and very impressive digital solutions out there, and there is often some overlap with what is being offered by each solution. New players seem to come to the market every week, and some of the arenas are quite congested. Price points can vary significantly, along with what is being offered and what can be achieved in the real world with each of the solutions.
The three main plays for us in 2025/26 are going to be around the digital solutions that everyone seems to be talking about: ambient scribe, robot process automation (RPA) and AI telephony. We’ve already created a PCN-wide electronic patient record and deployed electronic triage, so our next ambition was to look at how we improve efficiency, and in so doing, improve work/life balance.
Ambient scribe technology
Ambient scribe technology is an AI-driven tool designed to alleviate the administrative burden in healthcare. It will automatically capture and transcribe patient-clinician conversations, then synthesise the interactions into structured clinical notes.
It uses speech recognition, natural language processing, and machine learning, and will operate discreetly in the background, allowing clinicians to focus entirely on patient care rather than typing. You will get a transcript of the full conversation for reference, but also an AI-driven medical note that can be copied straight into the patient record - after a sense check.
It saves time on typing notes, can improve note accuracy and create a thorough record. Depending on the solution in question, it can differentiate between up to a dozen different voices in the room and create referral letters based on the content of the consultation.
Suggested SNOMED codes are produced, along with a variety of customisable options based upon the consultation type or clinician style. It not only saves time but also improves working resilience by reducing the job of having to document the consultation.
Before deployment in your surgery, you must ensure robust data privacy measures to protect sensitive health information, but many of the providers will help you through this process. Ask them for their clinical safety case and liaise with your commissioning support unit (CSU) for support.
You also need to obtain patient consent for audio capture, despite the audio files being automatically destroyed within 24 hours and (usually) being stored only temporarily on your local machine - but do check this. The benefits are significant, but you really need to ensure you deploy this digital solution correctly.
Robotic process automation (RPA)
Robotic process automation (RPA) shows promise to save both time and increase efficiency of the clinical admin.
Hospital letters are perfect for automation and coding, as the risk is low, and the volume high, meaning that patients’ notes can quickly be updated, and tasks automatically forwarded to the correct team. This not only saves time but increases prescribing efficiency and ensures that codes are correctly entered within the records. The time savings across the days will be modest for individual days, but this will compound with time, along with the benefits of correctly and thoroughly coded letters.
You will need protocols for the RPA to follow. This will be things like having clear paths for where coded letters go, task folders for when a letter asks for an updated prescription, or ways of highlighting serious diagnosis. There is increased complexity and nuance with blood tests too. Filing entirely normal test result is modestly easy as its binary as they are either entirely normal or they are not. The complexity comes when you want to set rules for blood tests that are ‘satisfactory’. We have created a small working group within our PCN to deal with exactly this, which means some time investment in the short term but benefits in the long term.
Setting the protocols up is the time-consuming piece of work, but once they’re created they should run themselves and pay dividends in the invested time. It's one of those things where taking time to get it right in the beginning is definitely time well invested.
The trick with the protocols is taking a safe and sensible approach to what is satisfactory, and to regularly acid-test the protocols to ensure they continue to do what you need. The robot processing we’ve utilised doesn’t use any AI, but you can see a future where that will come in, and the automation will not only file the results but also review the records and the requests leading to the test.
We will likely move to patient registrations as the next stage for the benefit of ensuring our patients are efficiently registered and that the surgery receives payments as early as possible.
AI-supported telephony
The next piece of work for us will be around AI-supported telephony. This looks really quite exciting and seems like it could fit exceptionally well with both our clinical hub and the triage work we are doing. There is an opportunity to leave the solutions running all the time, in a way similar to how you might run your triage function. This feels like a potential risk of uncontrolled demand for appointments, but something we’ll look at closely.
PCN strategy
As a PCN, our North Star is to achieve the most effective delivery system possible, ensuring patients get to the right clinician at the right time, and enabling our teams to work in innovative environments where unnecessary stress is mitigated.
For this piece of work, we recognised that there is seemingly insatiable demand on primary care resources, so we needed to employ a strategy that would help us mitigate demand from all of its sources, and then more efficiently manage the patients and tasks that are within our remit of control.
Our strategy was around:
- Ensuring those that need to be seen are seen; while maximising the skill sets across our entire PCN team, supported by triage and AI telephony.
- Appointments are incredibly valuable, so getting patients in front of the right healthcare professional at the right time was critical. Once again, signposting and telephony will help us achieve this goal.
- Numbers of appointments and appointment delays caused stress, so maximising face-to-face time with patients while reducing administrative burden felt critical, supported by ambient scribe.
- Clinical admin has significantly increased, causing stress and longer working hours across the teams. By automating, we could alleviate this pressure and improve work-life balance. RPA was the solution here.
We’re getting to a place where digitally augmented delivery is increasingly becoming the norm. Our teams are skilled at working differently and entirely adaptable to change.
For us, that’s the key to success. All the digital tools in the world are great, but the thing that makes all of it knit together is the people you have working in your team.