South London and Maudsley NHS foundation trust (SLaM) case study

The trust provides specialist mental health services to both adults and children, as well as inpatient care onsite, serving a local population of 1.3 million people. This trial is part of SLaM’s overall strategy to ensure 100% wireless connectivity coverage across the trust’s four main hospital sites and 65 remote locations.

5G enabled devices ensure seamless data handover across sites, as they are pre-registered to all connection points within the network

The trial involved implementing a private 5G network with the following objectives: 

• Objective 1: Deploy a private network exclusively for clinical purposes, ensuring high security.
• Objective 2: Build and manage infrastructure across all SLAM hospital sites, including exteriors and gardens.
• Objective 3: Control access to their 5G network and authenticate users.
• Objective 4: Ensure very high uptime and connectivity for clinical staff.
• Objective 5: Use the increased bandwidth to provide better quality of care to patients, including exploring new treatment possibilities.

As part of the trial, SLaM implemented a Private 5G Network within a 3-storey building at the Bethlem Royal Hospital. LoRaWAN was also implemented to provide a stable communication network for the IoT devices.

To meet their objectives and use this new connectivity fully, SLaM considered the following applications: IoT (Internet of Things), AR (Augmented Reality) and AI (Artificial Intelligence), as well as focussing on the advantages offered by strong mobile connectivity of staff ways of working:

IoT

IoT devices are  hardware  programmed for specific applications and can transmit data over networks. SLaM used new IoT devices to measure fridge temperatures allowing staff to remotely monitor conditions, leading to a reduction in waste of medicine.

IoT devices were also used to monitor air quality, allowing adjustments to reduce the risk of airborne infection.

SLaM is exploring additional IoT applications in clinical settings, such as devices to measure desk and room occupancy and asset management functions to plan less congested routes for patients.

These use cases offer benefits in measurement precision and saving clinical staff time, as staff can now react to alerts by exception rather than frequent testing.

Augmented Reality (AR) and Artificial Iintelligence (AI)

The improved connectivity from the Private 5G network enables innovative use cases such as the application of AR, allowing specialists to provide expert guidance remotely.

SLaM are also planning to use AI with CCTV feeds to gain insights into the movement of people through hospital spaces. This helps the hospital better understand queues and busy hotspots, allowing for more efficient route planning for patients and staff based on predictive modeling.

Mobile connectivity

One of the main goals of the 5G network is to ensure that clinical staff remain connected to high speed internet, enabling a fully digital system for patient observations and avoiding issues with the hospital’s Wi-Fi network. This will greatly improve the experience of staff and make for more accurate and efficient medical processes.

Private 5G Network increased coverage and bandwidth 

The implementation of the Private 5G Network is expected to result in a 3-fold increase in wireless coverage and increased bandwidth capabilities to new speeds of up to 799Mb/s.

IoT devices increased staff time efficiency

 IoT devices saved staff time by remotely monitoring 250 fridges, previously checked manually each day. This resulted in a reduction of 2 FTE (full-time equivalent). IoT Air Quality Monitoring also saved staff time with remote monitoring enabled by the 5G network.

IoT devices reduced staff travel time, lowering emissions from commutes. Additionally, IoT devices tracked space usage, increasing building efficiency with up to 100 devices monitoring desk and meeting room usage. The private 5G Network enabled the Mobile Connected Worker to increase the quality of service: Increased wireless connectivity provided by the Private 5G Network allowed more clinical observations. Virgin Media 02 estimated an average productivity gain of 15% when there is a 99.999% availability of the eOBS application (SLaM’s main medical observations logging application).

This would save up to 6 hours per week for each clinician, resulting in an effective cost saving £11,000 per Clinician per annum, based on average salaries. Faster observations allowed clinicians to spend more time with patients, improving care quality and reducing patient anxiety, a key priority for a mental health trust like SLaM.

Private 5G Network presented challenges due to equipment available and the procurement process

Constraints on equipment led to 5G coverage being installed on only 2 of the 3 hospital floors. Available equipment worked with specific radio bands, which may not be chosen for future deployment. Devices had to be carefully selected for compatibility with the 5G equipment's radio bands.

Planning 6 – 12 months in advance

SLaM experienced considerable delays due to supply chain issues caused by the current economic and hardware market climate. IoT devices and Network equipment should ideally be ordered further in advance than initially estimated to overcome this challenge.. The importance of early stakeholder management was also identified, further highlighting the need for comprehensive pre-trial planning and collaboration with suppliers.

The trust also found that the scale and complexity of implementation of private 5Gand IoT solutions required dedicated, full-time project team including architects, programme managers and other operational team members.

Understanding the full capabilities (and limitations) of technologies before deployment

During the trial, the trust found that their current version of Apple iOS software was not compatible with the Private 5G Network, which was problematic since many of the trust’s devices were Apple devices, including those used for eObs.

Virgin Media O2 and Apple were both unaware of this issue, but they successfully tested and deployed a Beta version of the iOS software during the trial, allowing the trust to use their Apple devices on the Private 5G network. Apple has since released updates to their IOS software which is fully compatible with non-standalone 5G networks. Such incompatibilities can introduce uncertainty and risk to a large-scale deployment and further highlights the need for proper technical planning.

Need for correct and robust change management procedures

Implementation on this scale represents a large change to the ways of working for an organisation, especially one with as many potential use cases as a care setting. The potential change will affect all areas of working, and as such would ideally require engagement and oversight from management to enable changes to operational processes and engagement of both operational and clinical teams.

If done in this way, key procurement, financial and change management activities would already be undertaken allowing the project team to focus on technical and use case development and overall implementation.

The trial demonstrated the benefits of the private 5G Network, especially for the Mobile Connected Worker, improving clinical outcomes by enabling staff to be connected over a large area.

Following the sucessful implementation of the IoT devices, SLaM plans to proceed with further IoT deployment to maximise use of the technology’s potential.

SLaM found that the increased connectivity from Wi-Fi 6 and Private 5G networks had limited impact for IoT use cases due to the low bandwidth and capacity of the devices. Therefore, for purely IoT use, cheaper Wi-Fi or LoRaWAN technologies could also be considered.