University Hospitals of Leicester NHS Trust - Digital Patient Wayfinding

University Hospitals of Leicester NHS Trust (UHL) have trialled an innovative digital wayfinding system in collaboration with NHS England’s Future Connectivity Programme. 

The trial used Wi-Fi and wayfinding technology to provide real-time navigation for patients and visitors, reduce the number of missed appointments and improve patient experience. The innovative wayfinding solution allowed patients to access hospital maps and personalised route planning via their mobile devices or kiosks with multiple languages supported, enhancing accessibility and inclusivity to serve a diverse community. 

Targeting savings of up to £672,000 annually from staff time savings and reductions in missed appointments, this trial demonstrates how technology can address navigation barriers, improve efficiency, and reduce healthcare inequalities.

This trial ran from August 2024 to March 2025.

University Hospitals of Leicester treat over one million patients per year, with 27 different languages spoken in their catchment area. The 2011 census identified that almost half the population is from an ethnic minority heritage, with the trust engaging with many patients for which English is not their first language.

This impacts not just the clinicians delivering frontline care, but also the support staff who work with these patients during their visits and provide administrative functions, such as sending letters and setting up appointments.

Achieving health equality is at the heart of the work UHL does in Leicester. In their 2022 NHS blog post Narrowing inequalities in waiting lists in Leicester, Dr Ruw Abeyratne sets out the trust’s mission of providing a high quality of care to all their patients, regardless of background or situation. 

Their trial supported this goal by assisting patients navigating their hospital sites and is aimed at improving the patient experience to reduce ‘Did Not Attend’ (DNA) rates for appointments across the trust. 

To read more about Wayfinding and other applications of Real time Location Systems in health see our guidance at RTLS Use cases and capabilities.

Considerable amounts of effort are employed in ensuring that patients can attend their appointments. DNAs are a burden to clinician time and to the hospital’s schedule planning and operational costs. UHL have an average of 7,000 missed appointments each month, costing roughly £160 each to rearrange, or £112,000 per month.

Supporting more patients to attend their appointments requires both understanding their needs and putting into place solutions to remove any barriers to attendance.

Leicester is one of the most diverse areas in England, with a large population of patients that do not speak English as their first language. Many also fall into the Core25 IMD1 category, all of which brings its own requirements and accommodations to be made. Details of this approach to reducing healthcare inequalities can be found on the Core20PLUS5 page - this includes the Core20PLUS5 infographic which is available to download as a PDF. 

Prior to this trial, the trust performed some user research to better understand why patients did not attend appointments, with some cohorts having a DNA rate as high as 50%. Amongst the results, one actionable trend was identified – that patients are having trouble navigating hospitals to find the right rooms for their appointments. 

Modern hospitals are spread across many large, multi-purpose sites with multiple wards and rooms. They can be difficult buildings to navigate for any visitor, and this difficulty is compounded if a patient does not feel comfortable or able to ask for directions in English and cannot read the signage.

Based on this, the trust has concluded that their current method of signage and providing direction to patients is not effective. Having identified this opportunity, the trust wanted to trial a solution that  leveraged their existing Wi-Fi infrastructure to provide patients and visitors with a more accessible way to navigate hospitals, via RTLS wayfinding technologies.

Using only the legacy Wi-Fi network, opportunities for location-based services such as wayfinding were limited, and so the trust were reliant on analogue or manual solutions, such as downloadable maps, signage (often English language only) and directions given by staff. These methods required patients to either know how to access this knowledge, or to be confident in English and communicate with staff to ask for support.

However, through a new deployment of NHS Wi-Fi as part of their infrastructure modernisation UHL identified an opportunity to explore how new technologies can be targeted to improve staff and patient experience with equality and inclusion as a priority. This trial only covered a pilot area rather than the whole of Leicester General Hospital, plans for expansion of the solution are now being considered.  

The trust went through a competitive procurement process to identify the most appropriate way-finding solution for their requirements, engaging with multiple suppliers before selecting one, Mazemap, to provide the wayfinding capabilities and application for this trial.

To use the wayfinding application in combination with Cisco DNA spaces platform the trust already had in place required the submission of hospital floor plans as a 2D model to the supplier. These floor plans were then uploaded into an AI software tool which converted them into indoor maps and provided routing around the estate.

Once the files were converted to indoor maps, UHL provided the interactive map of the trust to patients via personal mobile devices and static kiosks deployed in the pilot area. 

On mobile devices directions can be accessed from a browser or by using an app. The app was intended to include blue dot positioning, so patients could see their own live location in the map of the hospital when receiving directions. 

To allow for this each ward was assigned its’ own designated QR code, which the app can recognise and use to display a personalised route to the location. These QR codes could also be provided to patients with their appointment confirmations and were available at reception desks, allowing patients to download the app beforehand and familiarise themselves with accessing the navigation data before they attend. The app also provided a text search function of hospital departments or ward names as a backup if a QR code is unavailable. 

Signage around the hospital was also updated to include these QR codes, with the added advantage of allowing departments to be repositioned, by reconfiguring which room the QR code relates to, without needing to replace the signage each time. 

This image shows how the wayfinding solution works, showing how a patient's mobile device connected to hospital Wi-Fi network can scan QR codes to receive directions.

The trial aimed to provide each patient with an effective software solution dedicated to guiding them to their appointment, using technology to improve the guidance available. The targeted benefits to the trust included: 

• reduction in missed and late appointments from being unable to navigate the trust’s buildings - a 5% reduction in DNA rates was estimated to achieve a saving of up to £672,000 per year in saved productivity - to monitor this the trust tracked the number of DNA’s over a given period and compare them post deployment
• improvement in patient quality of care as barriers are removed from attending medical appointments
• reduction in disruption to staff productivity from assisting patients to their appointments and effect of late / DNA patients on clinician workflow
• improvement in patient and visitor experience due to ease of navigation, especially for those from deprived groups
• reduction in signage costs for the trust, as more navigation will be performed and updated digitally

As the trust is looking to accommodate all patients’ needs, there has also been consideration given to those patients without access to mobile devices or who are uncomfortable with or unable to use the mobile technology for the wayfinding solution. These patients can access wayfinding support via kiosks in strategically placed locations across the pilot area. The kiosks provide support in multiple languages and have been reviewed by both disabled and able-bodied patients for suitability user. The kiosks are a supported by volunteers trained to assist patients in finding their appointments using the kiosk.

The trust is allocating additional budget to support enablement and to raise awareness of the new services as well as investigating alternative language capabilities, and whilst digital navigation may not be used by every patient, the benefit in time saved can be used to better support those who need more specific help.

Work to commence the trust’s deployment of their wayfinding solution started in September 2024 and concluded in March 2025. 

The trial consisted of the following phases:

Design phase

The design phase began with an initial review of requirements, followed by a detailed feasibility analysis of the technical solution. A primary focus was the feasibility of the 'blue dot' functionality, for which the trust’s NHS Wi-Fi would be critical to the success of web-based real time wayfinding.

Detailed discussions with suppliers revealed a limitation: the wayfinding solution did not support the real time blue dot feature, due to how it interacted with the NHS Wi-Fi service. Not having 'blue dot' real time tracking functionality available impacted the capabilities and benefits of the solution, however static directions were still seen as a big improvement whilst work continued to resolve the technical issue. 

Installation and testing

During October and November, the project moved into installation and testing. This phase required multiple teams to work in parallel once the initial map configurations were completed. Specific activities included:

• evaluating kiosk placement options for best exposure to visitors 
• configuring the base software for kiosks
• setting up the network configuration, so the kiosks and app could correctly communicate with the trust’s Wi-Fi
• conducting testing and quality assurance of the maps

A collaborative test plan was created, allowing all teams to contribute to testing activities and schedules, supporting a thorough and well organised evaluation. The maps also underwent review and sign-off by subject matter experts based at the Leicester General Hospital.

Kiosks were placed at locations designed to maximise patient footfall and be easily accessible. The four kiosk locations were placed in:

• main reception 
• foyer outside orthopaedic theatre 
• maternity main reception 
• outpatient department reception

During testing, UHL determined that the blue dot real time wayfinding functionality could not be provided via the web browser due to coverage issues with the NHS Wi-Fi at the LGH pilot site. Lack of reliable Wi-Fi coverage meant that any attempts to use the system were inaccurate. As this was an important feature of the deployment, the trust began work on installing more access points and switches to improve Wi-Fi coverage at the site to address this. 

At launch, the wayfinding deployment was comprised of the web app and four kiosks, both with static maps and point to point directions.

The application and kiosks supported 13 languages: English, Norwegian, Swedish, Danish, German, Italian, Dutch, Thai, Spanish, Czech, Finnish, French and Mandarin, with plans to add Punjabi and Urdu. This is supported in both on-screen directions, and voiceover instructions.

DNAs for “other” reasons were reduced by roughly 19%

In October 2024 there were 141 missed appointments for “other” reasons vs 114 in November, providing a £4,320 saving within the first month (considering each missed appointment costs the NHS an estimated£160). The trust does not currently track difficulty locating the correct room as a reason for a DNA so this cannot solely be attributed to the new solution.

Good uptake of the kiosks and volunteer support

Over the first two months post deployment, the kiosks were used nearly 1,400 times, 947 in December 2024 and 436 in January 2025. The trust believes that the reduction seen in use of the kiosks can be partly explained by the added value that the trained volunteers and staff have brought to the hospital, meaning patients are less likely to need a kiosk for further direction. 

Feedback on the solution has been highly positive

Verbal feedback from patients and staff has highlighted the ease of use and how the solution enables patients to act independently when arriving at the site.

Better wayfinding minimises staff disruption

local data shows that 80% of the questions directed to help desks are about way finding. Assuming assisting a visitor takes 5 minutes out of a staff member’s work schedule and taking just half of the 974 kiosk usages recorded, freeing up 40 hours or more one week of a full-time staff members time for clinical work. 

Real-time blue dot functionality continues to be a struggle

Despite installing more switches and access points, additional challenges arose due to the system’s detailed design. It was found that for the web browser and app versions that when a device connects to the internet through NHS Wi Fi, it looks like all devices share one IP address, as individual credentials are not provided per user.

This has meant that the solution is currently not able to identify individual users to track their live location to inform the blue dot capability. Potential fixes have been explored but have raised additional issues around data security and server space. At the conclusion of the trial this issue had not been resolved, and work with the supplier and Wi-Fi provider was ongoing. 

It was found that when using the Mazemap app through a non-NHS Wi-Fi connection, there was a slight delay in the location mapping resulting in inaccuracies with the blue dot. This provides a poor user experience and has meant that the app was not used as often as the web version. 

The trust is continuing to troubleshoot this issue and refine their offering to allow for this important functionality to work as intended. This process involves technical discussions with the wayfinding supplier and the NHS Wi-Fi provider. The trust has reported that the ongoing engagement with all parties to resolve this issue has been a difficult process. One of the lessons learned from this issue is that early engagement with suppliers is key to identifying compatibility issues when integrating new technologies with existing connectivity infrastructure.

The trust has also provided a series of lessons learned from their deployment, to assist other organisations interested in adopting wayfinding technologies. 

Initial planning and scoping 

Where possible, the design should be thoroughly understood before starting to avoid early ambiguities. Examples were the Wi-Fi and network requirements. 

Governance     

UHL has an established Project Management Office function (PMO) which helped streamline processes with regards to regular reporting and the logging of risks, storage of documentation  

Longer timescales for governance approvals would have been useful to allow for planning and key decisions to be made in advance. However, working with an established team working on the EMPCC new build has meant the impact of this risk has been mitigated through quick engagement on the programme to move it forward. 

Coordination with supplier     

Having a responsive and proactive supplier significantly mitigates knowledge gaps. 

Resource allocation     

Working together with other local programmes, namely the East Midlands Planned Care Centre, was advantageous as they brought specialised, focused resources. 

Stakeholder engagement

Early stakeholder buy-in was crucial for integration and adoption of the solution by users. 

Network requirements and licensing

It is important to check license allocation for Cisco Spaces in advance to resolve issues proactively. The license challenge encountered by the network team was resolved on the same day via a call with Cisco but could have resulted in additional effort. 

Testing and feedback 

Continuous testing and iterative feedback loops improved system performance. 

Kiosk delivery 

Supplier issues caused delays to the delivery of the kiosks and confusion as to what the definition of installation meant. Clarification on the details of quotes and support offerings should be sought in advance.  

Kiosk security

One kiosk location incurred a security risk of theft and as such the kiosk had to be bolted down causing a slight delay to the deployment. 

Test kiosk in IT 

Having a test kiosk in the IT department for staff to test was invaluable for user acceptance testing and resulted in positive feedback from users and shared knowledge of projects in the department. 

Measuring metrics and KPI’s

Metrics should be well thought out so that they are measured in a way that will provide relevant and accurate statistics which can be used to show measurable progress.

University Hospitals of Leicester NHS Trust have combined modern connectivity technology with the engagement needed to understand the needs of their patient demographic to improve patient experience, reduce health inequalities at the hospital and realise savings from a reduction in DNA, while not leaving behind those who have difficulties engaging with technology.

Although they have faced difficulties with some aspects of the implementation, mainly the blue dot real time tracking technology, the trust has is confident of the benefits achieved already from the wayfinding support offered by the kiosks, website, app and volunteers. This project has demonstrated how the right applications of connectivity and technology can be used to remove language barriers to patients receiving the care support they need.