News Release

Cisco Cius and Nervecentre Software help Nottingham University Hospitals NHS Trust redirect 8,000 hours of nursing time a year into hands-on patient care

ACCA Study: New collaboration technology delivers cash savings of £97,000; estimated £292,000 per year of avoided costs in extended lengths of stay; improved patient safety and increased staff satisfaction
May 18, 2011

LONDON, 19 May 2011- According to a study commissioned by the European Commission, technologies such as wireless networks, tablet computers and portable phone handsets can speed up the treatment of patients, improve communication between medical and nursing staff and make medical and procedural information more easily available to junior doctors in hospitals.

The study by the Association of Chartered Certified Accountants (ACCA)assessed the impact of introducing newcollaboration technologyfrom Ciscoand Nervecentreat Nottingham University Hospitals NHS Trust (NUH).  The report reveals a significant improvement in patient safety, operational efficiency and clinical governance in NUH's out-of-hours ‘Hospital at Night' (H@N) Emergency Department service. 

The new hospital systems includes a Cisco medical-grade network to provide both wired and wireless (Wi-Fi) network access; a real-time workforce management system from Nervecentre; and 11 Cisco Cius™ tablets, mobile collaboration tablets built for business, for use by each H@N co-ordinator at NUH.


According to the ACCA report, benefits delivered through the use of these technologies include:

  • The reinvestment of £300,000 – equivalent to 8,000 hours – of additional clinical support into patient care asresult of the H@N coordinators' new mobile technology, which enables them to work on the wards and provide direct clinical care
  •  Better utilisation of resources resulting in the identification of £97,000 of cash savings per annum through changing the shift patterns of clinical support workers
  • The Cisco Cius tablet and portable IP phones give care staff better access to the latest patient information outside traditional working hours, when expert physicians may not be physically present in the hospital.  This helps to speed up treatments and reduce the length of hospital stays and has generated an estimated £292,000 in annual savings
  • The savings generated by the Cisco and Nervecentre technologies paid for the cost of the technology within four months

Further significant benefits that have already been seen by NUH include:

  • Patient safety enhanced following the introduction of tools to support the prioritisation of care for acutely sick patients and from improved handover procedures
  • Staff satisfaction significantly increased by improved communication across the team
  • Digital information processing greatly enhanced the information governance as well as the clinical governance of the work of junior doctors

The results and benefits are published as part of a study conducted by the ACCA into the impact of ICT in healthcare delivery systems, ‘Collaboration and communication technology at the heart of good clinical governance'.  The study follows a previous assessment of the use of wireless telephony and messaging in the NUH Emergency Department.

Key Facts:

The Challenge

  • NUH is the fourth-largest teaching hospital in the country, with more than 13,000 staff, providing a range of services to a regional population of around 2.5 million people
  • NUH introduced the H@N concept to both its City Hospital Campus and Queen's Medical Centre in 2006 with the aim of reducing the number of hours worked by junior doctors, without compromising the clinical quality or safety of patient care
  • Although initially successful, staff began to have concerns about the outdated pager and landline method of communication being used by the team, fearing that the system was introducing unnecessary delays that threatened the quality and safety of clinical care
  • Other issues identified included potential breaches of patient confidentiality, poor record keeping, disengagement of senior clinicians, and the deskilling of H@N coordinators, experienced nurses who now spent most of their time behind a desk answering telephone calls

The Solution

  • Following an internal review of the existing H@N service, a number of operational changes were recommended, including investment in an intelligent ICT system
  • In addition to the wired and Wi-Fi networks, Cisco telephony was introduced through both fixed and portable handsets, with the portable units utilising the Wi-Fi network
  • Nervecentre was deployed in September 2010 to increase the efficiency and effectiveness of the H@N system, tailored to NUH's requirements in full consultation with staff
  • The Cisco Cius business tablet provides highly secure mobile collaboration and computing capabilities. Designed specifically for business use, the tablet was introduced to allow H@N coordinators to instantly see which patients are waiting to be seen, the status of all outstanding tasks and the workload of each member of the team
  • The Cisco Cius tablet has put the H@N co-ordinator back in charge of the H@N service, giving coordinators the freedom to leave their desks and get back on the wards to provide clinical support where it is needed most and remain in full contact with all members of the H@N team
  • The new solution has helped NUH address its problem in recruiting H@N coordinators.  Whilst previously nurses had been reluctant to take on a desk-based job, the new mobile system has meant that NUH has reduced its persistent vacancies from four to zero full-time equivalent (FTE) posts
  • Satisfaction ratings have also gone up from around 60 per cent to 90 per cent across all staff surveyed in all categories

Supporting Quotes:

Mark Millar, Council Member, ACCA:

"The old system of H@N administration was complex and inefficient, raising questions of safety and had poor levels of staff satisfaction.  The H@N coordinators are now able to spend around 60 per cent of their shift providing direct clinical care on the wards, compared to at best three per cent before.  The investigation team showed that while previously H@N coordinators had spent under four hours per week on clinical work, using the new system they were able to spend over 75 hours per week on direct hands-on care."

Andrew Fearn, Director of ICT Services & Senior Information Risk Owner, Nottingham University Hospitals NHS Trust:

"Working with Cisco and Nervecentre we have been able to introduce a system that removes unnecessary complexity and from which NUH will reap direct financial and operational benefits, as well as being able to help patients get more timely care.  These results show that collaborative processes, supported by networked communications and collaboration, can deliver significant improvements in performance in the areas of quality and productivity - aligning with the overall NHS Quality, Innovation, Productivity and Prevention (QIPP) Programme aims and objectives."

 Rod Halstead, Managing Director, Public Sector, Cisco UK and Ireland:

"At a time when cost and efficiency are the two priorities for our healthcare system, effective communication has become increasingly important in ensuring NHS staff can do their jobs efficiently.  From the outset this project has been all about better collaboration between ward staff, nursing staff and medical staff.  As a result, NUH has been able to reap the rewards within just four months, leading to better clinical governance, information governance and planning."

Paul Volkaerts, Managing Director, Nervecentre Software Ltd:

"With £20 billion of savings to deliver by 2014, it is vital that NHS Trusts have proven blueprints that help them to deliver against this target.  I'm delighted that this report provides hard evidence of significant savings and improvements in patient safety delivered by the project.  I'm also particularly pleased that the staff survey shows an increase in staff satisfaction from around 60 per cent to 90 per cent.  Staff adoption is the cornerstone of any successful IT project and we placed a high priority on ensuring the technology was easy to use and addressed the frustrations of clinical staff."

Supporting Materials:

Notes to Editors

About Cisco

Cisco and the Cisco logo are trademarks or registered trademarks of Cisco and/or its affiliates in the U.S. and other countries.  A listing of Cisco's trademarks can be found at  Third-party trademarks mentioned are the property of their respective owners.  The use of the word partner does not imply a partnership relationship between Cisco and any other company.

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About Nottingham University Hospitals NHS Trust

Nottingham University Hospitals NHS Trust (NUH) is one of the largest acute teaching trusts in the country. It is made up of Queen's Medical Centre (QMC), Nottingham City Hospital and Ropewalk House, a facility in Nottingham City Centre where hearing services are based.

The Trust provides acute and specialist services to 2.5 million people within Nottingham and surrounding communities from QMC, City Hospital campuses and Ropewalk House.

NUH has an annual budget of £722million of public sector funding and employs over 13,000 staff, making the Trust one of the city's biggest employers.  In addition, NUH has over 1,500 volunteers who each make a unique contribution to NUH. The Trust currently has around 1,700 beds and 87 wards.

About the ACCA

1.       ACCA (the Association of Chartered Certified Accountants) is the global body for professional accountants.  We aim to offer business-relevant, first-choice qualifications to people of application, ability and ambition around the world who seek a rewarding career in accountancy, finance and management. 

2.       We support our 147,000 members and 424,000 students in 170 countries, helping them to develop successful careers in accounting and business, with the skills required by employers.  We work through a network of over 80 offices and centres and more than 8,500 Approved Employers worldwide, who provide high standards of employee learning and development.  Through our public interest remit, we promote appropriate regulation of accounting and conduct relevant research to ensure accountancy continues to grow in reputation and influence. 

3.       Founded in 1904, ACCA has consistently held unique core values: opportunity, diversity, innovation, integrity and accountability.  We believe that accountants bring value to economies in all stages of development and seek to develop capacity in the profession and encourage the adoption of global standards.  Our values are aligned to the needs of employers in all sectors and we ensure that through our qualifications, we prepare accountants for business.  We seek to open up the profession to people of all backgrounds and remove artificial barriers, innovating our qualifications and delivery to meet the diverse needs of trainee professionals and their employers.

About Nervecentre

Nervecentre Software is a healthcare focused consultancy and software development organisation founded in 2010 which is committed to enabling the NHS to improve productivity and quality through innovative collaboration technology.   Nervecentre is a collaborative workforce management system that addresses patient safety, clinical governance and resource management. The application is platform independent and integrates into a hospitals' existing IT system as well as any Cisco wireless and telephony infrastructure.

For further details visit