In the Spotlight: Lewisham & Greenwich NHS Trust

Background

Lewisham and Greenwich NHS Trust (LGT) is a community-focused provider of local and acute care, delivering high-quality services to over one million people across the London boroughs of Lewisham, Greenwich and Bexley. 

Challenge

Like many NHS Trusts, LGT struggled to balance the need for round-the-clock access to clinical photographic services with the regular working hours operated by its Medical Photography Team.  

“The NHS did not – and still does not – have a national solution to this problem, and none of the existing applications we looked at met our requirements,” explained Sally Foskett, deputy director of content, creative and engagement at Lewisham & Greenwich NHS Trust. “These included Trust oversight and ownership of captured media, storage safety and consent to photography.”   

Julian Beeton, head of content and channels at Lewisham & Greenwich NHS Trust, provided further insight: “We were looking for a solution that met our needs in a safe, secure, and appropriate way. Ultimately, we selected Node4 because we liked their attitude and approach. The team spoke in terms we could understand and didn’t try to overwhelm us with a barrage of technical details. In those early sessions, Node4’s status as a Microsoft Inner Circle partner made a big difference, giving us extra confidence in their expertise and strategic thinking – particularly around their ability to implement a Microsoft Power Apps-based solution, which they believed would be the best fit for our needs.”   

Solution

With Node4 onboard, the team began to develop Galerie – a bespoke, mobile clinical photo capture, annotation, and sharing application based on Microsoft’s Power Platform.

Galerie met LGT’s brief in four key areas:  

• User independent: Galerie is not tied to a single user. If a clinician leaves the Trust or the NHS, the images stay within the application environment and do not leave with them.    
• Compliant with patient record retention: Galerie ensures the Trust stores electronic patient data in line with current guidelines and legislation.   
• Able to provide detailed image annotation capabilities: Galerie enables clinicians to annotate individual images when uploaded and allows further notes to be added by other colleagues at a later point.   
• Directly connected into the NHS Spine: Galerie is the first application of its kind to directly connect clinical data from the NHS spine and store it in the Dataverse on the NHSmail Shared Tenant. This enables clinical staff to pull patient demographic data and create records.  

“Galerie is a revolutionary application and a genuine first for the NHS,” said Foskett. “It looks and feels like an NHS app, so it should be an easy transition for users. There’s a simple sign-on process, and it’s very intuitive – no need to read an instruction manual.”  

Results

Employee Engagement

“We have around 500 users. That’s almost twice as many as we expected by this point,” said Foskett. “Furthermore, in the last two months alone, we’ve photographed over 1,000 patients and captured nearly 3,300 images. Much of this is a result of considerable support and endorsement from senior leadership, with our IT Director reminding everyone of Galerie’s importance in terms of data security and compliance. It’s also thanks to our new medical photography administrator, Tousif Sumon, and his efforts to train and educate new users.”  

Secure access and data protection  

“Galerie works on a phone, laptop or a smart device and looks identical in each instance. The only difference is that when Galerie launches on a phone, it also launches the camera so the user can take a photo,” said Beeton. “In an important step forward, Galerie also allows keywords and notes to be added to individual images, which helps give additional context to doctors and other medical staff.”     

“However, the real innovation – and the most important component for us—is that photos never touch the user’s camera roll or photo gallery. They stay within the application environment, helping to protect against GDPR breaches. Galerie also restricts how photographs are shared via email, only allowing them to be forwarded to authorised accounts such as nhs.net emails and other approved DCB1596 compliant domains from partner organisations.”     

Diverse use cases across the Trust 

Both colleagues are excited about Galerie’s current and expected deployments across the Trust, with Foskett noting the diverse range of applications and use cases: “Our community care and hospital teams often work together on patient treatments. Two of the most common collaborations are around foot health and tissue viability. Clinical photographs taken in a hospital and community environment were previously stored on different systems, making it harder to quickly assess patient needs and provide integrated care. By storing community and hospital photos in Galerie’s central database, clinicians from both teams will be able to quickly determine a patient’s treatment history and work together to improve patient care.”  

She continued: “We were surprised to see demand for Galerie from medical records teams. They use it to compile images for reports and medical records. It wasn’t a use case we’d expected, but now they’ve built it into their systems and processes, it makes perfect sense.”  

“That’s not all,” added Beeton. “Our critical care teams are also using Galerie to create, annotate and send images that explain where minor adaptations are needed to help people live comfortably and with dignity in their homes. Beyond that, we can also see strong use cases for dermatology, burns, and plastic surgery teams. Outside the hospital, Ambulance crews could use Galerie to take pictures at the scene of an accident. Uploading the image before arriving at the hospital would allow clinicians to see the wound in situ and get a head start on planning appropriate treatment. Used in this scenario, Galerie would also remove the need for second-guessing, verbal explanations, or rushed notetaking.”    

Setting a new standard for the NHS

Looking to the future, Foskett and Beeton think Galerie could set a new standard for clinical photographic service delivery across the NHS.

“It feels truly innovative,” said Beeton. “However, we need to address some logistics and financial aspects – such as how we monetise the app. If we could sort out those issues, I think Galerie could be the catalyst for streamlining collaboration among healthcare teams and ensuring compliance with data protection regulations across our entire organisation.”