Convergence cuts costs at Guy's and St Thomas' hospital

Guy's and St Thomas' NHS Foundation Trust in the heart of London has cut costs and call waiting times after replacing an ageing analogue telephony system with a converged IP-based network that allows voice recognition .

Because the Trust is based over two sites at Waterloo and London Bridge the hospital used to have separate switchboard numbers and almost 7,500 internal phone extension numbers. This resulted in the two switchboards having to deal with 20,000 external and 11,000 internal calls every day between 9:00AM and 5:00PM.

There was little spare capacity in the existing system but the cost of a complete migration to a brand new IP network was too high so the Trust opted for a hybrid mix of traditional telephony and IP with BT and Nortel.

The converged infrastructure now supports analogue, digital and IP handsets, meaning that the hospital could reduce the cost of the switch-over by retaining legacy equipment. This means internal calls, which account for 80 per cent of all the Trust's call traffic, are now free.

The equipment, including 1,000 IP phones, was installed over a single weekend in 2004 at Guy's and St Thomas' in what Bobbie Lawrence, head of IT service delivery at the Trust, calls a "big bang" approach.

Patients now have one number to dial for the hospital and are first met by an interactive voice response (IVR) system that deals with nine out of 10 calls. Only after two failed attempts does it go through to a human operator.

Lawrence said the IVR system has proved very successful but admitted that strong accents can be still difficult for it to deal with.

"People struggle with accents and inevitably the IVR does as well," she said.

But it has reduced the number of calls the hospital has to deal with - now down to just 4,000 internal and external each day.

As part of a move to the new hybrid telephony system Lawrence also turned the traditional switchboard into a call centre for the hospital, dealing with diverted calls, recruitment applications, IT support and IT purchasing.

In recruitment alone - where the call centre staff take the names and addresses of individuals responding to job adverts for sending an application pack out - Lawrence estimates it has saved £40,000 to £50,000 a year. The trust also used to spend £12,000 a year on directory enquiries but now spends £840 after it was brought in-house.

But Lawrence says the benefits aren't just in cost terms. "It has freed up the senior managers to do more important things," she said.

Future plans include a WLAN-enabled phone that hangs around the neck of doctors, allowing them to be contacted anywhere in the hospital - even in theatre - and digital pens that automatically fill out patient medical prescriptions when they check out of a ward so that it is ready for them to collect when they leave the hospital.