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Nottingham hospitals to trial app bridging language barriers in parents with child patients

By Lauren Monaghan, Junior Local Democracy Reporter

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Nottingham’s hospitals will trial a new app to navigate language barriers of parents with unwell children this summer.

The innovative project was discussed in a Nottingham University Hospitals Trust (NUH) board meeting today (May 8) and is designed to reduce Failure to Rescue (FTR) rates in its children’s hospital.

FTR refers to failure to prevent patient deterioration – events which can lead to death and planned admission to critical care.

Over the past decade, NUH has worked to reduce this rate, with targeted educational programs to enhance staff knowledge and skills, assessing a patient’s journey before an escalation and establishing a dedicated Paediatric Critical Care Outreach Service.

These interventions saw NUH’s FTR rates drop from 24 per cent to under five per cent on emergency events in the children’s hospital – this has been maintained for over eight years.

But a consistently prevalent theme among healthcare reviews is families’ concerns not being heard.

NUH now wants to help combat this, but by targeting for ‘under-served, non-English speaking communities’ who may be at further disadvantage.

Promoting the project, Professor Joseph Manning, Professor of Nursing and Child Health, said:  “[Families] with a child will notice subtle changes – ones that may not be captured on a chart or by a clinician interaction.

“It may be as small as they’re not playing with their favourite toy or they just don’t seem right. To us that may be difficult to capture but for parents that is an absolute red flag.

“This is really important for families where those children are complex.”

The app will be be trialled from June 2025 and currently offers three languages – English, Polish and Urdu – based on Nottingham census data.

Families will scan a QR code, have some initial filtering questions and multi-tick-list questions, with any information going directly to the Paediatric Critical Care Outreach Team (CCOT).

Example questions are ‘I’m worried about how my child is breathing’ and ‘I’m worried things are just not quite right and I don’t feel my concerns are being heard’.

The board heard how the app uses professional translation but also input from relevant families to offer realistic translation.

Craig Wilcockson, Non-Executive Director, asked: “How does [information input] loop in? Does that go to the nursing team – does it flash up [as a notification]?”

Rachel Boardman, Director of Nursing and Professional Family Health, said: “It goes to the CCOT, who can go to the child and review them.

“It’s got the ability in it if they’re concerned with whatever the parents are saying, it can say straight away ‘please go speak to the nurse’ – it can do that automated part.

“It’s those small numbers of families that we still don’t hear in these events and how we get their voices heard, to get that five per cent number down to zero.”

Serbjit Kaur, Non-Executive Director, asked: “Do you have plans to include different languages and how long will it be to get more languages onto the app?”

Mr Manning replied: “We were limited by the resource. We were awarded $50,000 by the American Nursing Credentialing Centre, and the conversion rate was poor at that time.

“We had to prioritise what we would translate.”

Dr Umar Ahmad, Associate Non-Executive Director asked whether it could be expanded into other groups, such as the elderly.

Ms Boardman replied: “When we’ve shared this wider across the trust everyone’s very keen. [We’re] holding it a little bit to make sure we do the proof-of-concept to make sure it works before we start to expand it – there’s real opportunity.”

If successful, the project will see more inclusive assurance that NUH complies with Martha’s Rule.

This is a patient safety initiative allowing patients and families an urgent review if they or their loved one’s condition deteriorates and are worried it is not being responded to.

This rule followed the death of 13-year-old Martha Mills in 2021, who died after developing sepsis from a pancreatic injury after falling off her bike.

Her family’s concerns over her deterioration were not responded to, and in 2023, a coroner ruled she would have likely survived if moved to intensive care earlier.