Why East Sussex Healthcare NHS Trust Chose Frontier Health

Why East Sussex Healthcare NHS Trust Chose Frontier Health

East Sussex Healthcare NHS Trust (ESHT) operates two acute hospitals, as well as community health services and was facing mounting operational pressure in its Emergency Departments. Performance on the 4-hour breach target was regularly below 78%, falling short of the national standard. The Trust needed a solution that could address the root causes of avoidable delays, by supporting the stretched teams, without adding more staff given budget and headcount constraints.

ESHT chose Frontier Health and its Juno AI co-worker because it offered a fundamentally different approach: deploying AI to perform the repetitive, time-consuming administrative work that was consuming clinical and operational capacity. Juno offered the ability to work 24/7, something no substantive member of staff can do, while freeing up the human workforce to focus on patient care and clinical decision-making.

The Trust was also attracted by Frontier Health's NHS-specific design ethos, Frontier Health's willingness to undertake a detailed time-in-motion study to understand ESHT's specific workflows, and the clear pathway to measurable, cash-releasing savings, aligning performance objectives and efficiency improvements.

The Problem JUNO Was Built to Solve

Before Juno, ESHT faced a series of challenges across Emergency Departments and inpatient wards:

Avoidable Patient Delays in the Emergency Department

Tracking more than 100 patients per day per site manually was simply not feasible. Clinical teams were unable to consistently monitor blood results, imaging outcomes, and pathway milestones around the clock. When tracking staff went on break, coverage lapsed, and avoidable delays in patient pathways occurred as a direct result. Deploying Juno has standardised the tracking process, freed up team time to focus on patient focused work, and proactively alerted teams when actions need to be taken to deliver flow in real time. Juno now monitors patient pathways and results continuously across both sites, 24 hours a day, seven days a week. In one month alone, Juno checked that investigations were back over 9,000 times, ensuring results weren’t missed and no delay went unaddressed regardless of shift patterns or staffing levels.

Wasted Clinical and Operational Time

Staff were burdened with repetitive manual tasks: finding patients in high-risk categories, copying investigation results into discharge forms, and generating manual Situation Reports (Sitreps). These activities diverted both clinical and operational staff away from patient care. Juno provides all this information at the click of a button, or through an intelligent chat interface. By taking over the repetitive administrative tasks that were consuming staff capacity, saving over 51 hours of non-clinical staff time and 7 hours of clinical time every week. Sitrep generation, previously a manual process, is now automated every 15 minutes, giving the team timely data without anyone having to produce it.

Sub-optimal Departmental Visibility

The ESHT team lacked access to timely, consolidated data. There was no reliable way to know whether diagnostics were delayed, where golden patients were, or which pathway plans had gone stale. Decision-making was reactive rather than intelligence-led. Metrics that were previously unavailable, such as bloods and imaging turnaround times, are now visible across the whole hospital, driving cross-departmental service improvements and better collaboration.

Time-consuming Operational Analysis

When leadership requested breach analysis or departmental performance reviews, operational managers could spend up to five hours, and in complex cases, an entire working day, retrieving and validating data manually from disparate systems. Juno generates AI-powered historical analysis and breach validation on demand, reducing what previously took an entire working day to a matter of minutes. Operational managers now save 2–3 hours per analysis request, with accurate, specific data available whenever leadership requires it.

Financial Inefficiency

The Trust was funding administrative headcount for tasks that did not require human judgment. With tighter financial targets to meet, this represented an avoidable cost. By taking on administrative work that previously required substantive headcount, JUNO enabled cash releasing benefits, changes in the team composition, redeployment to more critical activities, and reduction in reliance on agency and bank staffing.

Ward Flow and Discharge Pressures

Site managers were manually navigating systems to identify patient flow blockers and locate golden patients. There was no AI-powered insight to support discharge decisions or unblock pathways at scale across all wards simultaneously. Juno’s AI flow insights give site managers immediate visibility of pathway blockers across all wards simultaneously, replacing the manual process of navigating systems one patient at a time. Juno has also supported over 10,000 discharges in a single month by automatically populating relevant data in discharge forms, reducing the burden on doctors and improving throughput.

Key Benefits and Outcomes Achieved

Juno has delivered measurable improvements across clinical, operational, and financial dimensions since going live.

Patient Flow and Clinical Impact

• Median time patients spend in the Emergency Department has reduced by 21.67%; achieved even during a period of higher attendances following Juno’s go-live.
• Juno tracked blood results over 9,000 times in a single month, ensuring no result was missed regardless of staffing patterns or shift changes.
• 400 potential 4-hour breaches saved in one month through proactive tracking and timely alerts.
• Over 10,000 patient discharges supported by Juno in one month through automated population of relevant information in discharge forms.

Staff Productivity

• Juno saves over 51 hours of non-clinical staff time per week, freeing trackers and operational staff from repetitive monitoring tasks.
• Juno saves 7 hours of clinical staff time per week, giving more time for patient care and supervision of junior doctors.
• 221 days' worth of manual work effort per site saved in the first 8 weeks alone, based on a detailed time-in-motion study.
• Sitrep generation, previously a manual task, is now automated every 15 minutes, providing the A&E team with near real-time operational data.
• Operational managers save 2–3 hours per historical analysis request, with Juno producing AI-powered breach validation and departmental performance reports on demand.

Operational Intelligence and Planning

• Juno delivers 24-hour trend charts and AI-powered root cause analysis, enabling out-of-hours issues to be investigated quickly and accurately.
• Juno is being used to plan implementation of new NHS England guidance, drawing on ESHT's own historical data rather than national benchmarks alone.
• Juno recommends staffing rotas based on demand patterns, supporting data-driven workforce planning.
• Juno escalates high-risk patients and provides Department Scores with associated actions, supporting appropriate governance when the department is at capacity.
• Ward-level AI flow insights are being used to unblock patient pathways and support timely discharge, with Juno also having been used to manage operational exercises including the Trust's Perfect Week initiative.

Metrics at a Glance

• 21.67%  reduction in median ED patient time
• 51+ hours  of staff time saved every week
• 9,000+  blood result checks completed by Juno in one month
• 400  4-hour breaches saved in one month
• 10,000+  discharges supported by Juno in one month
• 221 days  of manual work effort saved per site in 8 weeks

Future Plans

ESHT is not standing still. The Trust has identified a pipeline of additional use cases for Juno across the organisation.

The Trust views Juno not as a point solution for the Emergency Department, but as a scalable AI co-worker platform capable of delivering impact across the whole organisation.

Working with Frontier Health

The experience of implementing Juno with Frontier Health has been characterised by a genuine partnership approach. Frontier Health conducted a detailed time-in-motion study before implementation, ensuring Juno was configured to reflect ESHT's actual workflows rather than a generic template. The clinical safety process confirmed Juno’s status as a Class 1 Medical Device, providing assurance to both clinical and governance stakeholders.

Staff adoption has been rapid and enthusiastic. Operational and clinical staff log in to Juno every day. The response from the frontline has been striking:

• ‍“I LOVE it!”  — Urgent Care Service Manager‍
• “This is a game-changer.”  — Lead Clinician
• “Thanks to Juno, trackers have more free time to create flow and speak to AAU.”  — Service Delivery Manager, ED‍
• “Juno is doing a lot of the work for us.”  — Lead Clinician

ESHT is proud to be at the forefront of embedding AI into NHS operational and clinical workflows. The partnership with Frontier Health has demonstrated that the benefits of AI in healthcare are not theoretical, they are measurable, repeatable, and already making a difference to patients and staff at East Sussex Healthcare NHS Trust every single day.