Services Description
GPSoC Service Name
Eclipse Live
GPSoC Service ID
Functionality/Service
Overview
PSL02
Introduction
Eclipse Live reduces the Surgery's rate of emergency admissions relating to prescribing and is a
recommended interface within the NHS England's Any Town Toolkit*. It runs thousands of algorithms
against the individual patient's read codes, medication lists and blood results allowing clinical
interventions to be made that prevent a significant medical emergency.
The system is now utilised by over 1000 surgeries and is protecting over 7 million patients in England.
The System automatically informs the GP of at-risk patients, reducing emergencies, visits, admissions
and adverse outcomes.
To date the system has identified more than 50,000 life-threatening emergencies, 340,000 serious atrisk scenarios and 1 million significant risk scenarios for the member practices.
This has translated into significant improvements in outcome data.
On a recent audit of our Eclipse Live practices emergency admissions were 10% lower than predicted,
A&E admissions 8% less and outpatient appointments reduced by 17%.
This translated to 25,000 fewer emergency admissions, 73,000 fewer A&E Attendances, 51,000 fewer
hospital admissions and 447,000 fewer outpatient attendances than predicted standardised values from
the NHS Information Centre.**
* http://www.england.nhs.uk/2014/01/24/any-town/
** Full report at www.eclipsesolutions.org/impactassessment
Background on Prescribing Safety
Each year thousands of patients die from medication-related incidents, more than half of which are
preventable1. There are also tens of thousands of preventable medication-induced emergency
admissions causing tremendous unnecessary suffering and putting an enormous strain on the NHS.
Patient Safety Statistics

Research shows that 6-7% of all emergency admissions are related to medications and that
60% of these incidents are preventable.

Each medication-induced emergency admission is estimated to cost £3,0002.
How big is the problem?
In 2010, there were 4.9million emergency admissions, costing the NHS £8.8billion 3. If 7% of these were
related to medications, this would represent 343,000 admissions, of which more than 200,000 could
have been prevented.
With each admission costing around £3,000, this represents a potential saving of £1billion if a reliable
system could be implemented to identify these at-risk patients before they decompensated.
What is the solution?
We wanted to develop a system that could identify patients at risk from these emergencies and radically
improve patient safety.
The first step was to identify the different scenarios that resulted in patient admissions and most of the
differing emergencies fell into three main areas4,5:




Prescribing errors (35%)
Monitoring (26%)
Adherence to medication (30%)
Other (9%)
So the solution was to create a system that would identify at-risk patients for the majority of all these
common medication-induced emergencies – and Eclipse Live was born.
1 Winterstein A, Sauer B, Hepler C, et al. Preventable drug-related hospital admissions. Ann Pharmacother 2002; 36:1238–48.
2 (Value Health. 2011 Jan; 14(1):34-40.) HARM: Preventable hospital admissions related to medication.
3 www.nhscomparators.nhs.uk NHS information Centre based on national statistics for 2010 calendar year
4 Br J Clin Pharmacol. 2007 February; 63(2): 136–147
5 Winterstein A, Sauer B, Hepler C, et al. Preventable drug-related hospital admissions. Ann Pharmacother 2002; 36:1238–48.
How Does Eclipse Live Help GPs?
It provides essential decision support to the GP either by analysing the individual Patient that is being
seen or by analysing the entire cohort of patients being cared for by that Clinician. This results in:
1.
2.
3.
4.
5.
Identifying patients whose results demand an action (eg a patient with deteriorating renal
function or a patient who is bleeding).
Identifying patients being prescribed medications that are directly contra-indicated (either
because of a change in biochemical markers or because of a conflicting medication).
Identifying patients not complying with monitoring (eg not having those blood tests needed
for certain medications).
Identifying patients not complying with QOF, NICE guidelines or Local Projects.
Identifying patients through the surgery’s own audits (these are easily set up on the system).
(For those surgeries utilising Patient Access, the decision support will also create Patient Friendly
messages, instructing them on what action they need to take to avoid potential harm.)
Each night Eclipse Live runs thousands of algorithms to update patients at risk.
The algorithms come from the NHS England Patient Safety Alerts, MHRA Alerts, Shared Care guidelines,
NICE, BNF and the Nottingham University Team.
Why does Eclipse Live Make such a Difference?
Traditional General Practice involves looking after patients that present for a consultation rather than
finding those patients who are risk. Consequently the majority of GPs spend their time looking after
relatively well patients rather than those patients who are at significant risk of an emergency.
The example below reveals that in one region there were 36 patients with severe anaemia (a
Haemaglobin of less than 8g/dl) who had all collected prescriptions for blood thinning agents in the
previous 14 days!
Eclipse Live report informing practices of patients who are bleeding because of their medications.
These patients are all heading towards an emergency admission or even death and require urgent
intervention. Thousands of alerts such as this can all be easily configured and saved with an automated
action plan created.
Once the patients are identified to be at risk, the alerts are set as high, medium and low and fed back to
the GP.
These alerts can also be accessed through:

Automated emails to the Clinician

Through their Eclipse web portal

Through integration with Principal Clinical Systems

The risk stratification system identifies the patients and advises on what action to take but each
clinician can tweak this advice to embrace their preferred pathways.
During 2015 the eclipse live team will be focusing on fully integrating with the Principal Clinical
Systems to allow further empowerment of these Patient Specific algorithms.
The Eclipse Website Portal
When in consultation mode the alerts click through to the detailed patient view where all actions
needed for the patient being analysed are identified.
Clicking on the review button allows a number of actions to be undertaken enabling resolution of the atrisk scenario.
The clinician can save the action plan against a specific alert, which is then auto-completed for identical
scenarios.
How will Eclipse Live benefit your CCG?
Eclipse Solutions has just completed an extensive Impact Assessment1 analysis, utilising detailed
outcome metrics from the NHS Information Centre on all of its Eclipse Live surgeries. We wanted to look
at the association between the use of this system and outcomes related to admissions, emergencies and
referrals.
Of the 550 surgeries that had signed up to Eclipse Live at the time of the analysis, 370 had full activation
and complete Eclipse Live data sets. We then repeated the process for those surgeries that had the
highest usage of our system (the top 20%) to see if increased utilisation was associated with improved
outcomes.
The outcomes looked at:
1.
2.
3.
4.
5.
Emergency Hospital Admissions
Total Hospital Admissions
Accident & Emergency Attendance
The key 19 Ambulatory Care Conditions
Outpatient Attendances
The first two were also analysed for Diabetes, Asthma, COPD and Coronary Heart Disease.
A saving of:
£463,346 per 10,000 patients per year
For a CCG of 250,000 patients this equates to reduced NHS costs of:
£11,583,652
NB We are currently working with academics to undertake a prospective trial to ensure complete validation of the
system.
Full report is available at www.eclipsesolutions.org/impactassessment
Support
Standard Service Performance & Support:
Full telephone, email and helpdesk support for the duration of the contract available
between the hours of 9am and 5pm Monday to Friday.
Availability Standard:
>= 99% during support hours.
This is calculated using the following
formula:
b  a

100
% Availability =  b 
Where (a) is the sum of downtime in minutes,
(b) is the total time available in minutes. A
measurement period of 1 month will be used.
Incident Fix Times Standard:
Dependant on severity:
Major Incident effecting multiple users and
applications: 4 hours within the times of 7am
to 10pm Monday to Sunday
Minor incident not impacting multiple users
and not effecting core functionality of the
system: 72 hours from report of incident
Monday to Sunday.
Helpdesk Standard:
Dependencies
Full telephone, email and helpdesk support for
the duration of the contract available between
the hours of 9am and 5pm Monday to Friday.
Infrastructure dependencies
System requires internet connection and compatible web browser (Internet explorer 6 and
above, Chrome, Safari or Firefox)
Service dependencies
Requires ability to extract anonymised clinical data either through direct extract using the
pairing integrations platform , a third party Supplier or manual clinical data extracts.
Local Personnel dependencies
Related Products or
Services
Will require nomination of local service administrator to manage user access.
Related Products or Services that are enabled or can be provided more efficiently
consequent to this Product or Service being in place
Eclipse Analytics, Eclipse 24, Eclipse Remote, Eclipse Passport
Pricing Information
Pricing Approach
Standard Price (£’s)
Unit Price (£’s);
For CCGs £20,000 for first
100,000 patients activated and
£580 per practice per year.
Integrations with Principal
Clinical System Providers
then 10p/patient/year (or free
for manual uploads)
Where alternative prices are available for variant levels of service,
these must be elaborated below. These variant services must be
consistent with those identified within Annex A of Schedule 4.1
(Supplier Solution).
Description of Variant Service (as
Price of Variant Service
elaborated in Annex A of Schedule
4.1 (Supplier Solution)
Service Variant description 1:
Unit Price (£’s);
N/A
Where there is a current or proposed integration with a Principal
Clinical System Provider, details should be provided of any price
differences that apply for:
Compliant / non-compliant Lot 1 integrations or variations; and
Price Variations that are dependent on the identity of the Principal
Clinical System Provider
N/A – no price difference except free for additional patients
where practice manual uploads are implemented.
Invoicing Terms
Invoice frequency (e.g. monthly, quarterly, annually)
Annually in arrears
Invoice delivery period (e.g. 5 working days after end on month; 15th
of month following service period etc.)
Within one week of service commencement.
Other invoicing terms:
N/A
Payment Terms
Due date for payment (e.g. 30 days after receipt of invoice)
30 days after receipt of invoice
Details of any early payment discounts
N/A
Any other payment terms
n/a
Discounts
Details of any volume discounts, including details of the volume bands
and the discounted price applying to each discount band
N/A
Details of any multiple service discounts, including the service
combinations that qualify for a discount and the discounted prices
applying to each combination
15% off 3 or more applications if taken.
Details of other available discounts. e.g.to different customer
types(e.g. large/small; new/existing), by geographical area, by sector
If 3 or more linked CCGs sign up a 10% discount is available.
A 20% discount is available if the service is signed up for 2
years.
Dependencies
Related Products or Services
Detail all dependencies on 3rd parties (e.g. Call Off Ordering Party,
Practice, other supplier) relating to the provision of the product or
service
N/A
Infrastructure dependencies (networks, hardware, software etc.)
Our Data Centre (thebunker.net)
Service dependencies
N/A – in house
Local Personnel dependencies
N/A
Where multiple products and services are offered that have some
form of interdependency e.g. one product or service needs to be first in
place before this one can be provided or vice-versa then this should be
identified here;
N/A
Related products or services that can be provided at a lower price
consequent to this product or service being in place
Eclipse 24, Eclipse Analytics, Eclipse Passport, Eclipse Remote
(all 15% off if 3 or more taken on by practice)
Related products or services that need to be in place to enable this
Product or Service or to allow this Product or Service to be delivered
more efficiently
N/A
Resource Based Pricing
Where charges contain an element of charging for staff time (e.g.
training, consultancy services or bespoke activity) then such charges
should be referenced to the SFIA day rates contained within the
supplier details section of the catalogue together with any non-staff
components contained within the charge (e.g. training materials,
room hire etc.)
0.5 days remote training is included. Further training can be
purchased at SFIA Solution Development & Implementation
Other pricing information
Grade 3 at £250 per day (pro-rata) + travelling expenses for
on-site training.
Deployment arrangements: costs, duration and activities associated
with the deployment of this product or service
N/A
Exit arrangements: costs, duration and activities associated with the
termination of the supply of this product or service
N/A
Other
N/A