Secondary Care

HTN Digital Week: Day five in review

HTN Digital Week Day Five: Friday 24th January 2020 

As HTN Digital week draws to a close, we reflect on day five now the final three webinars have taken place and what an excellent way to end a hugely successful week.

Once again, a huge thank you to all our presenters this week who took the time to share and discuss with us their ideas and innovations; it has been a truly insightful and educational experience!

Read below for HTN Digital Week Day 5 review.


Dr John Byrne, Senior Responsible Officer and Lee Rickles, Programme Director – Yorkshire and Humber Care Record

“We are 1 of 5 LHCRE receiving £7.5 million over 18 months national investment which is locally match funded. We build on existing shared local care records with new technologies to provide a long term. Leadership is headed by health and social care professionals and citizens, and this is the key to the success of LHCRE.”

“Our vision is to deliver the right information, to the right person at the right time” – the attempt is to have people being actively involved in their own health, having the ability for clinicians to access real time health records across healthcare providers and improve intelligence from large scale data sets.

“The ultimate aim is ‘how do we engage with citizens to improve the quality of their own healthcare’ and interact with their own healthcare.”

The LHCRE is looking at what concerns do staff have and realistically how can these concerns by remedied. In the future, the LHCRE is looking at how to share information for urgent care, to have shared care and crisis plans and generally to have access to better information, faster.

“It is the patient’s information that is to be used; we need to know what the patient’s principles are and how far can we take any programme of work when it is data sharing.”

“2000 people were spoken to across the Yorkshire and Humber region and 12 focus groups were used across Humber and the Vale, South Yorkshire and Bassetlaw and West Yorkshire and Harrogate. There was also an online survey shared by CCG staff and partners.”

“When asked ‘who should see your records’, GPs came up as number one followed by hospitals and nurses with employers being the last group of people to be able to see health records.”

“95% of people supported one or more uses of the record but had a great distrust of commercial research; possibly rightly so based on recent data scandals if we think back to the like of Facebook. There was strong support for public health uses such as screening invitations and health advice. There were concerns about data being sold to companies and the security around stored data.”

“People do not feel that the NHS will not buy the most secure systems due to cost saving.”


Lauren Bevan, Head of Healthcare, BJSS presented ‘How to build an agile technology business case’

BJSS works with the NHS for around 7 years with 200 people doing over 20 engagements – “we like to think we know what we are doing!”

“Before you start, be clear why you think the business case needs to be done.”

Lauren focuses on several questions; what problems are you trying to solve, why are you trying to solve the problem now, who approves the spend, what business case do you need to fill in and why is this so complicated.

“The 12 agile principles are something we work to” – processes and change should not be linear, customers should be satisfied through early and continuous delivery of valuable work, breaking big work down into smaller tasks, recognising the best work emerges from self-organised teams, providing motivated individuals with the environment they need, creating processes that support sustainable efforts, maintain a constant pace for completed work, assembling on a daily basis the project team and business owners, frequent reflections at regular intervals by the team, measuring progress by the amount of completed work, continually seeking excellence and harnessing change for a competitive advantage.

“Businesses cases for the NHS should be considering is the spend necessary, where will the budget come from, when will it be incurred, what is the approval route and the typical length should be a summary of 30 pages, a business case outline 100 pages followed by a full business case.”

“The business case process should follow the structure of the initial outline of the issue and propose a solution, asking is this a problem that ‘we’ can solve. Following that, set the vision of what success is, and how has the market been tested. Next, work out the timeline of the project followed by articulation of the delivery model with funding options. Lastly, the hardest part, delivery!”

“I’d like to propose thinking about this differently; as a discovery. It is about working smarter, not harder.”

“Where sprint planning and cadence is used, with stand-ups and show and tells. Consider, what would an MVP business case look like, engage with stakeholders and tell the story not just the fact. The aforementioned should lead to less documentation, less rework and better outcomes.”

“We are all emotive but we should tell the story and not just the facts” – the idea is to get people to believe in your idea; the emotive aspects behind your story could be the deciding factor in getting your business case approved.

“It is far better to have a project fail at a bid stage” – projects failing later down the line are far more costly when you have ploughed everything into it.

“The critical success factors are clarity on the business need” – as well as having a clear timeline, repeating iteration, have early engagement with procurement and vendors, have clarity on budget, conduct a risk assessment, seek out sponsors from clinical, admin and board levels and ask what clinical change will it enable.

Lauren goes on to state that you must realise your benefits in a quantitative and qualitative manner; support costs, staff costs, error reduction, patient experience, staff experience and information.

“Moving from paper based will end up in error reduction. Patients want interoperability.”

All of the aforementioned should be considered when putting a business case together; they produce a more rounded and holistic case. Some common pitfalls are options being considered to be unclear, procurement routes being unclear, assumptions are not articulated and not enough detail on the change management effort required.

Other pitfalls include a lack of user engagement, post project benefits realisation review needs articulation, the business case owner is unclear, each governance point adds content for their own means and the case ends up cluttered and verbose. The key pitfall is forgetting why are you doing this! Remember the central premise!


Nicola Hall, Ingenica Solutions presented 10 things NHS buyers can learn from retail solutions 

Ingenica’s customers include 14 NHS trusts, 2 global leading healthcare companies, 1 international hospital and 1 government organisation. They have an experienced team of 32 who have detailed knowledge of healthcare, supplies management, IT solutions and public sector procurement.

Nicola opened with some questions “Why is track and trace important in hospitals? What are the benefits? Are you embracing GS1 standards in your organisation? Do you know who your GS1 lead is? and do you know the core use cases for GS1?”

“Understanding negotiations on price is not the only dimension to relationships with suppliers. As we go forward in healthcare, we need to think about the relationship we have with our suppliers.”

Harness the power of the NHS brand to achieve best pricing – “there’s still a lot of price variation out there and are we getting the best value for money?”

Active supplier management – “really understanding your suppliers’ capabilities; are they big or small, are they niche or wider and where do their products come from?”

It is about having information available to understand what your supplier can do and understanding the suppliers supply chain and vulnerabilities that may affect you – “in the last few days we have seen a strike by drivers delivering to NHS hospitals.”

“Product DNA is becoming more and more important” – the unique identification of products is crucial to stop counterfeit products entering the supply chain and being harmful to patients and increasing cost to the NHS.

Data standards should be supported throughout your supply chain – “don’t rely on suppliers to provide you with information, have your own and make sure it links to SMART principles.”

“A lot of end users refer to their supplier because it is quite difficult to get that information now.”

“The next new phase is data analysis” – use data analysis to really enable prediction of product trends and requirements. Look for trends and impacts of trends.

“Look at whether it is possible to predict demand” – can demand be predicted several months or years down the line; doing this is cost effective and more beneficial to the customer.

The supply chain is another important aspect – “look at managing the internal supply chain in your organisation”, with this you can create efficiencies, where products can be moved to the point of care more efficiently.

“One of the big messages and topics is about waste management” – particularly in the age of climate change, how can waste be reduced to the point of having zero wastage. “Waste is a significant cost to the NHS.”