HTN Now: what is the role of digital and data in NHS trust strategies?

The latest HTN Now focuses on all things strategy, transformation and change.

In this feature, we take a closer look at five different NHS trust strategies; exploring Barnsley, King’s, Sheffield, Gloucester and the Isle of Wight strategies to compare their approaches and focuses, examining where priorities lay and the common themes when it comes to digital and data.

More and more trusts are electing to lay out their technology-based aims and plans in specific data and digital strategies, but here we’ll be exploring their main strategies to see the importance of digital in their wider system plans. How big is the digital and data priority for these trusts, and in what areas do they see digital transformation making the most significant impact?

To start, let’s take a look at some of the priorities laid out in their strategies.

Barnsley Hospital NHS Foundation Trust highlight digital transformation straight away in their mission and strategic goals for 2022-2027. Categorising the work as “best for patients and the public”, the trust says: “We will focus on continuous quality improvement, patient engagement, best evidence and research to improve patient safety, transform services and introduce new ways of working… we will continue to use digital transformation to support new ways of working and will build on solutions that enable our teams to work fully electronically and remotely.” In addition, they note that investment in research and development is also a priority, along with adopting “new innovations as soon as practicable and appropriate to do so.”

For King’s College Hospital NHS Foundation Trust, digital falls under the category of delivering “outstanding care”; they pledge to  “transform our outpatient services, using new digital tools and improved accessibility, and by incorporating patient feedback to improve the care we provide.” Additionally, digital has a part to play in their ambition to become a leader in research, innovation and education. In their strategy, released in April this year, the trust share how they intend to “grow and embed our innovation culture, by launching the SC1 Innovation District, supporting over 10 home-grown innovations through the King’s Health Partners Medtech Joint Venture, and by establishing a new Innovation Steering Group.”

Sheffield Teaching Hospitals NHS Foundation Trust meanwhile, list their intention to “seek continuous improvement and innovation in the quality of services we deliver” at the very top of their strategic priorities for delivering the best clinical outcomes. Moving on to the role of research, education and innovation, the trust says that they will “transform digital and IT infrastructure to keep pace with demands of modern healthcare delivery and drive sustained improvements that support the integration of services across different organisations”, as well as seeking “to apply digital innovations in areas such as artificial intelligence, remote monitoring and clinical decision support.”

Elsewhere, Gloucester Health and Care NHS Foundation Trust place focus on sustainability through digital transformation. “Sustainability will be central to how we do business and will involve embracing the latest technology,” they state in their strategy, sharing their sustainability strategic objectives which include the ambition to “take forward Design by Digital to transform our service delivery”. Gloucester Health and Care go on to set out a digital-specific section in their main strategy in which they state that “digital technology will be a key driver and enabler for the trust over the next five years”, adding that it will assist them in being “efficient and effective, make better use of our precious workforce and help improve the experience and outcomes for service users, their families and the wider community.” Technology will be used to support the achievement of strategic aims in numerous areas, including out-of-hospital care and remote monitoring, and smarter use of physical buildings.

Isle of Wight NHS Trust categorises digital transformation under place, highlighting how investing in digital can improve patients’ experiences but also help them tackle “some of our unique challenges” born of being an island trust. “Our services must respond to the needs of our island community,” they say. “Investing in better buildings and IT will improve services and reduce the amount that people need to travel for their care,” adding that “better use of technology, like video consultations, will provide new ways for our population to access specialist advice and reduce the need for people to travel to hospital.” Additionally, the trust acknowledge that “better IT will enable improvements in all of our services.” Ultimately, they say, they will focus on using “IT that helps us work with our partners and makes life easier for our patients.”

From these strategies, it’s interesting to note where different trusts place the emphasis for digital impact, from patient care to integration to sustainability to place. We recently asked our LinkedIn audience for their thoughts on which area digital transformation can have the greatest impact; you can read the results here.

When it comes to data, the way the trusts use and discuss it within their strategies is also varied.

Of course, data underpins everything the NHS do, and these trusts are no different. For some, however, data is more of a background player in their strategies; a constant that they gather, use and store but do not intend to alter in any significant way, whilst others have ambitions to do more with data and utilise it in new ways.

Isle of Wight NHS Trust, for example, don’t specifically mention data in their strategy, but they do list accountability as one of just four key values at the very core of the trust. The delivery of quality improvement, highlighted under this key value, ties directly into the trust’s data collection and analysis, as does their strategic objective focusing on performance, with intention to “improve clinical effectiveness, improve service quality [and] improve financial efficiency.”

Along with identifying similar quality improvement techniques, Barnsley Hospital NHS Foundation Trust opt to highlight the role of data in the development of the strategy itself, as a way to demonstrate how and why they have selected their aims and ambitions. The strategy describes how the trust “conducted internal and external analysis to identify all known risks and opportunities”. They followed staged methodology to gather detailed intelligence at national, regional, place and organisational level, evaluating the information gathered to draft strategic recommendations, reviewing those recommendations to decide which should make it into the strategy, and presenting the drafted strategy once complete to the trust board for review and feedback.

They note that the development of the strategy involved extensive stakeholder engagement with patients, the public, staff, local and regional partners and more, using methods such as focus sessions, questionnaires and social media to gather feedback data, which was in turn analysed and used to shape the goals and plans laid out in the five year strategy. By providing a thorough overview of the method in which their strategy was developed, the trust show how data has been used to generate meaningful goals that translate directly into their services.

For Kings College Hospital NHS Foundation Trust, data is at the heart of one of their “golden threads – our cross-cutting strategic themes”. The trust identifies that in order to achieve their digital transformation aims, they must commit to “embracing and integrating digital technology and clinical data to improve the quality of care we deliver, and make our services more accessible.” Data is also key to Kings’ ambition to “develop and deliver world-class research, innovation and education”, with the strategy setting out the following action to achieve this ambition: “We will invest in digital and data innovation to improve patient care and deliver better services”.

Sheffield Teaching Hospitals NHS Foundation Trust use their population health data to identify the most urgent and widespread needs of their population in the opening pages of their strategy, including main causes of illness and health determinants for people living in South Yorkshire and Bassetlaw. “Being aware of these data is one consideration but actively working to prevent and improve these population health challenges with our partners is of major importance,” the trust states. “Being proactive and supporting services to use data to promote and prevent ill health are increasingly important to everything we do.” In line with this, the strategy shares a key objective: “Develop the digital maturity of our clinical informatics systems [and] work with partner organisations to ensure seamless and safe exchange of clinical information.”

One of Gloucester Health and Care NHS Foundation Trust’s strategic objectives is based around the concept of “Better Health”, which the trust describes as working with people who use and work in their services to “meet the needs of our diverse communities with services that are culturally sensitive and focus on early intervention and prevention”, and to be “an active partner at both a locality and system level to tackle the root causes of health inequality and use information, evidence and experience to guide us.” With this in mind, one of their Better Health objectives is to “use Population Health Management and health data at a locality level to identify how people and communities can be best supported”.

The trust also recognises the need to use data “to drive our decision making and targeting of resources” in order to be more “efficient and effective in making best use of workforce and improving experiences and outcomes for service users and the wider community. As part of their “best value resourcing approach” which “underpins the delivery of our four strategic aims and all of our enabling strategies and strategic objectives”, Gloucester notes, “There is a new financial regime on the horizon as we move towards a more blended payment system and we will continue to use the growing body of community and mental health benchmarking data to continually identify new efficiencies.”

To access the selected trusts’ strategies in full, you can click on their names: BarnsleyKing’s College, Sheffield, Gloucester and Isle of Wight.