Mid and South Essex Health and Care Partnership has published its digital strategy entitled ‘Setting the North Star: our shared direction for digital services’.
“As an ICS we are committed to taking a ‘digital-first’ approach and to realising the benefits that data and digital technology can deliver for our residents,” the document begins. Highlighting the progress brought about in this area by the pandemic, it continues: “We are determined to build on these changes, consolidating and strengthening what has already been introduced as well as addressing gaps identified and developing new services.”
It adds that the strategy is intended as a ‘live document’ capable of responding to the ICS’s evolving situation, and is designed to support them on their journey to become a digitally mature system.
The ICS’s vision is to “deliver better outcomes for residents and create an attractive place to work for staff”.
To achieve this, the strategy sets out six key areas of work: prioritising prevention and wellbeing; focusing on service pathways; elevating and prioritising clinical and professional leadership; letting residents, patients, service users and staff lead in order to achieve better outcomes; to be resident-centric at system, alliance and neighbourhood. level; and to develop standards, define outcomes and set common clinical and professional policies to guide safe, high quality and responsible services.
- Digitise focuses on digital services and infrastructure; digital capabilities and capacity; and innovation and work with third parties.
- Connect centres around improving access to date where and when it is needed. Analytics is a major part of this, with focus on population health management, clinical insight, informed decision-making and performance dashboards. In addition, emphasis is placed on service design and development with a safe and secure testing environment; digitally supported reporting; supporting partners with access to quality datasets; and enabling testing and scaling of innovation.
- Transform is all about services – making sure that they are designed for care pathways rather than settings or organisations, ensuring that they are user-focused, that they have automation processes in place for admin and triage, and that preventative interventions generated through data are provided.
Underpinning these three workstreams, the strategy adds, is effective leadership along with governance and partnership working.
The area describes how the ICS agreed to eight principles that would guide all work in the development of the digital strategy:
- Be system-wide first, but remain considerate of local plans along with work happening across the sustainability and transformation partnership.
- Be patient and resident-focused, ensuring digital inclusion, equity of access and cultural awareness.
- Be based on a foundation of partnership, working between clinical, operational and technical teams.
- Focus on driving clinical and operational value.
- Ensure consideration for health and social care needs in line with potential for different impacts on individual organisations.
- Be underpinned by explicit deliverable outcomes with clear measurable outputs.
- Use data at the heart of all plans to support and inform decisions.
- Balance innovation and new developments with existing technology and processes, optimising existing services and looking for new where appropriate.
Effective leadership, strong digital governance and improved partnership working
“Our success in delivering our vision will rely on effective digital leadership, strong digital governance and improved partnership working,” the document notes, adding that refreshed digital governance and developed leadership roles will support the ICS in delivering the strategy and working together at system level.
A number of key factors are identified which will enable the implementation of the strategy’s roadmap, with clear accountabilities, managed risks, participation in the wider region and collaborative approaches to cross-system priorities. These include strong leadership, with a digital board of leaders empowered to make decisions; effective clinical leadership roles; and cross-ICS governance with oversight of digital programme delivery and a community of digital, clinical and professional leads across the ICS.
Six functions of the ICS’s digital governance are highlighted. Managing the strategy and roadmap with regular reviews so that it remains a live, responsive document is one; portfolio management is another, with strategic prioritisation of programmes and projects, a need to align innovation and technology developments to make to most of investment across the ICS, and focus on tracking and oversight to ensure that progress is made in relation to priorities. The other four functions include delivery of digital programmes (enabling programmes for the ICS that are wholly or primarily of digital nature); participation in cross-ICS programmes through digital; performance management of cross-system services; and engagement and collaboration to improve partnership working.
Digital capabilities and capacity
The strategy states: “To realise the benefits of data and digital technology across the ICS, we need to build dedicated capacity at the centre. We also need to ensure our workforce have the necessary digital capabilities.”
A key part of this work is around strengthening clinical input into digital. The document shares the ICS’s clinical digital resource principles:
- Digital transformation must be supported through the clinical and professional workforce.
- Clinicians must have protected paid time to support the digital agenda.
- There must be a spectrum of practice from social care, mental health, AHP, primary and acute.
- There must be clinical leadership at system and local organisation level, and this leadership must have a voice at board level.
- There needs to be a balance between local organisation clinical leadership and that at an ICS level.
The approach taken by the ICS indicates that there should be a hub for clinical digital leadership; that the ICS should have a clinical digital lead; that each partner organisation should provide their confirmed clinical leadership network; that the partners should have a clinical digital lead who represents their spectrum of practice; and that there needs to be a governance framework to allow the people in those roles a grip on the agenda.
On workforce capability, the strategy says: “As well as building capacity at the centre, there is a lot we can do to develop digital capabilities across our entire workforce. We need to create a culture that puts digital at the centre while also ensuring our staff have the confidence and skills to make effective use of digital tools.”
It highlights an ambition to improve digital literacy, to empower staff to drive digital change (which will involve creating conditions to ensure that staff can put digital skills to best use, and using cross-organisational networks to encourage co-creation of digital tools), and to join up informatics expertise.
Digital services and infrastructure
Here, the document states: “As an ICS we will move to a shared infrastructure with the data capabilities to support the delivery of high-quality care and effective collaborative working across the system.”
The ICS highlights a need to establish strong infrastructure and meaningful shared data through integrated information systems that are reliable and safe, agreed protocols around data capture, coding and reporting, and connected systems which are adaptable to incorporate new innovations to meet future needs.
Those future needs include new ways of working; new clinical and care delivery models; estates and organisation reconfiguration and optimisation; increasing use of virtual consultations and remote medicine; leveraging analytics and AI to augment clinical practice; contribution to clinical research; and links to national services and reporting.
To achieve this, the ICS focuses on agreeing and implementing their overarching ICS Information Framework; building their Target Operating Mode (TOM); and delivering priority applications and infrastructure. An overview of the TOM can be found on page 37 of the strategy, whilst the priority applications and infrastructure include a unified shared care record, data platforms and an ICS-wide approach to remote monitoring.
Innovation and work with third parties
In this area, the document says: “Our digital governance, operating model and functions need to enable innovation to address MSE health and care priorities. We need to be able to work effectively with third parties to design, test and scale.”
The strategy states that health and care priorities need to be addressed through innovative services, focusing on users and pathways along with leveraging data and analytics from across the system.
“Digital and technology needs to support the development and scaling of innovation, and not be seen as a blocker,” it adds.
ICS enterprise data platforms must “serve and be served by new applications, often developed by third parties – setting expectations for future data systems, architecture and governance.”
Areas of focus include governance (building common understanding through portfolio management and transparency of services in developing); the operating model (ensuring that all third party services fit in within the architecture principles and standards set by the ICS); and collaborative working (working with transformation to create a mechanism to enable ideas and opportunities to flow from the frontline).
“As an ICS we are committed to placing residents at the centre of our planning and to designing system-wide tools to empower residents to manage their own health and wellbeing,” the strategy states.
Views expressed by members of the ICS’s Citizen’s Panel along with feedback gathered by Healthwatch around the NHS Long Term Plan indicate that residents want greater choice in how to manage their health; better access to professionals for advice and treatment; improved communications and advice on diagnosed conditions; support to manage their condition at home; and confidence that professionals are communicating with each other about an individual’s care.
“As an ICS we would like to have an agreed set of digital channels for residents to access information and the tools to manage their care,” the strategy explains. It shares a number of ambitions for residents including the ability to access information to help them make informed decisions; manage appointments; take part in virtual consultations across care sectors; seek advice and exchange messages with professionals; undertake remote monitoring; and review their own records, with the opportunity to suggest changes or corrections.
“In order to do this the digital solutions may need to be able to undertake identity validation to enable secure access to personal data, to set permissions for access to data, and enable proxy and delegate access,” the document notes. “When streamlining and enhancing our resident-facing services, we will ensure that we agree how information on the uptake of services will be collected, analysed and used to guide how services are developed in the future.”
The ICS also emphasises the importance of digital inclusion, sharing key steps to drive uptake and adoption of digital services. They include ensuring that all digital services meet public sector accessibility standards by December 2023; producing services that are intuitive and do not require training; and making it easy to find services through signposting and active awareness campaigns.
To read the strategy in full, please click here.