What’s happening in digital and data across the East of England?
Following on from our two recent features exploring the role of digital and data in integrated care systems across the Midlands, and across the North East and Yorkshire, we’re moving on to explore health tech in the East of England.
In this region, there are six ICSs in total: Bedfordshire, Luton and Milton Keynes; Cambridgeshire and Peterborough; Hertfordshire and West Essex; Mid and South Essex; Norfolk and Waveney; and Suffolk and North East Essex. We’ll take a look at each ICS in turn, examining their digital strategy, programmes and projects.
To begin, some news from the end of last year involving all six ICSs from the East of England – in October, they all purchased a procurement and spend data analysis tool, said to save NHS organisations between £250k and £5m per year through its price benchmarking, price index and catalogue checking tool.
In addition, last month, we covered how the East of England Cancer Alliance has delivered a new algorithm-based tool designed to support newly diagnosed prostate cancer patients. Patients can enter personal metrics into a secure web link and the algorithm will analyse their data and set out possible treatment options with benefits and risks tailored to the individual.
Hertfordshire and West Essex
First up, let’s take a look at the digital strategy for Hertfordshire and West Essex ICS.
HTN covered it in January this year; the document focuses on supporting ICS transformation initiatives with ICS-wide solutions that remain consistent with place needs; making a measurable difference to collective health and care provision across the footprint through common approaches to digital technology; improving the commonality of digital solutions and their interoperability; driving up digital maturity in line with What Good Likes Like; and securing the best value for the ICS through digital investments.
The ICS’s goals are to maximise opportunities through coordination and multi-disciplinary approaches; to bring together essential connectivity, information, intelligence and data for all care settings, and to use technology to keep people well in their homes, addressing the challenges of demand and capacity in doing so. The ICS says that it will “encourage targeted investment and digital innovation at the front line that has potential scaleable benefits to improving health and care outcomes.” There are plans to work with Academic Health Science Networks (AHSNs), universities, and the private sector where possible to further digital work, and focus is also placed upon improving inclusion, both by supporting the population to make the most of digital means to access healthcare and by building a digitally skilled workforce.
In order to achieve these aims, Hertfordshire and Essex share a number of strategic principles around which this work will be built. Firstly, around investment, they pledge to prioritise the things that residents and staff actually need; to get the best out of digital suppliers; to set clear and realistic goals; and to invest in a dedicated, cross-functional ICS team. Secondly, looking at delivery, the ICS is to “think long-term, deliver in the short-term”; to embed a culture of testing, measuring and learning; to support change where necessary, with “rigorous delivery assurance against business cases and outcomes”; and to build trust in digital, by addressing inclusion and exclusion explicitly, adopting a clear and structured benefits realisation framework; and investing as necessary in education and training.
There has been plenty of digital-focused news coming out of the ICS recently. In the last two weeks alone, we’ve seen two big news stories – firstly, the the ICB awarded a three-year contract to implement a digital mental health service for children and young people in the region, which will provide seven-day access to online professional counsellors, forums, self-help materials and more.
Elsewhere, the Princess Alexandra Hospital NHS Trust (PAHT) awarded a £28 million contract to implement the Cerner electronic patient record system in a 10-year deal set to run until February 2023, as part of the trust’s ambitions to become “one of the most technologically advanced in the country”.
We asked Jeffrey Wood, deputy director of ICT at PAHT, for his thoughts on the digital direction of his trust and wider ICS. He says: “The ICS provides a number of shared services, not least of which is the procurement team which allows us to co-ordinate spend and projects to get the best for the individual organisations and ultimately the best for our residents. We are also working with our ICS colleagues on other shared initiatives such as security and pathology.
“PAHT’s 2030 vision is to be a modern, integrated and outstanding trust with one of our key priorities being digital health, through which we will harness new technology and digital solutions to transform patient care and improve how we work. Our patients are at the heart of our strategy, and we will provide them with the best care and outcomes.”
Jeffrey describes some work that the trust has done around customer journey mapping, illustrating different patient journeys. “It is these illustrative journeys together with our clinical digital senate, patient panel and various boards that allow us to ensure our strategic direction needs the needs of our end users whether this be patients, residents or personnel,” Jeffrey continues. “To undertake this extensive piece of work we have actively been renewing our infrastructure and resilience including moving to cloud telephony, as well as deploying WiFi6 and a 4G Distributed Antenna Systems with a 5G Private network.
“Our Unified Communications programme is almost complete and allows us to remove our bleeps and pagers. This in itself has had many dependencies – ensuring the right equipment is with the right person, ‘choose your own device’, corporately-owned personally-enabled devices, PC-as-a-service, multi-carrier sim cards, device charging for visitors, patients and staff, and moving our desktop-based devices to a more mobile basis. It also feeds perfectly into our newly-procured EHR system. Alongside our integration engines and robotic process automation work, it will ultimately give back valuable time to our clinicians to enable them to spend more time with patients.”
The trust will undertake many proof-of-concepts in the next few years to assess the viability of technologies, Jeffrey adds, such as real-time location services, holographic virtual assistants, virtual ward rounds and training using HoloLens.
“We always keep our core values of keeping the patient at the heart of things, creative collaboration and everyday excellence foremost in our minds,” he says. “It’s vital to recognise that technology is just a small part of the story to achieve true digital transformation.”
Contents
- Hertfordshire and West Essex
- Bedfordshire, Luton and Milton Keynes
- Norfolk and Waveney
- Mid and South Essex
- Case Study: Lantum on obilising and engaging healthcare workers across the East of England
- Cambridgeshire and Peterborough
- Suffolk and North East Essex
Bedfordshire, Luton and Milton Keynes
Next, there’s the digital strategy from Bedfordshire, Luton and Milton Keynes (BLMK), covered by HTN earlier this month.
Opening the strategy, chief digital information officer Mark Thomas notes that the system is “at its heart, all about orientating services to enable everyone in our towns, villages and communities to live longer, healthier lives” with the digital strategy underpinning this by “[enhancing] the resident’s ability to participate in all elements of their care and data.”
BLMK’s strategy features six key themes: to take a resident first approach; to support teams; for digital to be an enabler; to put data at the heart of decision-making; to ensure personalised care; and to support collaboration and innovation. The strategy also places emphasis upon the need to have a culture of sharing, noting that this underpins the digital strategy. Through the strategy’s deployment, the ICS says, it will seek to identify best practice and share learnings within the ICS and with other NHS organisations too, with the aim of building more effective collaboration through standardisation.
On our sister site, Integrated Health, we recently interviewed chief executive of the ICB Felicity Cox. Felicity shared further insights into the ICB’s areas of focus: “Data and digital is a huge priority – because the nationally given responsibility of an ICB is to improve the health of the population, it’s really important that we can track that carefully. Health service data is one thing, but that only tells you if someone has had an episode of illness. Tracking the health of the population requires the linking of different data sets, so we’re spending a lot of time on that.”
Another important part of the digital strategy, Felicity added, “looks at how we can keep people well in their own homes, including remote monitoring, so we can spot if someone is not as well as they should be. We’ve also put a lot of investments into care homes, supporting them to keep people safe.”
We also recently spoke to Matthew Davies, clinical pharmacist at BLMK, to find out more about how the ICB has implemented intelligent messaging technology. Matthew shared how the ICB sought to use digital means to improve hypertension care, with focus on improving the efficiency of processes, reducing administrative workload, and empowering patients to self-manage.
“If we can bulk upload 100, 200 or 300 patients to the platform, that reduces the administration time of printing and posting letters,” Matthew said. “Data comes back into a dashboard so we can see what stage the patient is at within the hypertension pathways. This also allows us to identify people who are not engaging with the pathway and why they haven’t submitted their blood pressure to us, reducing the risk of someone being lost to follow-up.”
BLMK also featured in HTN’s awards last year for their work on their bespoke digital epilepsy health record and, as Felicity raised above, their work on developing a remote health monitoring solution; for the cohort of patients using the solution, this led to a 11.5 percent reduction in emergency admission and a 44.3 percent reduction in length of stay.
Norfolk and Waveney
Next up, we have Norfolk and Waveney. Their digital transformation strategic plan and roadmap sets out high-level objectives including improving communications within the system; introducing an EPR across three acute trusts; scaling virtual services; and improving data storage and use. The ICS has developed a programme called Connect-NoW which aims to see a fully integrated digital service in place across Norfolk and Waveney, which will focus on improving safety and quality of care, allowing staff more time to care, and helping people to self-manage.
Looking at the next three years, planned programmes across the ICS include work on the Shared Care Record with focus around visibility of GP, community, social care, mental and acute patient records, and improving health and care data architecture with a single data source for system-wide analysis.
Population health management is to be expanded across the system, with risk stratification tools and customer relationship management in place to better understand and engage with the population. The ICS will improve WiFi connectivity, network upgrades and cloud telephony, and expand its virtual wards and remote monitoring. In addition, Norfolk and Waveney aim to implement a single digital front door through NHS App integration.
With regards to their plan to introduce an EPR across three acute trusts, in February we reported how a financial plan has been approved for a shared EPR between The Queen Elizabeth Hospitals King’s Lynn NHS Foundation Trust, Norfolk and Norwich University Hospitals NHS Foundation Trust and James Paget University Hospitals NHS Foundation Trust. Sam Higginson, chief executive at Norfolk and Norwich University Hospitals, has commented that the programme is “hugely exciting and a flagship project for the three acute hospitals… The EPR will improve patient care and allow us to manage clinical information to make it more easily available for hospital clinicians, other healthcare professionals and patients.”
The Hewitt Review, published earlier month, also highlighted best practice in Norfolk and Waveney with regard to the integration of data from multiple sources to take a proactive approach to population health. The review points towards Norfolk and Waveney’s GP-led collaboration, where data analytics and risk stratification are used to identify people at risk of undiagnosed or poorly-managed Type 2 diabetes.
Mid and South Essex
HTN covered Mid and South Essex’s digital strategy last month. The key areas of work for this ICS include 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; and to develop standards, define outcomes and set common clinical and professional policies to guide safe, high quality and responsible services.
In order to achieve this, the ICS is to focus on digitising services and infrastructure, improving digital capabilities and capacity, along with building upon innovation work and partnership work. They will emphasise the importance of connection between sites to improve access to data, noting that analytics play an important part of this – population health management, clinical insight, informed decision-making and performance dashboards are all highlighted for their roles, along with service design and development with digitally supported reporting. The final workstream underpinning their digital strategy is all about transformation. Here, the ICS state that they will make sure that services are designed for care pathways rather than for settings or organisations; keep them user-focused; ensure that automation processes are in place to support admin and triage; and support the implementation of preventative interventions generated through data.
Mid and South Essex also share eight principles set to guide all digital work: to be system-wide first but remain considerate of local plans; to be patient and resident-focused with sight of digital inclusion, equity of access and cultural awareness; to be based on a foundation of partnership; to focus on driving clinical and operational value; and to ensure consideration for health and social care needs in line with potential for impact on different organisations. In addition, their digital work is to be underpinned by deliverable and measurable outcomes, will use data at the heart of all plans, and will balance innovation with existing processes.
There’s been plenty of digital news from Mid and South Essex in past months. Last summer, we heard how the ICS has created a single waiting list across the system in order to speed up their elective recovery and drive down backlogs; the project provides a single view of waiting patients for all clinicians and operational managers across the ICS, whilst also enabling the ICS to explore opportunities to standardise processes. As part of this project, the ICS is working to combine and standardise data from three PAS systems into one data management platform, which consolidates and quality checks the data. Find out more here.
In February this year, NHS England highlighted a pilot at Mid and South Essex NHS Foundation Trust wherein artificial intelligence is used to predict likely missed appointments. The algorithm uses a range of external insights such as the weather or traffic to identify where and why a patient could potentially miss an appointment, and offers them an alternative. In January, Mid and South Essex ICB partnered with NHS Arden & GEM Commissioning Support Unit with a view to delivering business intelligence services across the ICB; the work aims to support the ICB’s digital vision in delivering data-driven solutions. The month before, we heard how the ICS has implemented an app designed to support patients facing a communication barrier across all health and care services.
Lantum on obilising and engaging healthcare workers across the East of England
The East of England is a picturesque, expansive, and diverse part of the country. It also presents a unique set of challenges for the medical profession.
Diverse geographies and population densities mean a one-size-fits-all approach to workforce management doesn’t work. The different landscapes also frequently present different patient needs, adding an extra layer of complication.
A key issue is how to get more staff into the isolated coastal areas in Norfolk and Suffolk. Too often, these regions are seen as less popular places to live and build a career, which can make it difficult to recruit staff and offer high-quality patient care.
Other leaders report issues around integrating their multidisciplinary staff into their flexible staff pool schemes, or offering opportunities to staff who might be interested but don’t want to deal with self-employment.
Tackling regional challenges is difficult but not impossible. Read on to learn how your ICS can deliver workforce innovation in the East of England at scale.
Shaping localised solutions on every level
Finding ways to work with staff across all levels and functions is essential, and there’s no such thing as a one-size-fits-all solution. Flexible working gives staff a choice in when, where and how they work to increase their job satisfaction, helps the organisation address new challenges, and encourages retention.
Connecting flexible staff pools to training hubs is a key way to boost awareness and buy-in on every level. “Once you’re in a staff pool and start to build relationships, it makes you want to stay longer and work more in your area,” notes Ishani Patel, GP and clinical co-founder of Lantum. Staff are able to get easier access to new opportunities, opening doors for them to stay working across the region.
New models of care and a comprehensive staff skill mix are just as important as technologies like flexible staff pools. Roles can be redesigned and new ones developed, with the input of staff and patients, creating community and team cohesion.
Flexible working is also central to improving morale and retaining talent in the healthcare space. This could include chances to migrate into other areas and to supplement in-person shifts with remote work.
Working side by side with ICSs across the East of England
Workforce resilience is a key topic of focus right now. The COVID-19 backlog, pressure on resources and the cost of living crisis have all pushed care even higher up the agenda. A resilient workforce that feels supported and able to adapt is essential to meeting this need.
Lantum is already working with Norfolk and Waveney ICS, Cambridgeshire and Peterborough ICS and Bedfordshire, Luton and Milton Keynes ICS to improve workforce resilience in the region. Through these partnerships the ICSs are empowered to quickly and efficiently build out flexible staff pools that;
- Enable staff to fill vacant shifts
- Support multidisciplinary staff types
- Adapt to changing demands and new pressures quickly
Why Lantum is a tool to improve engagement
To deliver change with flexible staff pools, flexible working has to be a more attractive option than what’s been available in the east of England in the past. This is where Lantum best supports ICSs in the area with:
- Centralised clinical governance so staff can work across organisations
- Perks for staff like next-business-day pay with Lantum’s Rocketpay feature
- Full visibility over available shifts across the region in a variety of clinical settings
- Automated invoices, pensions and paperwork to reduce the admin burden
Lantum’s award-winning Connected SchedulingTM approach boosts engagement, morale and staff retention all at the same time. It allows leaders like you to see how and where your staff are working at a glance, which is crucial to ensure your ICS can adapt to new pressures.
Lantum currently works with 18 ICSs, 300+ PCNs and 1-in-2 GP practices across England to connect healthcare leaders with their workforce.
To learn more about how Lantum delivers ICS solutions in the East of England, click here.
Cambridgeshire and Peterborough
The Cambridge and Peterborough ICS Development Plan was shared a couple of years ago, with system and digital transformation as one of the six key focuses set out by NHS England (alongside roles and capabilities, leadership and accountability, oversight and quality improvement, leadership and people development and financial framework and use of resources).
The plan highlights the ambition “to fulfil the potential of digital and data to improve system working and drive patient outcomes that systems will need”. As part of this, the ICS notes that focus has been placed on work around their Shared Care Record, and that the system is working to overcome challenges including funding, staff upskilling and digital exclusion.
In addition, last month the ICS shared their first estates strategy, with a key aim to focus on “improving the quality of estate data to help us make insightful decisions on our shared estate both now and in the future.” The estate planning principles outlined in the strategy revolve around keeping estates accessible, efficient, effective and future-proofed; underpinning this, the ICS emphasises the need to “optimise digital platforms to provide maximum choice and create estate efficiencies.”
The strategy goes on to note a need for better integration of digital, workforce and estates, adding: “There is an opportunity to improve integration of these workstreams to optimise the opportunity for supporting workforce and patients – cross fertilisation of plans and objectives, for example working with ‘Connecting Cambridgeshire’.”
Digital also plays a key role in Cambridge and Peterborough’s green plan. A key workstream here focuses on sustainable models of care; the ICS shares a strategic objective to maximise digital solutions and promote personalised care, population health management along with supporting knowledge sharing.
Research and innovation are highlighted as other key areas in the green plan. “In Cambridgeshire and Peterborough we have global leaders in research and innovation centred around the Cambridge biomedical cluster and are strengthening our partnerships here,” the strategy states. “At the same time, we are already progressing the exploration and piloting of sustainable innovations, including but not limited to: green inhalers, air pollution monitoring, fly-ash capture technologies, smart valves, plastic alternatives/recycling and digital applications; all of which have the potential to be key drivers of carbon reductions.” It adds that the recently-established Cambridge Innovation Adoption Hub is a key delivery partner within the ICS when it coms to implementing their sustainability and innovation agenda.
In terms of digital projects, last summer we covered how Cambridgeshire and Peterborough NHS Foundation Trust implemented a digital mental health solution for people aged 14 to 35 who are struggling with distressing experiences such as paranoia or hearing voices. Cambridge University Hospitals also piloted a digital optometry platform which enables optometrists to connect with secondary care colleagues digitally, through locally-designed care pathways, to ease pressure on the region’s eye care services.
Suffolk and North East Essex
Here we come to Suffolk and North East Essex ICS. “We are focused on defining and adopting standards and best practice alongside coordinating investment,” the ICS states. “These include a common information governance framework, standard and shared capability operating models. Local innovation and ideas will continue to be shared as well as standards, core architecture principles (the equipment) and cyber security controls to protect our systems.”
By 2024, Suffolk and North East Essex aims to ensure that all health and care professionals involved in a person’s care have secure access in near-real time to a care record and care plans; that solutions are based on open standards to create a common record for the individual; that de-identified information is used to support the delivery of population health management approaches; that the ICS demonstrates ways in which they have engaged with the public; and that people and particularly carers are empowered to manage their own care.
Having agreed to four priorities around access to data for healthcare professionals and for citizens, digital inclusion and better outcomes as a result of insight, the ICS sets out planned actions around each priority. In order to support professionals in accessing data, the ICS pledges to develop a digital workforce capacity and capability improvement strategy to help staff develop their digital skills, to mitigate risks introduce by new capabilities, to encourage local innovation and integration, and to work towards an ICS-wide wireless network.
To support citizens in accessing digital information about their care, Suffolk and North East Essex will enable more choice through digital options, support the adoption of new applications, and adopt or develop standards for care plan and health records connected to the NHS App.
To ensure digital inclusion, the ICS states that it will work with people, practitioners and clinicians to improve and adapt digital capabilities; ensure that coordinated information can flow as needed; ensure that digital capability is easy, useful and improves productivity; and make existing combined data sets available to support population health management planning as appropriate.
Finally, in order to see better outcomes as a direct result of near-real time insight, the ICS says that it will ensure technologies work for everyone, develop interoperable information systems supported by telehealth, use population health management solutions to identify groups of people at risk of adverse health outcomes, and implement data security and monitoring systems across the whole ICS. It will also move towards full integration with smart home and wearable devices, and use de-identified data to enable more sophisticated population health management planning and to support research.
A case study was recently made available by NHS England, covering the ICS’s work with the Eastern Academic Health Science Network to fund a Head of Innovation role. The case study shares how the focus on innovation has “facilitated greater knowledge trust and relationships across local organisations” and resulted in an additional in-year investment of around £0.5 million into evidence-based innovative technologies.
In January, HTN covered the launch of a specialist app tailored for patients at East Suffolk and North Essex NHS Foundation Trust, which provides patients undergoing robotic knee surgery with educational content and virtual rehabilitation guidance, as well as connecting patients with clinicians to provide real-time information on their condition.
