Next up in our feature series exploring digital and data across the ICS regions, we’re looking to the South East and its six ICSs: Buckinghamshire, Oxfordshire and Berkshire West; Frimley; Hampshire and the Isle of Wight; Kent and Medway; Surrey Heartlands; and Sussex.
In August last year, we interviewed Ross Fullerton, chief digital and information officer at Buckinghamshire, Oxfordshire and Berkshire West Integrated Care System (BOB ICS).
Ross told us about some of the digital projects he and his team have been working on; he described how the ICS is heavily focused on integration and interoperability, along with placing emphasis on how different organisations within the system can access each other’s data to improve care, planning and research.
“We’re working to ensure that we’ve got a clear foundation of digital capabilities,” Ross said. “We’ve got some really strong digital centres of expertise in some of our trusts, but we’ve also got some trusts that rely predominantly on paper to operate day-to-day. So we need to get everyone working at the same level. So that includes common projects like electronic patient records, but it’s also about digitising the diagnostics pathways and working with areas like the cancer networks, to digitise those in a joined-up way.”
In addition, the ICS is focusing on increasing the level of support they can provide to patients through virtual wards and virtual care, and working on their analytics to better understand their data sources, population health, and how interventions can be targeted.
Digitising social care, Ross said, is something that the ICS is getting increasingly involved with. “We’ve been successful in receiving some of the funding for digitising adult social care so we’ll be using that to work with our care homes; for example, to increase what they do digitally and start to share that data in a more joined-up way.”
So what does the ICS’s overarching strategy have to say about digital?
Digital is identified as as a key enabler of the ICS’s five priority areas – to start well, live well, age well, improve quality and access, and promote and protect health. The system pledges to focus on the “digital solutions, data and insights available to those who work or volunteer in our area as well as how we use digital technology to move care closer to people’s homes and to support people to self-manage their health conditions.”
It is picked out as having a particular role to play in the ‘age well’ category, with the ICS noting the need to support people to access relevant technology and increase their digital skills and confidence so that they can remain virtually connected and cared for.
Technology is also highlighted for its part in improving quality and access, with the strategy noting that “waiting times for some diagnostic and specialist services are particularly high… by working better together across our entire system we plan to make better use of capacity and provide a faster service to patients.” To tackle this, the ICS states that technology must be embraced in order to develop innovative models of support.
Looking at how they will deliver on their priorities, the ICS says that the success of the strategy will rely on “adopting new and innovative ways of working, including how we use digital technology and data.” The strategy acknowledges that better use of information and data will allow a shared understanding of need and therefore allow the ICS to take proactive and targeted action, and also that strong processes and systems will only be valuable if people are equipped to use them.
Focus areas for digital, data and technology therefore include supporting providers to reach a minimum level of digital maturity; delivering a single shared care record for care settings across the ICS; delivering technology solutions that can enable the workforce to collaborate and support work/life balance; supporting people to receive virtual care in or close to home; supporting staff, volunteers and citizens to feel confident in use of digital solutions; and using population health data to drive decision-making.
On this last note, the ICS specifies that their population health focus will include building a stronger community of analysts to improve analytical functions; using data from across providers to identify individuals or groups with similar characteristics and needs; moving from people reactive to proactive through empowering staff to develop and implement targeted interventions; and using data to identify health inequalities and possible causes, in order to provide more holistic, person-centred care.
This week, on 16 May, we’ll be hearing from the ICS’s chief clinical information officer Dr Dan Alton as part of a panel exploring digital integrated care systems, examining the challenges, opportunities, new models of care, digital projects and more. Sign up for your free ticket here.
As part of their commitment to harness the benefits of digital technology, Frimley ICS has launched Wavelength – a programme bringing together clinical, operational and IT staff from across the system to explore digital possibilities for improving health and care and break down barriers inside and between organisations.
Wavelength is designed to imbed a “closer partnership working on digital matters, a network of technology role models that spans the ICS, and a professional digital culture across the system.” The programme encompasses participants from across the ICS and focuses on leadership development, with support from local corporate, community and academic organisations.
Programme director Sharon Boundy says that she is “utterly inspired by the conversations that have been sparked” and calls Wavelength “a great opportunity to work in partnership with healthcare and digital leaders in the way we transform and provide healthcare to residents… we need to be in a space where all of our leaders take responsibility for thinking: ‘How can we do this digitally?’”
Let’s take a look at the integrated care strategy. Digital is included in the headline strategy commitments, with the ICS highlighting the need to make “outstanding use of resources” through utilising digital innovation to deliver greater value for the population. “We aim to be known for working together to maximise the impact of the skills and capacities of our staff, making decisions based on good intelligence [and] our digital capabilities,” the document shares. “The ICS will ensure joint prioritisation and effective utilisation of all our resources including financial, estates, digital and workforce, recognising these as our as our key strategic assets.”
The role of digital when it comes to sustainability is highlighted by Frimley, with the ICS pointing to the “new opportunities [that] have arisen in areas such as digital wellbeing and connectivity, population health management, remote monitoring of health and wellbeing and remote working”. The strategy says that they have the potential to “dramatically reduce resource consumption in non-clinical estate” and adds:”We want to enable our staff to work in the most efficient way by utilising the estate and digital capability to maximum impact.”
The strategy pledges to future proof the system by “having a leading digital and analytics ecosystem which will deliver practical improvement through transformation and cultural change using digital innovation.” They plan to develop a digital offer for patients, residents, staff and system that supports delivery of strategic ambition and provides greater insight from data, in order to make informed decisions and target improvement actions.
Frimley goes on to share some of the key achievements they have made in digital and analytics over recent years, including developing a population health intelligence platform and establishing population health analytics support that is now embedded in decision-making across the system. Population health management has been used to improve diabetes and hypertension management and outcomes, the document notes, with “measurably reduced variation” in deprived communities. The ICS has developed digital enablers to improve primary care access, used population analysis to target communication activity and spend for key cohorts and established close collaboration between clinical leadership, digital, transformation and analytics in order to drive change.
Towards the end of last year, we covered how Frimley Health NHS Foundation Trust launched a new app to provide traffic light guidance on childhood illness, and earlier in the year we covered how the ICS utilised an analytics tool to identify trends such as patient behaviours and areas of increasing demand.
Meanwhile, in Hampshire and the Isle of Wight, the key areas of digital activity are summarised as ensuring comprehensive, longitudinal integrated care records; providing clear and consistent information governance; ensuring a strong digital foundation for recording and viewing information at point of care; better use of data to drive improvements; enabling patients to interact and collaborate in their care; and ensuring involvement of professionals and citizens in the development of digital plans.
On their website the ICS specifies how the data, digital and insights team intersects with other teams across the system, including management, corporate IT, the Wessex Care Record, projects and programmes, Care & Health Information Exchange, and population health. Their work focuses on the ICS’s four key principles – improving outcomes, tackling inequalities, enhancing productivity and ensuring value for money.
Future plans are focused around local people being able to receive care at home where appropriate and reducing duplication so that patients only need to provide information once; helping people to feel involved in their own care; supporting them to self-care; improving digital inclusion; supporting staff to access modern, reliable and fast equipment to improve productivity and release more time for providing care; and helping staff to use joined-up systems to communicate across organisational boundaries.
Overall, the ICS aims to enable real-time, consistent capturing of information to improve understanding of needs and help decision-making, and to enable the creation of joined-up data sets to support a population approach, along with reducing inefficiencies and improving access.
Last year, Hampshire and the Isle of Wight’s head of population health management Faye Brooks joined HTN to deliver a presentation on the system’s key learnings and experiences from its population health journey. Faye described how the ICS is “using joined-up data, predictive analytics and partnership working to move and shift from a reactive to a more proactive model of care for our vulnerable groups. It includes approaches such as re-stratification and segmentation, but also identifying at-risk cohorts using historical and current data to meet their needs.”
Citizen co-production has been a key part of designing interventions fit for purpose, Faye said. “We have spent quite a lot of time working with our leadership teams to ask ‘what is the art of the possible?’, ‘what is the ambition as an ICS’, ‘how do we want to drive that forward?’ and ‘what are our intentions?’ so that we can detail out our roadmap. We have had really strong clinical leadership which has been absolutely critical for the success so far.”
Faye also shared some key learning points from the ICS’s approach, including engaging early with senior stakeholders to maximise investment opportunities; investing in the core delivery team; and discussing data sharing early. Catch up with Faye’s session in full here.
Next up, we’ve got the interim integrated care strategy from Kent and Medway ICS, where a main enabler for the strategy priorities is to “drive research, innovation and improvement across the system”.
The ICS places emphasis on how they will improve flow through the system, with digital tools highlighted to play a key role. “Joined up systems that provide streaming at the front door of emergency department can direct people to the best service for them,” the document notes. Improving patient flow also means prioritising shorter in-patient stays where possible; here, the ICS states that as part of their system-wider digital transformation, they are aiming to achieve a single electronic patient record that will allow clinicians to provide continuity of care and improve access to information.
With regards to growing the workforce and skills, Kent and Medway share how they intend to develop their work with local employers, schools, career services and education partners to create a “robust pipeline of local workforce for future years”, with focus on “new ways of working such as cross-organisational portfolio roles with the skills and digital capability to be ready for the modern workplace.” In addition, the ICS will use its anchor institutions to “develop one workforce at place, create integrated neighbourhood teams with embedded flexible working, mobility and enabled through digital technology and capabilities.”
Coming back to the enabling factor – driving research, innovation and improvement – Kent and Medway set out a number of outcomes to achieve in this area. One is to ensure that research evidence is utilised to support improved outcomes; the ICS plans to achieve this by “enabling system-wide capability to access and synthesise new evidence.” Another is to enable and support the adoption and spread of proven innovation, through horizon scanning and industry engagement “to generate a rich pipeline of useful innovation.”
Ultimately, the ICS says, its digital aim is to “reduce complexity, communicate digital plans and deliver healthcare transformation through a series of digital and data programmes.” Some of the ways in which it will achieve this include “empowering digital champions to lead transformation, building confidence within our workforce around digital and data and developing a sustainable service that does away with waste and consolidates in areas where there is duplication.”
Looking at other news from the area, HTN shared how East Kent Hospitals are investigating ways to improve patient outcomes by using 3D printed models and advance image augmentation of body parts, along with the news that Medway NHS Trust adopted a diagnostic medical device designed to detect cervical abnormalities and provide assessment of cervical tissue in real-time.
At Surrey Heartlands ICS, the digital team works in several key areas.
The Digital First Primary Care programme is designed to support patients in quickly accessing advice, support and treatment through digital and online tools, and work around the Surrey Care Record focuses on bringing records together from different organisations to benefit patients and clinicians. In addition, Surrey is the process of developing a Personal Health Record for each resident, which will enable people to access their own records online. Then there’s the ICS’s digital inclusion project, through which the team deliver work such as digital skills training for cohorts who may be struggling with using technologies. Finally, Surrey’s population health management programme centres around the analysis of data to develop new ways of providing care and reducing waste, making best use of combined resources and making informed choices through examining data.
Looking in particular at their digital primary care officer, in 2021, before the formation of the ICS, the region set out a five-year roadmap. The roadmap outlines Surrey’s focus on bettering their understanding of the digital landscape; putting clinical pathways before procurement by ensuring that digital entry points are joined up; encouraging user-centric innovation; transforming and upskilling teams; embedding new digital initiatives and adopting agile ways of working; and driving partnership models by co-designing patient pathways with innovators, using technology to support them.
It notes how change is to be delivered through collaborative working, and is based around six key themes. Those themes include ensuring that digital tools and ways of working are used on a day-to-day basis and absorbed into the culture; leveraging digital to work at scale by minimising siloes; getting the basics right with an equal standard of basic infrastructure; engaging with patients through communication, messaging and support; maximising datasets; and getting the patient to the right place in the first instance, by working to deliver a seamless patient journey where needs are identified early in the process. The roadmap shares some planned actions such as developing a training programme, partnering with universities to co-design modules, creating a knowledge management tool and a data controller console, and ultimately sets out Surrey’s hope to present a digital-first offer for all citizens by 2023/24.
Last year, we interviewed Surrey Heartland’s chief executive officer Dr Claire Fuller. Claire gave advice for people undertaking digital transformation: “It’s about maintaining our steady state, currently and then building. We’ve got the factors that we know and trust to work, and a lot of change has happened already. A good digital leader needs to understand patient care. I think they should probably know more about patient care than they do about digital.”
She added that Surrey’s chief digital officer Michael Pantlin has a dual portfolio and is also the ICS’s chief people officer. “That’s because I wanted to make sure that our digital interventions either improve the working day for staff, or they improve patient care, rather than taking on beautiful but standalone digital projects that don’t have a strong impact on those key aspects. In my view, a lot of the best digital leaders probably have a clinical background, in terms of understanding how things actually work from the staff and patient perspective, and not just from a technical aspect.”
In other news, we recently covered how North West Surrey Integrated Care Services – a GP Federation which brings together the 38 GP practices in North West Surrey – has collaborated with a health tech supplier to implement a governance solution “to help them truly understand and use their data”, along with reducing paper use. The solution allows the Federation to build bespoke forms that collect and store data within the system, centralising it and feeding it into a reporting dashboard which can be shared with team members.
Elsewhere, Royal Surrey NHS Foundation Trust launched a digital tool for pre-operative assessment which is designed to support patients ahead of surgery by building an interactive patient summary, providing two-way file sharing between clinician and patient.
“In Sussex our ambition is to keep improving our digital health and care services, giving you and those who care for you the tools, information and services you all need,” the ICS states. This includes ensuring that there are digital ways for people to connect with professionals, ensuring that patients have the information they need to stay healthy and/or self-manage where possible, and improving learning around how to make the services the best that they can be through data.
Digital is named as a success factor in Sussex’s five-year plan, with five related objectives: connecting services, improving technology and sharing data, supporting staff, giving local people information, and supporting people to use technology.
The strategy specifies how the ICS wants to connect information better across our different services so that they can work in a more joined-up way; to support organisations in improving the way they use technology, and how they share data; to help staff access the information they need, wherever and whenever they need it; to help local people to access and manage their own health and care information, care preferences and choices; and to support people and their carers in improving their digital literacy.
In March this year, HTN chatted to Lisa Emery, chief transformation, innovation and digital officer at NHS Sussex. Lisa discussed the immediate digital priorities for NHS Sussex, describing how they are “looking at ways in which we can influence the agenda around prevention and reducing health inequalities. Part of that work includes addressing digital exclusion – how do we think about designing systems with our population? Co-design needs to be at the heart of everything we do.”
Lisa continued: “We’ve used the ‘digitise, connect, transform’ framework, so initially there will be a lot of work going into ensuring that we have digital foundations in place, with all of our organisations reaching a minimal level of connectedness. Then it’s a question of working to connect them and looking at our data systems, improving how clinicians can access data and use it. After that we’ll be focusing on the transformational work, which is where we’ll start putting work in place to immediately alleviate operational pressures. From there, we’ll start looking into innovation for the future. How can we do things differently? We want to undertake work that lets us give time back to care and really improve the care experience for our population in Sussex.”
Other news from the region covers how the ICS adopted a digital tool to support its bowel screening programme in collaboration with South, Central and West; they worked together on a web application designed to identify hotspots of low bowel screening uptake and high cancer positivity rates within their area, and created a bespoke mapping tool as a result. In addition, we heard how the ICS worked with a provider of digital infrastructure to facilitate patient-specific pathways between primary and secondary care, and how their remote monitoring service for managing COVID patients at home was estimated to save 440 emergency attendances, 750 GP visits and 1,150 calls to 111.
From concentrated urban areas to highly isolated coastal regions, providing equitable access to healthcare services in the South East is a complex and challenging task.
Leaders across the South East experience common issues, whether it’s meeting the complex needs of big cities or reaching underserved rural areas where staff are scarce.
Keep reading to learn how Lantum supports workforce solutions that account for local needs and help you deliver high-quality care.
Understand your local needs and increase workforce capacity
As a leader, you need to understand:
One example is to incentivise staff to take up positions in underserved rural practices. Workforce management solutions like Lantum help you highlight sessions across such underserved regions and redirect resources in a way that increases employee satisfaction and patient care.
How to deliver local solutions for regional success
Everyone needs access to healthcare, no matter where they’re living.
But how do you deliver?
Remote consultations are a valuable tool for delivering equitable access to healthcare across the South East. Lantum slots in seamlessly with your existing providers and increases the pool of clinicians available to staff shifts.
When it comes to staffing in-person services, Lantum makes sessions visible to all staff across your organisation, not just a few. This helps to improve coverage in less desirable urban areas that are commonly overlooked by recruitment agencies. Plus, it helps prevent siloed working and encourages staff to move to more remote locations.
In areas where you have an established locum network, Lantum offers staff perks and streamlined communication. When your entire organisation can access one staff bank, it increases morale, improves job satisfaction, and boosts locum loyalty. This is key when it comes to ensuring locums work where they’re needed most, and don’t become tempted to move into less cost-effective agency roles.
Enhancing flexible staffing across Kent and Medway ICS
Established in 2019, Kent and Medway ICS covers 188 GP practices, 41 PCNs, and serves a population of 1.9 million. With some of their population in coastal and rural areas, finding GPs and delivering services can be challenging.
With the lowest GP-to-patient ratios in the country, Kent and Medway had trouble fully staffing services, especially considering the amount of time, effort, and expense it took to find locum GPs through locum agencies.
Kent and Medway ICS originally came to Lantum looking to move away from costly agency solutions; they were able to achieve this and so much more. The shift to Lantum was performed at speed and scale, and caused minimal disruption. This was essential to maintain the high standards of patient care the ICS is known for.
When Kent and Medway ICS partnered with Lantum, the shift happened quickly and with minimal disruption. Key decision-makers worked with the Lantum team to understand where staff are working and why. From there, they were able to:
The result? A robust, resilient and highly flexible workforce that can adapt to the ever-changing needs of their patient population.
How Lantum works across the South East
Connected SchedulingTM ensures that Lantum is so much more than a flexible staff bank. Our comprehensive approach improves staff mobility so healthcare professionals stay engaged and motivated by the new opportunities their careers provide.
Lantum supports ICSs in the South East with:
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 across the South East, click here.