We’ve come to the last of our feature series exploring digital and data across the ICS regions – the latest edition focuses on London, looking at the plans, projects and programmes in place across North Central London ICS, North East London ICS, North West London ICS, South East London ICS and South West London ICS.
Without further ado, let’s get stuck in and see what’s happening in digital throughout the capital.
In their integrated care strategy, North Central London ICS lists integration as a key priority and focus area, drawing particular attention to digital integration through population health management tools. Building local integrated teams is also part of this, with the strategy setting out an ambition to develop a digital supported offer for more proactive care at home along with increasing levels of digital inclusion.
Going into more detail on their work around population health, the ICS shares a number of aims and activities, including building a network of intelligence functions across partners, embedding data on key communities into frontline care, and developing and embedding a suite of system quality metrics to support the Core20PLUS5 framework. The ICS notes that work around digital inclusion will be embedded into all programmes.
The ICS lists ten overarching principles set to guide their new ways of working; building from insights is one of these, with the strategy pledging to “create digital partnerships and use integrated qualitative and quantitative data to understand need”.
Digital is also highlighted as playing a role in the ICS strategy around building ‘one workforce’, “to provision a sustainable model that enables us to pivot towards a model that focuses on population health improvement.” Data is to play a key part in this, with the strategy acknowledging its “unique opportunity and role to generate visibility of roles, opportunities and capabilities and used an evidence-based approach to support strategic workforce planning and coordinate planning activities across the system”.
In terms of workforce transformation, the strategy also notes how the ICS plans to explore opportunities for innovation by piloting initiatives and designing an ecosystem that provides “a clear route to scaling and enabling workforce transformation impact at scale; maximising the datasets and advanced technologies within the system (and explore new ones) to increase access, efficiency and continuously evolve our workforce and operating model.” The ICs will also embrace new ways of working through technology, with the creation of holistic roles that provide support across health and care boundaries, increasing productivity through digitally supported pathways.
HTN recently spoke with James Davis, the previous chief innovation officer at Royal Free London NHS Foundation Trust. James shared some of the projects he worked on at the Royal Free, including setting up an innovation directorate as a way to share learnings, ask questions and provide access to expert skills through an NHS-to-NHS service.
“One of the things I’m most proud of is a national COVID testing platform that we built for the system in the pandemic. It’s still up and running at the moment. That involved an alternative testing method for COVID; the individual would spit into a post and their saliva would go into a machine that would analyse it and produce the same level of certainty as a PCR test. We rolled that out to just under 30 different organisations in the country, which was really cool,” said James.
“It took a lot of time and effort in design, thinking in terms of how to build a platform, how to build a digital wrapper for sample collection. As an end user, how is it that I can interface with this digital solution to deposit my sample, to track it and understand where it is in its process. Then from the perspective of the engineer or the laboratory, how do I receive this sample, note on the system, make sure it’s checked properly? From the data and analytics viewpoint, or the person responsible for monitoring it, how can I assess how we are doing and what our performance looks like at scale?
It had a really positive impact – the programme lasted for nearly two and a half years. It was all built and delivered through us at the Royal Free and we collaborated with the Department of Health, NHS England, NHS Digital and Track and Trace to do it. I’m very proud of that one.”
We also recently heard from Peter Thomas, chief clinical information officer and director of digital medicine at Moorfields Eye Hospital, for a discussion on building the foundations of scaled AI implementation. As part of his discussion, Peter shared some of the work underway at the Clinical AI Centre at Moorfields, where an algorithm has been developed in-house that can analyse the back of the eye to assist in the handling of geographic atrophy.
In other recent news from Moorfields, a team has worked in collaboration with UCL to explore a new AI model that could provide an effective way of identifying retinopathy of prematurity, the leading cause of childhood blindness. The algorithm has been trained on a sample of 7,414 images of the eyes of 1,370 newborns and has been developed to help identify which at-risk children have retinopathy of prematurity, along with improving access to screening.
Moving onto North East London ICS, let’s take a look at the digital focus in their interim integrated care strategy.
The plan sets out a focus on building the partnership’s digital foundations along with the role of digital in prevention, with improvements to be made in how the ICS uses the data it collects; personalisation, with social prescribing teams to have access to digital templates in primary care, and ambitions to develop sharing platforms for personalised care; population health management, with the ICS to develop a methodology and identify cohorts where interventions will add value; and tackling inequalities, with data to be better used to address unmet needs.
The strategy also places emphasis on the ICS’s need to foster a learning system to improve, with an action to drive data and insights, to improve the evidence base to drive investment in transformation, and to grow its analytical capacity.
In addition, North East London plans to improve its digital infrastructure, stating that “digital transformation will enable people to improve their own health, tackle rising demand, integrate services, and empower staff. Our focus will be on connecting systems together and minimising the number of different systems and to utilise the high amounts of data available.”
In terms of projects coming out of the area, HTN covered how North East London NHS Foundation Trust won an award for digital innovation at the NHS Digital Pioneer Awards with their MyMind app, which was co-designed by young people and clinicians to meet a growing need for better adolescent mental health care. The app signposts users to approved advice and support, helps them to manage their recovery journey with appointment reminders and access to care plans, and features video messaging technology to encourage communication with clinicians.
Another project is the deployment of cloud-based speech recognition technology from Homerton University Hospital NHS Trust, which utilises artificial intelligence to speed up clinical correspondence and reduce transcription costs. Paul Adams, head of clinical information system at Homerton University Hospital said that the speech recognition engine “is incredibly fast and accurate – making life for our clinicians easier. We’ve seen considerable month-on-month cost savings as we replace our transcription services with front-end speech recognition and we’ve also reduced expenditure by not having to invest in additional hardware or recruit scarce and expensive technical resources to run the software day-to-day.”
The digital, data and technology transformation plan for North West London sets out an ambition with three main features; for digital, data and technology to help to provide great care for patients and communities by giving them easy access to the information they need for clinical decision-making regardless of location; for patients and service users to have digital options for interacting with services; and for collaborative working across the ICS to be made easier through having the right technology.
The ICS sets out a collective approach for leaders across the system to sign up to. At the heart of the approach is the digital record, supported by data sharing and digital engagement with patients. This in turn supports integrated care with better management of complex pathways and population health management through the use of analytics, artificial intelligence and machine learning. The final aspect of the approach, supported by the other factors, is innovation; the ICS seeks to implement digitally-enabled new models of delivering care, with digital support for clinical decision-making through intelligent systems.
A number of key focus areas are highlighted, including patient flow and capacity (with the ICS aiming to provide innovative digital and data tools to enable better demand planning and data-led deployment of capacity), and end-to-end pathways (with the ICS seeking to improve population health and patient engagement through developing a strategic solution for virtual consultations, implementing a single system for advice and guidance, and demonstrating the case for remote monitoring in improving outcomes).
Digital-first primary care is another focus area; here, the strategy shares how the ICS intends to support GP practices and PCNs through innovative approaches to digitally-enabled online consultations, remote long-term condition management and social prescribing. In terms of digital inclusion, the ICS pledges to use digital technology to increase inclusion and access; to support and encourage people to access digital tools; and to ensure that there are ways for everyone to access services.
The fifth focus area is to rationalise clinical systems, with North West London aiming to standardise and improve ICT infrastructure, remove paper and digitise records, improve patient safety and enable low-friction data sharing. Finally, the ICS emphasises the need for resilient infrastructure, calling it “the foundation for our digital data and technology objectives”. The ICS aims to provide ICT infrastructure that gives staff access to digital records from any location, with a short-term ambition to “level up our organisations to modern levels of security to ensure our systems are protected”.
Towards the end of last year, HTN covered how the ICS signed a deal to implement a cloud-based interoperability service, which sees the ICS launch a five-year partnership to facilitate electronic data flows between care settings and promote digital transformation across the region.
We’ve also shared plenty of news from Chelsea and Westminster Hospital NHS Foundation Trust; a couple of weeks ago, NHS England shared a case study from the trust on their digital preoperative assessment triage, with key takeaways such as a waitlist reduction of 17,003 patients and an eight percent improvement in theatre utilisation. Then there was the news that the trust and their official charity CW+ launched a new version of their app Hand Therapy: The Exercise Prescription App, which provides patients with a therapist-tailored programme to recover from hand and wrist injuries. CW+ also announced the launch of a virtual reality project last summer to support women who experience loss in the early stage of pregnancy.
London is a unique city in the UK in terms of both population density and sheer scale. Add in the diverse and ever-changing patient populations, and leaders have a highly specific set of challenges.
Lantum is designed to help leaders make better decisions so that they can meet the complex patient needs of London residents.
Adapting to the unique needs of a sprawling city
Each of London’s five ICSs face unique challenges because of their rapidly changing patient demographics. The key is finding a better way to connect your flexible staff pool with effective service delivery. When your practices get the support they need, they’re able to deliver better healthcare to their patients.
Leaders have to be able to call on a workforce that’s both robust and adaptable. Specialist areas like dermatology, EA, or phlebotomy need to be catered for just as efficiently as more commonly requested general practice services.
To avoid overstaffing specialist areas, Lantum’s Connected SchedulingTM solution helps deliver an agile workforce able to shift with daily demands. This is especially valuable given higher paitent volumes and rapidly changing demographics in communities across London.
The ability to seamlessly move staff back and forth across organisational boundaries is critical. Lantum gives leaders real oversight by showing them where their staff are working, how they’re being used today, and what’s needed tomorrow.
Lantum provides support across London
Lantum started as Network Locum back in 2012, giving us a well-established and proven locum presence in the area. This background has enabled us to scale into not just a city-wide solution, but a national one.
Lantum currently partners with South East London ICS to maximise resource sharing across the six boroughs under their control. Before Lantum, administrative boundaries and borders were historically difficult obstacles to navigate – making it harder to make data-driven decisions and carry out day-to-day work at the practice level.
Lantum’s solution was to work side-by-side with leaders from South East London ICS to build an ICS-wide flexible staffing bank. As of April 2023, there are 212 registered practices and 204 clinicians in the staff pool, and 7,061 hours have been posted to Lantum. This is a clear demonstration of how one tool can be used share and allocate existing resources for the benefit of all.
We’re currently working with South East London ICS to help their leadership team roll out solutions for staff types beyond locum GPs, demonstrating Lantum’s commitment to developing organisation-wide workforce solutions above and beyond traditional locum shift tools.
A long-lasting workforce solution that delivers
For more than a decade, Lantum’s been building a skilled network of locums in London and understanding what healthcare leaders need to build a strong workforce.
Through Lantum’s Connected SchedulingTM platform, ICSs can build flexible staff pools, connect with locums long-tmer, and give practices tools to manage their staff more efficiently. When you need to stand up new services quickly, a flexible staff pool can help mobilise your workforce in a matter of days.
There are currently thousands of doctors right across London who choose to work through Lantum in addition to their ICB contracts. This represents a pre-made workforce with the experience, commitment and energy needed to adapt to the ever-changing needs of the city’s patients.
Why Lantum is a tool fit for the modern city
Lantum provides leaders a clear view of how staff and resources are being used and allocated. It delivers flexibility, agility and a joined up service across a wide variety of specialist and more general roles. This is essential given the rapidly evolving needs and patient demographics that exist in London in 2023 and beyond.
Lantum supports ICSs in London 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. Learn more about how Lantum delivers ICS solutions across London.
The South East London ICS digital strategy has been framed around the six domains of their strategic digital investment framework, which was developed and adopted by the ICSs in London as a basis for prioritisation and decision-making. The domains focus on system leadership and collaboration; a single view of a person’s health and care information at the point of care; real-time information for proactive care; information and control for patient empowerment; leveraging population information for health improvement; and robust foundations and digital maturity.
The ICS has included another domain for prioritisation in their strategy around driving innovation in South East London, “as we believe that a focus on innovation is essential to optimise our progress in the other SDIF domains.”
The strategy goes on to explore a number of key areas for the ICS, including digital diagnostics; developing the analytics capability; digitising social care; digital inclusion; overcoming barriers to innovation; and developing the digital workforce.
At the time of publishing, the immediate priorities for the ICS included establishing the Digital Transformation Board in the ICS governance framework; launching a communications and engagement campaign to generate discussion in the workforce around the strategy; consolidating the strategy into a roadmap, and designing and building an ICS digital team.
Moving on to look at the projects and programmes in South East London, HTN covered how the ICS signed a two-year deal to deliver workforce technology across the region last July, with 200 GP practices and 58 extended hub sites to be connected via Lantum’s workforce scheduling platform. We also heard how the ICS launched a scheme to improve digital access for people with learning disabilities or severe mental illness, with focus on improving digital access to GP services.
Other news includes Guy’s and St Thomas’ NHS Foundation Trust using a virtual visiting platform to improve communication for patients in intensive care in collaboration with King’s College London. Originally launched as a response to the COVID-19 pandemic, the project sought to embed virtual visiting technology into routine intensive care practice. An app was adapted to provide a secure communications platform for families to use, with further technology partners helping to turn the concept into “tangible, usable tech over the course of just 10 days”.
Elsewhere, South London and Maudsley Foundation Trust launched augmented reality and virtual reality applications to support people experiencing needle phobia and anxiety. The technology was introduced by the trust’s digital innovation team in partnership with the vaccination team and clinical teams, with senior innovation architect Milos Kresojevic calling it “really exciting work which has huge potential to change lives”.
Finally, let’s take a look at the digital priorities, plans and projects from South West London ICS. On their website, the ICS states that they are supporting their services and systems to level up their digital capabilities and maturity as a priority, with the aim of ensuring that all partners have a core level of infrastructure, digitisation and skills.
Another priority is to develop system-wide plans; this includes coordinating acute, community, mental health and ambulance providers to develop plans that meet a core level of digitisation by March 2025, in line with the NHS Long-Term Plan commitment. The ICs has been working on a three-year digital investment plan in line with What Good Looks Like, to establish “dedicated teams to deliver robust cyber security across the system, consolidation of purchasing and deployment of digital capabilities”. In addition, the ICS is to set out steps for how they will use digital services to support the NHS Net Zero Agenda.
The second priority is to connect health and care systems and records, with the ICS emphasising the role of the London Care Record. Improvements are to be made to create a system which is more joined-up, safer and more efficient; to give clinicians immediate access to relevant and appropriate data; to reduce incidents of misinformation or misunderstandings; and to provide people with better access to their medical records. The NHS App also plays a role in ensuring better connection of services, with the ICS acknowledging that their GP practices are encouraged to engage with patients on the topic.
Finally, South West London prioritises workforce development, sharing how it is “developing workforce plans to support the skilling up of health and care staff across South West London to maximise the opportunities of digital solutions.”
In terms of news coming from the area, there has been plenty; last month we heard how Kingston Hospital has digitally optimised their fertility pathway by partnering with OX.DH, a health tech start-up with links to the University of Oxford. The hospital has introduced a cloud-native digital platform to support patient-centric, individualised care, supporting cyber security and enabling patients to have greater control over their own health by managing their own appointments and documentation online.
In March, The Royal Marsden NHS Foundation Trust went live with Connect, its electronic patient record, along with a patient app and website. It has been described as “the largest and most important digital transformation programme in The Royal Marsden’s history”. HTN will be interviewing chief information officer David Newey in the coming weeks to hear how the launch went, so keep an eye out for more information coming soon.
We also heard how the Royal Marsden, in collaboration with The Institute of Cancer Research and Imperial College London, has been investigating how artificial intelligence could help in identifying the risk of cancer returning in non-small lung cancer. The ongoing study uses imaging and clinical data from patients following curative radiotherapy, and aims to develop and test machine learning algorithms to gauge how accurately the. models can predict the recurrence of cancerous cells.
Looking further back, 2022 brought the news that two of the ICS’s trusts – Epsom and St Helier Hospitals NHS Foundation Trust and St George’s University Hospitals NHS Foundation Trust – have joined forces to share their electronic patient record system as part of their working partnership and close collaboration on research, staff development, education and training.
In addition, Croydon Health Services NHS Trust launched an interactive mapping service to help visitors route their care and plan their visit in advance. The service allows users to view directions, with guidance on their exact location within five feet on an interactive map. Users can search for specific departments, services, rooms, elevators, restrooms, dining areas and inpatient care areas, and see estimated walking times and distance. It has also been translated into multiple languages to support inclusion.