The role of digital in the 2023 mandate for NHS England

The government has published their mandate to NHS England, setting out their objectives for 2023 onwards.

In the foreword from the Secretary of State for Health and Social Care, Steve Barclay states: “We need to enable the health service to deliver and recover in two key ways; through supporting innovation and the adoption of the right digital health technologies, and through ensuring the workforce is well supported to deliver the excellent care they provide.”

On the former, Barclay comments that “we know, for example, that digitally mature trusts operate with approximately 10 percent improved efficiency… we also know that it helps to reduce length of stay in hospital, which is of critical importance.” Levelling up digital maturity is called a “key priority”, and Barclay also comments that he has “seen and been inspired by the use of new artificial intelligence (AI) technology to support clinicians to diagnose skin cancer, lung cancer and strokes”. He adds that he wants to “challenge the NHS to go even further to adopt safe, ethical and effective AI tools to improve outcomes for patients in other clinical areas, making the most of the opportunities that this revolutionary new technology creates for improving public services.”

Concluding his comments, Barclay notes: “There is also great potential for better care, and better patient experience, through the transformation of the NHS App as the digital front door of the NHS and in May 2023, we announced plans to increase patient choice via the NHS App to help continue reducing hospital waiting times.”

The first priority is to cut NHS waiting lists and recover performance. Here, the document draws attention to the need to improve GP access by delivering the primary care access recovery plan, covered by HTN here. “Modern General Practice Access should be implemented by moving practices to digital telephony, procuring new digital tools and providing care navigation training and transformation support to all practices that require it,” the mandate states.

It highlights expectations for all practices to have been offered procurement support and asked to sign up for digital telephony by July 2023, with aims to have 1,000 transitioned before the end of the year. In addition, by the end of 2023, all practices should have new digital tools made available to them.

“NHS England should develop and deliver the service specifications and patient group directions for the common condition service in community pharmacy and the necessary underpinning IT improvements,” the mandate adds.

The second priority is to “support the workforce through training, retention and modernising the way staff work“, which emphasis placed on the need to ensure that the workforce works sustainably and is capable of meeting patients’ changing needs.

Priority three focuses on delivering recovery through the use of data and technology. The mandate states that it is “crucial” that the NHS makes progress in adopting innovation and technology to help ensure long-term sustainability. “The system must utilise the power of technology and the skills, leadership and culture that underpins it, to drive a new era of digital transformation,” it says. “This will allow the health and care system to thrive long into the future, delivering vast benefits for patients – such as using AI to give better treatment, the latest screening techniques to detect illness sooner and equipment that allows more people to be treated at home.”

NHSE should continue to prioritise tackling variation, the document continues, with a need to support digital transformation in areas where there is the greatest challenge. In order to do this, it is “vital” that staff have the skills and resources to implement digital tools effectively, so that they can deliver high quality care.

The mandate specifies three key aspects to this delivery. The first focuses on ensuring innovative, safe and effective delivery of live services, with focus on reaching pre-set EPR targets and implementing the national cyber strategy for health and social care. In addition, by March 2024, “all trusts should adopt barcode scanning of high risk medical devices and submission tot he national, mandatory Medical Device Outcome Registry” in order to improve patient safety and outcomes.

The second aspect focuses on developing and delivering the federated data platform and maximising trust and ICB take-up of platforms and tools. Here, the mandate stresses the need to optimise the use of health and social care data “to deliver better services and outcomes for patients, maintaining the highest standards of data protection and ensuring cyber resilience to maintain and build public trust in our protection of people’s data.”

Finally, NHSE should prioritise the transformation of the NHS App as the digital front door for the NHS. This should include increasing its use for booking and managing appointments, ordering repeat prescriptions, accessing patient records and accessing digital health therapeutics, with an aim for 75 percent of all adults in England to be registered by March 2024.

In addition, the mandate notes a priority to increase the uptake of AI tools to support the NHS workforce in applying best practice.

The mandate can be read in full here.