The NHS England board met Thursday 27 July for discussion on key topics, including how technology is a “critical” element service of transformation and how a new framework is planned to tackle digital inclusion.
During the board’s meeting, the national director of transformation reported on the use of technology and innovation to transform delivery of care. The report noted that although progress in using biologic and data science to increase diagnostic capacity and deliver additional tools to manage demand, ” the infrastructure on which these developments were being rolled out required substantial updating to ensure it is fit for purpose to deliver a digitally enabled health and care service.” The board emphasised that technology is “critical” for transformation and essential to reduce the transactional friction that occurs when people interact with the healthcare service and to streamline clinical pathways and deliver operational and financial efficiencies.
EPRs in place at 88 percent of organisations
The board went on to provide an overview of progress made against the Digitise, Connect and Transform strategy. They noted that electronic patient records are in place at 88 percent of organisations at present. Other work includes implementing electronic bed management systems, establishing shared care records across integrated care systems, procurement underway for the Federated Data Platform, and the migration of the NHS Spine Platform to the cloud.
The board drew attention to examples of technology use in practice, including medical photography in dermatology; technological innovations for delivering echocardiograms; artificial intelligence tools in radiology and stroke diagnostics; and digital health therapeutics for musculoskeletal disease and mental health. They added that work is planned to align data standards to ensure interoperability across shared care records.
Innovation prioritisation based on benefit
The board discussed the challenge of prioritising pathway-specific transformation, noting that prioritisation would be based on the innovations capable of delivering the most benefit for the NHS. “In line with this,” the papers state, the board “supported the planned publication of the list of potential innovations prioritised according to impact. The commercial complexities associated with this work were also considered, noting the change in commercial approach for true innovations where something is singular and brand new and when they become a commodity.”
Digital exclusion, primary care, NHS App…
Members also discussed the importance of ensuring that active consideration is given to digital exclusion. They observed the benefits technology can bring can increase capacity for delivery of services in person or over the phone, and added that improved data utilisation will support providers to understand where people are not accessing digital services, and where digital exclusion may be producing a barrier.
With regards to the Primary Care Access Recovery Plan, the board noted that demand for these services varies across different age groups, with patients over 65 shown to have “five times as many appointments per year as younger adults due to multi-morbidity and complex care needs”. As part of efforts to address this, the plan aims to support patients to access care through the NHS App and encourages the move to a digitally-enabled way of managing incoming demand. The board “commended the integration of digital and technology into all aspects of the plan”.
On the NHS App, the papers highlight discussions around opportunities to improve access to the App, along with releasing capacity and streamlining service provision.
Tackling inequalities
Coming back to the topic of digital exclusion, the papers highlight how NHSE has set five strategic priorities for system action on health inequalities since 2021/22, which they anticipate will be in place until at least 2026/27. One priority is to mitigate against digital inclusion; another is to ensure that datasets are “complete and timely, particularly with regard to ethnicity coding”.
In terms of ongoing activities, the papers note how the plan for digital health and social care sets out an intention to publish a framework for NHS action on digital inclusion. A draft framework has been developed over the year, using co-design and engagement with key stakeholders as well as an evidence review.
NHSE has developed an approach to assess progress on the Core20PLUS5 approach, developing a measurement framework with indicators for monitoring progress so that they can be included on the Health Inequalities Improvement Dashboard and other data tools.
In addition, the papers point to the programme of work that NHSE has developed on sickle cell disease management with the aim of accelerating action and interventions, including digital care plans and a digital platform for patients.
Planned actions for delivery in the next three to six months and beyond include delivery of key frameworks and strategies in support of NHSE’s strategic priorities, including a new framework for action on digital inclusion. Another action is for NHSE to progress their data monitoring approach with a set of approved indicators, with the aim of providing a monitoring framework to increase transparency and inform ongoing oversight and actions on inequalities.
Over the next period, the NHS Race and Health Observatory is to finalise work on its online action resource programme, providing data visualisation on ethnic health inequalities and open access to case studies and research.
Preparing for winter
Discussing the 2023/24 winter plan, the board drew attention to the 10 high-impact priority interventions drawn from the Urgent and Emergency Care Recovery Plan, which includes standardisation and improvement of care across virtual wards.
With regards to system roles and responsibilities, the papers state the importance of national and regional NHSE teams having “oversight of pressures across the system. This will be supported by an Operational Pressures Escalation Levels (OPEL) Framework and strengthened System Control Centres.”
In an update ahead of the board’s meeting, NHSE shared plans to expand care ‘traffic control’ centres nationwide, to speed up discharge through coordinated data use. NHSE shared an expectation that “a third of patients could be discharged using this model by December”.
The board papers can be found in full here.
