Digital health and data across the ICS regions in 2024: South West
So far in our feature series exploring digital and data across the integrated care system regions, we’ve looked at London and the North East and Yorkshire; next up, we’re placing our focus on the South West.
It’s coming up to a year since our last deep dive into what’s happening with digital and data in the South West, so we are taking the opportunity to look at what has happened since in terms of news, strategies, and other recent developments impacting on digital and data at a local level.
Here we explore what’s happening in digital across the South West’s integrated care systems: Bath and North East Somerset, Swindon and Wiltshire; Bristol, North Somerset and South Gloucestershire; Cornwall and the Isles of Scilly; Devon; Dorset; Gloucestershire; and Somerset.
Digital strategies in the South West region
Firstly, let’s consider how many of the seven ICSs in the South West have a publicly-available digital strategy.
From our research, the answer is three – Bristol, North Somerset and South Gloucestershire, Devon, and Gloucestershire.
Bristol, North Somerset and South Gloucestershire’s digital strategy for 2023 – 2025 is available here, and places a key focus on several key areas including embedding digital and data into the organisation’s “integrated design process”; avoiding duplication by “integrating and reusing systems, architecture, shared services, support and expertise”; providing digital-first channels for citizens, empowering them to self-serve; and using digital functionality to underpin an experience of seamless care.
Devon ICS has published a digital strategy covering 2022 – 2027, outlining digital priorities such as developing an interoperable EPR and operational systems, providing a unified technical infrastructure, working on the Devon and Cornwall Care Record, building a single population health management solution, and promoting a single digital service for the ICS.
Gloucestershire ICS’s digital strategy for 2022 – 2025 focuses on delivering “simplicity for the citizen”, using preventative and assistive technology, establishing a digital working culture, enhancing partnership working, and joining up care through a shared care record.
Digital is included in other strategies for the other ICSs; for Bath and North East Somerset, Swindon and Wiltshire, the ICS’s Primary and Community Care Delivery Plan, published at the end of 2023, makes mention of digital in a number of areas, specifically on enhancing personalised care with digital and remote incentives, increasing access, and using data to inform decision-making and reduce health inequalities.
Similarly, in Cornwall and Isles of Scilly ICS, the Integrated Care Strategy which was published in March of 2023 includes digital in supporting the delivery of planned outcomes including in patient engagement, patient access, and productivity.
In Dorset ICS, digital again plays a role in improving access and empowering patients, with a dedicated section for digital within the ICS’s wider Joint Forward Plan for 2023 – 2028. The plan highlights work around virtual wards, population health management data, shared care records, cyber security, and a “one stop shop electronic patient record”.
Finally, in Somerset, work is reportedly underway on developing an ICS digital strategy, and the ICS recently published its digital strategy strategic data themes, with a focus on the four core principles of predict, prepare, prevent and improve. Planned actions include providing training for staff on predictive modelling, developing tools so that front-end users can create their own data dashboards; and developing early warning systems designed to help reduce risk to patients and to monitor pressure and capacity across the ICS.
Contents
- Digital strategies in the South West region
- Case study: ReStart Supporting the South West
- Insights from the South West
- Health tech from the South West: snapshots from the past year
- Do the ICSs have digital representation on their boards?
- Progress on virtual wards in the South West region
Insights from the South West
As part of our exploration of the current digital and data landscape across this region, we reached out to the ICSs themselves for any insights they might like to share about existing projects and priorities for the next six to 12 months.
Bath and North East Somerset, Swindon and Wiltshire ICB shared that it has completed its move to the cloud with “all key ICB and GP primary care systems, inline with the NHS Cloud strategy.” They added: “Cloud-based technology will increase the efficiency of the ICB’s data warehouse, which will improve data gathering and decision-making, particularly in terms of health inequalities. In addition, the cloud technology has enabled the ICB and GP practices to have a truly agile approach to the use of its estate, while also contributing to lowering running costs.”
Additionally, working with NHS England, the ICB has provided funding to GP practices to upgrade their phone systems from old analogue systems to modern cloud-based systems, which the ICS said “will significantly improve patient experience whey trying to call their practice.”
Over the past 12 months, the ICB shared that it has worked closely with primary care and other system partners to increase public awareness of the NHS App, and as of February this year, the ICB has the “second highest rate for new NHS App registration in England. This will set the foundations for future years to deliver quality digital services to patients through a single simple digital front door.”
Touching on security, the ICB added that work has continued to go into promoting the importance of good cyber security from board level down, “with increasing collaboration across our partner organisation to work collaboratively and further improve our defences to keep patients’ data safe and IT systems functioning.”
We also heard from Richard Greaves, interim associate director of digital strategy at NHS Somerset’s directorate of strategy, digital and integration.
Richard shared that over the past six months, the digital projects that he has been most proud of at the ICS include enhancements to its countrywide shared care record and agreement of a new technology partner contract set to operate until at least April 2029, as well as roll-out of multi-factor authentication across the organisation. The ICS has also been focusing effort on NHS App promotion and enhancement and delivery of prospective records access.
Additionally, Richard shared, one project has seen the adoption and use of an artificial intelligence tool said to be capable of predicting an individual’s risk of an emergency admission in the next 12 months across primary care settings. Another project has seen the embedding of an operational pressures escalation level dashboard with connected data from all core settings and delivery services.
As for Richard’s hopes for the future regarding digital at NHS Somerset, he said that he would like to see further enhancements to the shared care record, adoption and use of robotic process automation and artificial intelligence at scale, and the creation of ICS-wide digital and cyber security strategies.
“I’d also like to see investment in a population health management platform, an agreement to procure a single electronic health record across acute, community and mental health settings, and ICS digital system consolidation and convergence,” Richard shared, “to improve interoperability and support direct person care.”
Case study: ReStart Supporting the South West
Having worked in all but one of the South West ICSs and aided by a highly skilled technical team based in the region, ReStart has a wealth of experience in data migration and interoperability across the South West.
Devon Partnership NHS Trust (DPT) needed a data archive solution, and they needed one fast…
To enable seamless data migration to their new SystmOne EPR, the Trust had a 90 day window to get an archive solution in place – it had to be simple to navigate, allow access to historic data, integrate with in-context launch from SystmOne EPR and offer a single-click access into patients’ archived records.
With such a rapid schedule to go live, DPT and ReStart commenced the challenge of building and customising the archive solution around the Trust’s requirements. This was intensified by the complexity of the structured data and many user defined forms, plus a vast number of forms that needed to be built to clinicians specific needs.
Having data migrated to SystmOne offered much more flexibility in sharing appropriate patient data with other local organisations across the ICS. ReStart’s IMX Archive solution enabled DPT to access ‘in context’ patient data, held in their database, in an easy-to-read format which is secure and accessible via the new EPR system.
Following successful testing between both digital and clinical teams, go live was achieved well within the 90 day deadline. As of go live the clinical teams have rapid access to their legacy data, accessed via an ‘in context’ link within the new SystmOne EPR.
Integrating ePMA in mental health
Devon Partnership NHS Trust (DPT) had a vital requirement to implement an Electronic Prescribing and Medicines Administration (ePMA) system and integrate to an intelligent medicine cabinet. This sounds simple enough, but with their original PAS system unable to support the implementation, the project required a Trust Integration Engine to be rapidly deployed, to facilitate the data exchange and support the transmission of Admit, Discharge and Transfer (ADT) messages. As a result of real collaboration with the Trust, full rollout of the solution was achieved on schedule for all inpatient wards at the mental health trust.
The implementation of ePMA contributed to improved operational efficiency at DPT. Clinicians now find their tasks streamlined, saving valuable time when prescribing and administering medicines. The shift from manual to digital has increased transparency, with a noticeable reduction in missed tasks. Vast improvements to reporting and plans to introduce a comprehensive dashboard overview are now on the horizon.
“The work with ReStart delivered integration to reduce burden for staff, increase the consistency of data and improve the quality and safety of the care and treatments we offer”. Rafael Sorribas, Chief Information Officer, Devon Partnership NHS Trust
Epic support across Devon
With the Royal Devon University Healthcare NHS Trust having opted for Epic’s EPR solution, neighbouring Trusts; Torbay and South Devon and University Hospitals Plymouth NHS Trust, have both selected Epic as preferred supplier for their electronic patient record systems.
The Trusts will no doubt be grateful of advice and guidance from the Royal Devon, however they also recognise the need for specialist support for such a strategic and transformational project. With experience in supporting the recent Epic roll out across multiple Trusts in London, ReStart were asked to offer specialist services for the pending South West projects.
ReStart’s technical team will offer interoperability services including technical, integration and development services to support the Trusts. The deployment of Epic will require the migration of existing data and ongoing integration of system wide data, to give staff a complete overview of a patient’s care record and support a joined-up approach to care through access to more accurate data, in real-time.
ReStart has worked with 49% of NHS Trusts, providing 24/7 integration support to 20% of Trusts and currently working in over 50% of ICS’s. ReStart’s team of interoperability experts and solutions connect healthcare leaders to support patient care across all regions.
Health tech from the South West: snapshots from the past year
Let’s take a look at some of the news and updates ICSs and trusts across the South West.
In Cornwall and the Isles of Scilly, progress has been made on launching an EPR programme at Royal Cornwall Hospitals, with ongoing collaboration planned with clinical teams and the trust’s supplier, Oracle, over the next 18 months prior to expected launch in spring of 2025.
Cornwall Partnership NHS Foundation Trust also recently announced an update on the progress of its virtual wards programme in winter of 2023, highlighting that capacity has grown to 212 patients, and that 1,900 patients were treated through the programme over the course of the year, saving “more than 16,500 inpatient days in hospital” according to estimates. The trust also launched a partnership with Accexible and BoxHealth for the pilot of a “digital system that identifies vocal biomarkers for disease detection and monitoring”, using voice recognition to detect early stages of cognitive impairment, and working on models to detect conditions such as Alzheimer’s and stroke.
The last 12 months has seen the continued rollout of the Devon and Cornwall Care Record across multiple partners in Devon and Cornwall, including social care organisations, the 111 service in Cornwall, and the two independent ophthalmology surgical units who undertake work for the NHS. The opening of a new HealthTech Research Centre (HRC) as a result of £3 million in funding from the NIHR, is also hoped to bring new opportunities for research and innovation.
Devon Partnership NHS Trust went live with TPP’s SystmOne Mental Health EPR towards the end of 2023, and One Devon ICB announced the launch of patient-facing tech including the HANDi paediatric app, and the Lumi Nova app supporting children and young people’s mental health.
In Dorset, virtual wards continue to play a role in the ICS’s ambition to allow more eligible patients to recover in their own home. NHS Dorset announced in June that it has partnered with Inhealthcare to launch the Oncology Monitoring @ Home service, aiming to help patients manage their symptoms at home. Through the service, patients undergoing chemotherapy and immunotherapy treatment are supplied with devices such as pulse oximeters and blood pressure monitors. They are asked to submit regular observations for analysis and complete a questionnaire on their symptoms three times a week, with clinicians able to take action if the patient-submitted data falls outside expected parameters.
Looking to Gloucestershire, we reported that a lab was opened by the University of Gloucestershire and Gloucestershire Hospitals NHS Foundation Trust, with the aim of exploring how “innovations like wearable technology and artificial intelligence can be used to help the NHS”. We also recently noted that NHS Gloucestershire has announced free access to app designed to help combat anxiety for children aged seven to 12.
In Somerset, the publication of Somerset NHS Foundation Trust’s digital strategy strategic data themes in February of 2024 revealed a focus on four core principles of predict, prepare, prevent and improve, setting out planned actions including providing training for staff on predictive modelling, developing tools so that front-end users can create their own data dashboards; and developing early warning systems designed to help reduce risk to patients and to monitor pressure and capacity across the ICS.
On preventative care, NHS England shared toward the end of 2023 that AI solutions are being deployed across NHS with the aim of identifying patients at risk of hospital admission, so that teams can provide preventive care in the hopes of reducing pressure on A&E. In Somerset, four GP practices are trialling an AI system designed to identify patients at risk of admission, those with complex needs or those who rarely contact their GP so that the practices can reach out to these individuals with the offer of preventive care, such as providing links with a local voluntary group to combat loneliness or putting in support to avoid falls.
Do the ICSs have digital representation on their boards?
We set out to find out more about the make-up of the South West ICS’s, using publicly available information to see which ICS boards currently have digital representation.
Whilst it’s worth pointing out that some members of the board may have digital backgrounds or skillsets not mentioned on ICB websites, from our research it appears that five of the seven ICSs from the South West region currently have digital representation on their board: Bristol, North Somerset and South Gloucestershire; Cornwall and Isles of Scilly; Dorset; Gloucestershire; and Somerset.
Notably, Bristol, North Somerset and South Gloucestershire ICS is alone in having two members of its board offering digital representation, with Professor Steve West CBE as a non-executive member covering finance, estates and digital; and with Deborah El-Sayed (interviewed by HTN here) as chief transformation and digital information officer.
Progress on virtual wards in the South West region
Over recent months, HTN has been exploring the progress made around virtual wards via the data released on a monthly basis from NHS England.
So where do the South West ICSs place?
According to the most recent figures from March 2024, the South West ICS registering highest for virtual ward capacity per 100,000 members of GP-registered population aged 16 or over is Cornwall and the Isles of Scilly with 41.9. This means that the ICS is meeting NHS England’s original aim that ICSs should achieve between 40 and 50 virtual ward beds per this figure, by December 2023. Gloucestershire is almost at that mark according to the March figures, with a reported 36.1 beds per 100,00 people. The average capacity across England for this period is said to be 23.1, with further two of the South West ICSs exceeding this; Dorset with 23.6, and Bath and North East Somerset, Swindon and Wiltshire with 23.3.
Regarding occupancy of those virtual wards, Gloucestershire comes out on top with 81.4 percent occupancy, followed by Somerset with 81.3 percent, Devon with 75.4 percent and Bath and North East Somerset, Swindon and Wiltshire with 57.1 percent.
Click here to access the statistics on NHSE’s website.
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