Digital health and data across the ICS regions in 2024: Midlands

In the latest edition of our feature series exploring the digital and data landscape of each ICS region in England, we’re turning our attention to the Midlands.

You can find the three editions we’ve already published here – London, North East and Yorkshire, and the South West.

There are 11 integrated care systems in total coming under the Midlands banner: Birmingham and Solihull; Black Country; Coventry and Warwickshire; Derby and Derbyshire; Herefordshire and Worcestershire; Leicester, Leicestershire and Rutland; Lincolnshire; Northamptonshire; Nottingham and Nottinghamshire; Shropshire, Telford and Wrekin; and Staffordshire and Stoke on Trent.

Digital strategies

How many of the 11 integrated care systems have a specific digital strategy, separate from wider strategies, that is publicly available?

According to our research, the answer is five. Black Country ICS’s digital strategy spans 2021, 2022 and beyond with focus on three key commitments: co-production with communities, partners and workforce; collaborative working; and keeping learning at the heart of the approach. We also heard from the ICB that the development of their 2023-2026 strategy is driven by three pillars – digitise, connect and transform – based on the foundations of the What Good Looks Like framework. Over the coming weeks, the ICB is planning to complete the recently-released digital maturity framework assessments to support them in carrying out a gap analysis of the strategy and milestone plan.

Derby and Derbyshire ICS’s digital strategy was published in 2022 and is available here. It highlights priorities including the provision of digital services to improve patient experience, transform delivery models and reduce costs; delivering and extending the shared record programme; developing the ecosystem of digital products and services; supporting and developing citizens and the workforce in digital adoption; and delivering a system-wide approach to population health intelligence.

For Nottingham and Nottinghamshire ICS, the strategy can be found here. There are five programmes underpinning the Digital Notts strategy – public facing digital services, digital and social inclusion, frontline digitisation, interoperability and supporting intelligent decision making.

The digital strategy for Leicester, Leicestershire and Rutland ICS covers 2020-2024 and places emphasis on working with partners, establishing a collaborative approach to population health management, supporting digital self-care, and more.

Northamptonshire ICS does have a digital strategy available, though it has technically just run out as it covers March 2021 to March 2024. Themes include empowering patients, their families and carers; ensuring the basics are in place to provide a solid foundation; connecting systems; providing insight to support decision making; and collaborating for a shared purpose.

Although not a specific strategy available for download, Coventry and Warwickshire ICS has set out aims and priorities on its website. This includes overall aims by 2028 and key focuses over 2024 and 2025, such as detailed baseline assessments and compliance plans linked to the national digital transformation framework What Good Looks Like, and the implementation of a federated data platform to help maximise capacity, reduce waiting lists and coordinate care.

Staffordshire and Stoke on Trent ICS, meanwhile, has recently published their ‘digital vision’ (covered by HTN here a couple of weeks ago), sharing priorities such as the introduction of Your Care Connected, a new digital shared care record. The ICS also shares a roadmap highlighting the different digital systems and products used within the ICS along with plans for the future.


  • Digital strategies 
  • Insights from the Midlands
  • Case study: ReStart in the Midlands
  • Health tech from the Midlands: snapshots from the past year
  • Do the ICSs have digital representation on their boards?
  • Progress on virtual wards in the Midlands region

Insights from the Midlands

From Black Country ICB, we heard insight into the Black Country Connected Programme, designed to “support and enable our population to embrace digital as a means of support.” The programme “supports people to get online by loaning laptops to people with no current access to a computer, helping them learn IT skills and build confidence to access health and wellbeing services and information online, including virtual GP appointments, the NHS App, search/apply for jobs and keep in touch with relatives via phone or video calls.” Recipients are invited to an ad-hoc hub day to collect their device and given one-to-one assistance, with a baseline survey completed upon collection of device and after three months helping with evaluation.

Among survey results from June 2023 and December 2023, Black County ICB found that searches for health information online rose from 25 percent to 42 percent; 47 percent of participants accessed the NHS App regularly in December, as opposed to the previous figure of 33 percent; confidence in ordering repeat prescriptions online has “more than doubled”; and recipients’ confidence in accessing healthcare online has increased by more than 50 percent. Additionally, of those who responded, over 95 percent of participants reportedly stated at the three month stage that they felt more confident using digital devices after taking part in the programme.

Over the next 12 months, Black Country ICB will be looking to “assess our position – the care system is evolving and digital has the potential to lead that change. In the past digital has been seen as an enabler for traditional care processes. We are changing that perception in the Black Country so that digital is seen as a catalyst for change. Care processes need to evolve to keep up with the technological advancements and sophisticated use of data.”

Additionally, the ICB acknowledges rapid growth around emerging technologies such as AI. “Recognising that AI will become an increasingly important innovation in helping to achieve the strategies and objectives of the Health and Social care system, the Black Country ICS Digital programme has established an AI working group that involves members from partner organisations and a range of professions including clinical, digital, operational, governance and intelligence/analytics.”

Dr Penny Kechagioglou, chief clinical information officer and deputy chief medical officer at University Hospitals Coventry and Warwickshire, also provided insights.

“Our main digital priority is the implementation of our integrated EPR system across the three acute trusts in our ICS, starting from UHCW which is going live on 15 June. This includes our citizen portal for engagement, appointment bookings and viewing results and correspondence. Through the implementation of a single EPR incidence, we are looking to enhance our system datasets to be able to embed a population health management approach to health and care,” she said.

What is Penny proud of, with regards to recent digital work within her region? “UHCW has been recognised as a centre of excellence for process mining by NHS England as a result of the collaborative work to improve outpatient flow and citizen engagement, between our trust, IBM and Celonis. We have managed to transform the way we engage with citizens within eight weeks, reducing outpatient DNA rates from 10 percent to 4 percent, bringing waiting lists down, improving patient experience and staff satisfaction. We have managed to sustain this positive impact over the last few months and spread this innovative approach to other trusts,” she highlighted.

Looking to the future, Penny said: “We envisage that over the next 12 months, we will be scaling process mining and genAI to create intelligent workflows, improving productivity and the experience of our staff and patients. Our patient engagement portal will make a positive impact in terms of patient-clinician interaction and our EPR system will enable us to  build the first two data-driven integrated clinical pathways.”

Jane Scarborough, public facing digital services programme and change management lead for Digital Notts shared her thoughts on recent and upcoming digital health work in Nottingham and Nottinghamshire.

“Throughout 2023/24 we have worked hard to increase the utilisation of Patient Engagement Portals, integrated into the NHS App, and one highlight has been the introduction of digital appointments and digital appointment letters for patients to view within their NHS App. For patients, this offers an improved service and more convenient way of accessing appointment information. Early evidence also shows that receiving appointments digitally reduces the number of Did Not Attends (DNAs),” she said. “The introduction of digital outpatient letters has also had a significant impact on both cost savings (reduced postage, printing and paper costs) and carbon savings.  Over the past 12 months, one hospital trust has saved over four tonnes of carbon, which could be scaled quite easily by expanding the use and raising awareness of the availability of digital letters with patients.”

On the recent update to their digital strategy, Jane said: “There is a significant pipeline of digital programmes of work across the ICS, including in primary care, secondary care and working with community providers too.

“The major digital priority and biggest digital investment for 2024/25 across all our trusts is the procurement and implementation of EPRs. A significant amount of planning and business engagement is already underway, to ensure organisational readiness once implementation is ready to start. Staff engagement and development of digital skills is a key component towards organisational readiness.” Jane also discussed the core priority of delivering a shared care record for use across all system partners, adding that they are working towards full implementation by the end of this year.

“Within primary care, our digital focus is supporting the principles of modern general practice; giving patients the choice on how to contact their practice. Digital priorities for this year include continuing improvements in telephony, enabling online services via highly usable and accessible websites and online consultation tools, encouraging patient utilisation of the NHS App. As part of our digital services, we will also be supporting practices to give their patients access to their records.”

Jane continued: “We also have a strong Public Facing Digital Services programme of work and priorities here will focus on driving up patient use of the NHS App, whilst ensuring we maximise the benefits to patients of having the NHS App. For 2024-25 our priorities include extending the use of the integrated Patient Engagement Portal and Patient Held Record, both integrated into the NHS App. We are actively working on ‘Emeet & Greet’ to include a digital patient referral welcome and digitise the pre- and post-op patient engagement journey.

“Finally, the use of data is a continuing priority across our ICS, to support intelligent decision making and enable the system to focus and tailor resources where they will have most impact. Designing interventions that help to prevent ill health and support a reduction in Health Inequalities across the system.”

From University Hospitals of Derby and Burton, chief information officer Will Monaghan shared: “The main focus for UHDB is the transition to a single Electronic Patient Record (EPRs), following NHSE approval in April 2024, work has commenced to replace our two existing EPRs with Nervecentre. Over the next two years we will be working at pace to ensure that all our current systems and processes are upgraded and optimised ready for the full implementation of the EPR. As part of this we will be working on a number of programmes including paperlite, the shared care records for both Derbyshire and Staffordshire, increased development and deployment of automation and the removal of obsolete systems and servers.

Will raised the implementation of single sign-on technology as a project he is particularly proud of, noting that it has allowed approximately 12,000 users to “sign into all of the systems they use on a daily basis, with a simple tap of their smart card, making it simple, easy and more efficient for our clinical colleagues to access, update and record patient notes. Working closely with our clinical teams the project has been successfully completed within the last 12 months, at a time when clinical colleagues have experienced some of the biggest challenges faced in the NHS, however through the use of digital technology we have been able to support them by taking away the need to remember and input multiple logins, freeing up more time to provide outstanding care for our patients.”

What does the future hold? Will shared his thoughts, focusing in on UHDB’s experiences: “We are pleased to be part of the federated data platform development, successfully delivering two elements of this in 2023/24, the Care Coordination Solution and OPTICA, enabling patients to receive surgery quicker and supporting timely discharge respectively.”

Additionally, he said, Badgernet will be launched in June this year to support maternity colleagues, and work to enhance the patient experience portal is is a “top priority in 2024”.

He added: “Working with colleagues across Derbyshire and Staffordshire the focus on the single EPR will increase our focus on eliminating paper case notes across UHDB, the first stage in this process is the continued roll out of our paperlite programme, aiming to reduce the use of paper and move to digital notes for patient care. Both Badgernet and Nervecentre will place patient records in the hands of clinicians without the need for paper, not only does this reduce administration time, it will also support the net zero ambitions of the trust and NHSE.

“Finally, the  use of automation in the trust to support both clinical and administrative functions will be one of the main focusses of our data science teams, providing a real opportunity to provide cash releasing benefits that can be redirected to patient care, reducing waste and improving patient care through efficiencies in time and processes. The ambition for UHDB over the next 12 months is to harness the expertise and talent within our digital and data teams to support our clinical colleagues in providing the best care possible for our patients and families, through the use of technology.”

Case study: ReStart in the Midlands

ReStart has strong ties in the Midlands with data integration solutions at acute hospitals as well as ongoing projects to support the digital progress for the West Midlands Ambulance NHS Trust.

ReStart’s team focus on integration and data migration projects, supporting a number of systems including Rhapsody, Ensemble and Health Connect integration engines. They are experienced in developing data interfaces for systems including Cerner, Lorenzo, IPM, Epic, CaMIS and System C.

Digital handovers to A&E at West Midlands Ambulance Service NHS Foundation Trust (WMAS)

West Midlands Ambulance Service University NHS Foundation Trust serves a population of 5.6 million and responds to 4,000 ‘999’ calls each day, covering over 5,000 square miles across the Midlands.

Working in close partnership with WMAS, ReStart developed an interface to support the automation of patient handovers to A&E departments. WMAS is recognised as a leading digital Trust, however they were keen to make use of their existing Cleric EPR system and integration engine, as this would save significant time and money in achieving a digital handover solution.

Following an intensive plan with tight deadlines, the ReStart team delivered a fully tested A&E interface to WMAS last year. Since November 2023, the team at WMAS have been using the ReStart interface with Walsall Healthcare NHS Trust. Using handheld devices, the ambulance crew capture patient details in real-time which is shared promptly with staff at the acute Trust. Before the ambulance arrives at the emergency department, Walsall digitally receives all the necessary information about the patient. This enables A&E staff to determine and plan the best course of treatment and also saves time on the manual handover of patients.

ReStart will continue to support WMAS with the wider roll out to additional acute hospitals across the region over the coming months.

Support for Epic at Birmingham Women’s and Children’s NHS Foundation Trust (BWC)

In January 2024 BWC signed a contract with Epic to provide the trust’s future electronic patient record  system. The Epic solution is planned to go live next spring and will replace a number of IT systems, including both the Lorenzo and IPM Patient Administration Systems.

In order to achieve the planned go live in 2025, the Trust selected ReStart as an experienced partner to deliver the vital data integration aspect of the EPR project, or following live service commencement.

ReStart has embarked on the project which will use an up to date Rhapsody Integration Engine at the Trust and high availability architecture to deliver the platform for the data migration. A key aspect of the project includes a disaster recovery plan in the event of any issues during the EPR migration.

As well as an in-depth hardware gap analysis at BWC, ReStart is in the midst of the interface communication and functional testing phase of the project. Following this work and key to the success of the integration, is a detailed user engagement and system readiness plan. This is vital to ensuring BWC has the knowledge transfer from ReStart’s expert team and is confident and skilled to deliver this progressive digital solution to support women and children needing vital care in Birmingham.

“The Epic electronic patient record programme is a hugely exciting digital project for Birmingham Women’s and Children’s NHS Foundation Trust and we’re delighted to have taken another step forward by choosing ReStart as our integration provider.”  Christopher Hughes – Deputy Head of IT, Birmingham Women’s and Children’s NHS Foundation Trust   

ReStart has worked with 49 percent of NHS trusts, providing 24/7 integration support to 20 percent of trusts and currently working in over 50 percent of ICS’s. ReStart’s team of interoperability experts and solutions connect healthcare leaders to support patient care across all regions.

Learn more about ReStart >

Health tech in the Midlands: snapshots from the past year

What are some of the main Midlands stories that we’ve covered here at HTN over the past 12 months?

We recently looked at Birmingham and Solihull’s 10-year strategy, which highlights the key role of data in tackling inequalities, identifying opportunities for intervention, and enhancing understanding of areas of shared priority. It looks to the better use of data and analysis as a means of achieving shared objectives such as delivering on integration, building an inclusive workforce, and contributing to the wider determinants of health.

We highlighted a three-year partnership from The Black Country Local Maternity and Neonatal System, which sees the ICS collaborative with ImproveWell, a digital platform designed to use real-time feedback to identify areas for improvement. The solution is to be used in maternity services across the region, providing an avenue for staff to submit their own ideas for service improvements.

From Coventry and Warwickshire we noted how University Hospitals Coventry and Warwickshire has collaborated with tech company IBM and data processing company Celonis to implement an artificial intelligence process mining tool, with the aim of helping the trust to better understand processes and where they could be improved. NHS England funded an eight-week programme to help the trust examine whether their Did Not Attend rate could be reduced, with the trust stating that the use of AI provided “a far bigger picture of our patient demographics” to assist them in this.

Looking to Derby and Derbyshire, HTN reported the news that University Hospitals of Derby and Burton NHS Foundation Trust and Chesterfield Royal Hospital NHS Foundation Trust named their preferred supplier for a joint electronic patient record system. Also from University Hospitals of Derby and Burton, HTN interviewed executive chief digital information officer Will Monaghan to find out more about their digital projects and priorities, as well as their focus on user-centred design. In addition, William joined us in March for a panel discussion exploring the role of the CIO in developing digital maturity and skills, across an integrated care system, and more.

In news from Leicester, Leicestershire and Rutland, we looked into the latest strategy from University Hospitals of Leicester which lists digital and data as enablers of success with a “new continuous improvement approach” planned to drive large-scale transformation. In terms of practical progress, the strategy goes on to share how a new data platform has recently been launched at the trust, reportedly bringing “a wealth of anonymised information together” to support advancements in research, innovation, care planning and the tackling of health inequalities.

On Lincolnshire, we’ve recently shared how Lincolnshire Partnership NHS Foundation Trust has launched a new Virtual Autism Hub, and we covered an update from Lincolnshire Community Health Services NHS Trust on its  virtual ward programme, including that their frailty virtual ward made just under 500 admissions in its first year which reportedly saved more than 2,000 hospital bed days.

From Northamptonshire, we hosted a webinar with digital lead for the ICS Matthew Hutton as he discussed his work developing digital and data skills in the workforce. We also highlighted how Northamptonshire Healthcare NHS Foundation Trust is offering a headset and behaviour training app as a treatment option for patients with depression, with the ‘Flow’ headset delivering  transcranial direct current stimulation treatment and patients using the app to control the headset and monitor progress.

Moving on to Nottingham and Nottinghamshire, HTN covered Nottingham University Hospitals NHS Trust’s announcement of its EPR supplier, and we looked into an insights report from the ICS which highlights the role of digital in delivering access, data in promoting capacity planning, and more. In addition, we shared insights from Jonathan Lee, assistant director for business and finance at Digital Notts, as he discussed the benefits of closer links between digital and finance in healthcare in a blog for HTN.

From Staffordshire and Stoke on Trent, we noted the launch of a pilot project at North Staffordshire Combined Healthcare NHS Trust which sees virtual reality technology used to support staff wellbeing. From the same trust, we reported the launch of PatientAide, an online tool designed to provide patients access to their health documents, and connect personal tech and data from smartwatches; and we covered their Go Digital Go Green’ sustainability awareness week, which highlighted the ongoing partnership between the trust’s digital transformation team and sustainability working group.

Do the ICSs have digital representation on their boards?

Next, let’s take a look to see whether the Midlands ICSs have digital representation on their boards.

We looked at each ICS website to check out the make-up of boards within the region and discovered that six of the ICBs in the Midlands include representation for digital and wider transformation.

Black Country ICB includes a non-executive member for finance, performance and digital; Coventry and Warwickshire ICB, a chief transformation officer; Leicester, Leicestershire and Rutland a chief people officer with a focus on transformation and technology; and Shropshire, Telford and Wrekin ICB includes an executive director of delivery and transformation. Staffordshire and Stoke on Trent actually has two individuals providing representation, with a chief digital officer and an interim chief transformation officer both sitting on their board.

Our research indicates that there are 192 people sitting on integrated care boards across the Midlands, and seven individuals in total representing digital and transformation. In terms of percentages, that makes up 3.6 percent of the Midlands ICBs.

Virtual wards

Let’s take a look at the latest available data on virtual wards from April 2024, to see how each of the Midlands ICSs are performing.

When looking at capacity, Northamptonshire ICS is the top performer with 40.7 virtual ward beds per 100,000 adults in the GP-registered population. Next up is Shropshire, Telford and Wrekin ICS with 31.4; then Black Country ICS with 25.5; and Lincolnshire ICS with 20.6.

When it comes to occupancy rates, two of the Midlands ICSs – Northamptonshire and Coventry and Warwickshire – reportedly have a rate of more than 75 percent occupancy, with 80.7 percent and 77.8 percent, respectively. Staffordshire and Stoke-on-Trent ICS has a rate of 74.7 percent, and two other ICSs, Shropshire, Telford and Wrekin ICS and Herefordshire and Worcestershire ICS, have an occupancy rate of over 70 percent.

Explore the HTN ICS Region Series...