Digital health and data across the ICS regions in 2024: East of England

East of England ICS region series

Our regions series continues with a deep dive into what’s happening with digital and data across the East of England, covering Bedfordshire, Luton and Milton Keynes ICS; Hertfordshire and West Essex ICS; Cambridgeshire and Peterborough ICS; Mid and South Essex ICS; Norfolk and Waveney ICS; and Suffolk and North East Essex ICS.

So far in our ICS region series, we’ve explored digital and data in the Midlands, South West, North East and Yorkshire, and London.

Digital strategies

Firstly, let’s consider how many of the integrated care systems in the East of England have a publicly-available digital strategy.

From our research, the answer – for the first time – is that all six ICSs in this region have one in place.

Bedfordshire, Luton and Milton Keynes’s digital strategy for 2022 – 2025 is available here, and focuses on five key themes: a resident-first approach; using digital as an enabler to providing “better care” across the ICS; putting data at the heart of decision-making; looking for new ways of delivering personalised care; and working in collaboration to “improve the health and care” provided.

Cambridgeshire and Peterborough’s digital strategy for 2023 – 2026 can be found here, with aims of improving outcomes in population health and healthcare, tackling inequalities, enhancing productivity and value for money, and helping the NHS support “broader social and economic development”. Strategic priorities also include using tech to “optimise health and care services”, maximising the efficiency opportunities presented by digital, putting in place the right digital foundations to “hold and protect residents’ data”, and ensuring the workforce has “the right skills and training to be confident in using digital”.

The digital strategy for 2022 – 2032 from Hertfordshire and West Essex can be found here, and focuses on collaborating to “maximise the opportunities to coordinate system wide digital solutions”; bringing together information and data from all care settings to help improve the health and wellbeing of the local population; using digital tech to help “keep people well in their homes” and to address demand and capacity; encouraging “targeted investment and digital innovation at the front line that has potential scaleable benefits”; and improving inclusion and access through digital and building a digitally confident workforce.

Mid and South Essex’s digital strategy has been in place since 2021 and is available here. The digital vision is aimed at providing “digital and data solutions that drive insight led decisions, support our workforce and enable better outcomes for residents”. To achieve this, the strategy sets out six key areas of work: prioritising prevention and wellbeing; focusing on service pathways; elevating and prioritising clinical and professional leadership; letting residents, patients, service users and staff lead in order to achieve better outcomes; to be resident-centric at system, alliance and neighbourhood level; and to develop standards, define outcomes and set common clinical and professional policies to guide safe, high quality and responsible services.

Over at Norfolk and Waveney, the ICS’s digital strategy is based on the vision of developing “a fully integrated digital service” across the region. Underpinning this vision are the ICS’s commitments to using digital systems to help people access their health and care records easily; to using tech to support clinical and strategic decision making; to improving system-wide IT services to enhance safety and reduce duplication; to supporting people to maintain health and wellbeing through digital solutions; and to investing in “the infrastructure and technologies needed to help drive improvements to services and provide better care”.

Finally, Suffolk and North East Essex’s digital strategy for 2023 – 2028 forms a part of the ICS’s Joint Forward Plan, and can be found here. It incorporates two of the 12 core functions of the ICS: leading system-wide action on data and digital, and ‘using joined-up data and digital capabilities to understand local priorities” and drive continuous improvement in performance and outcomes. Priorities include developing a common digital front door, enabling support for the workforce to “thrive in a virtual world”, supporting an approach to digital care technologies and remote care to increase capacity, and establishing a “linked data set platform that will provide data insights for a range of purposes”.


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

Insights from the East of England

Adam Lavington, director of digital transformation at Hertfordshire and West Essex ICB, told us that the main digital priorities at present for his ICB are around investing in “proven technology” in areas including supporting care in the community, offering more same day care, and reducing pressures on A&E. Examples include increased information sharing and falls prevention/detection technology in care homes, and digital telephony in primary care and virtual wards. The ICB is also prioritising elective recovery and reducing waiting times, “investing in technology that improves and shows patient flow in our hospitals”; and focusing on empowering patients with patient portals “enabling patients to be informed, make choices, and take ownership of their own care.”

When it comes to digital projects, Adam shared that he is particularly proud of the ICS’s work on developing a “very mature” shared care record, “with all providers connected and sharing data including providers in Cambridge, Essex and London to name a few”, and with the record “passing one million views in the last few weeks”. Adam said that this is “transforming care and triaging patients to the right care setting, saving time by reducing unnecessary tests, and keeping patients informed much faster than was previously possible; not to mention saving lives.” Adam also highlighted progress around digital social care records, with over 80 percent of the ICS’s social care providers now using a digital care record, which he credits with “improving care, increasing recording of incidents, reducing paper, and improving data collection compliance.”

Over the next 12 months, Adam told us that whilst progress and priorities are dependent on funding, aims include “new replacement patient records in two acute hospitals, pushing more uptake and usage of the NHS app capabilities, and implementing advanced care plans for a yet-to-be-agreed cohort, subject to funding approval”. He added that the ICB also intends to “deploy acoustic monitoring devices to care homes and have a new data platform enabling us to use data to commission services and manage population health.”

From Mid and South Essex ICS, main digital priorities as featured in the ICSs digital strategy are around “digitise, connect, and transform”. A representative from the ICS told us: “At its core, the strategy emphasises collaboration across all parts of our health and social care system, including acute community, mental health, primary care, and the VCSE sectors.”

The ICS is prioritising digital initiatives which make a difference to the collective health and care provision across Mid and South Essex and its borders; improving “the commonality of solutions and their ability to communicate with each other, thereby better catering to the needs of the workforce and population”; and “driving up digital maturity in line with the ‘What Good Looks Like’ framework”.

To achieve “such fundamental transformation”, the ICS “must prepare for the future and ensure our digital foundations are robust. This involves modernising software and operating systems, reducing the number of systems in use, resolving networking challenges, improving WiFi coverage, and introducing modern telephone systems. Additionally, enhancing our cybersecurity at both organisational and system levels is critical. These enhancements will help us meet our future goals and deliver better care for our residents.”

What digital progress so far inspires particular pride in Mid and South Essex? A key component of the ICS’s digital strategy is the upcoming launch of the region’s shared care record, which “will bring together key information from various health and social care records into a structured and easy-to-read format”, and provide professionals with a holistic view of a person’s clinical and care history, “facilitating better connected care and safer treatment”. The ICS also highlighted implementing a unified EPR as “one of the most significant clinical transformation programmes across Mid and South Essex NHS Foundation Trust and Essex Partnership University NHS Foundation Trust”, with “significant progress” being made in setting up the EPR programme for success, and “the intention of going live with our new EPR in 2026/27”.

Plans for the future include reducing the number of duplicate systems and paper-based processes, standardising and automating processes, making progress on a new patient portal, and introducing Athena, described as “an ICS-wide strategic data and analytics platform” which “uses cloud-based technologies to integrate separate data sources into one system, creating a single source of truth” and supporting population health management, decision-making and care delivery.

Bedfordshire, Luton and Milton Keynes (BLMK) ICS shared priorities around their data strategy, which will see “healthcare staff across primary care, hospitals, community and mental health services have an improved level of health data available to them”, through rolling out the region’s shared health and care record and making improvements “to the way we analyse and report data”. According to the ICS, the data strategy “will help to identify those people with greater health and social care needs” as well as supporting self-care and making care “more tailored to the individual”.

BLMK added that work around digital “is also about supporting our teams to do their jobs, making the best use of our resources, and making it easier for services and care providers to work together”, with websites and apps supporting patient access and software and tools providing staff with more time to focus on care.

Sharing some of the digital projects from the past year that the region is particularly proud of, the ICS highlighted the Share For Care project”to enable health and social care professionals across Bedfordshire, Luton and Milton Keynes to share a single digital health and care record about each person they care for”. The ICS is also planning to share patient information, where relevant, with health and care providers outside Bedfordshire, Luton and Milton Keynes, with Milton Keynes University NHS Trust already sharing data with providers who are part of the London Care Record, including providers in Hertfordshire and West Essex.

Digitising social care has also been a focus in the past year, with focus on to “reducing the chances of residents developing serious health issues that require a hospital stay” through “remote monitoring, increased use of digital records and falls prevention”. Through case studies, videos, newsletters and an annual conference, “local care providers have engaged with the programme and implemented a number of tools and systems – benefiting staff and residents alike”.

On the future of digital health in the region over the next 12 months, the ICS shares that its Enhanced Wellbeing Through Digital programme “will offer technology to support adults to live independently, reduce avoidable hospital admissions/re-admissions, and improve care quality and safety”. This will include the use of PainChek, an electronic device designed to help identify and manage pain for those who are unable to communicate it verbally by measuring small changes in facial expressions and voice to quantify a pain score. Additionally, “around 1,300 care home residents will be provided with a robotic companion to provide comfort and decrease loneliness” with the Robopets innovation providing “a calming influence”, and giving people “greater independence and confidence”, as well as hopefully improving mental health and wellbeing.

In a statement from Mark Stanton, chief information officer at East and North Hertfordshire NHS Trust, the trust’s use of the Alertive app is highlighted as a significant development in the use of digital technology, offering “a new way for clinicians to receive emergency messages through a mobile phone application”.

Mark said: “Using Alertive, users will be able to send urgent notifications to their colleagues when they need support, enabling them to instantly provide more information about a patient’s condition than is currently possible through a bleep. We expect Alertive to improve communication between staff by providing a clearer and more concise messaging service for teams and departments across the Trust, supporting more collaborative and aligned patient care.”

Cambridge University Hospitals NHS Foundation Trust shared details of two major projects from the last year, including a collaboration between GigXR, Cambridge University Hospitals and the University of Cambridge Faculty of Education on “medical training using mixed reality technology”. This is designed to help healthcare professionals looking to enhance their clinical skills to “use holographic patients to practice high-level, real-time decision making and treatment choice”. Training modules include emergency scenarios and deteriorating chronic conditions that lead to hospitalisation, focusing on “the responses and human factors needed to provide accurate care”.

The second project highlighted by the trust is the use of AI in tackling waiting times for cancer patients, with the OSAIRIS solution enabling specialists to “plan for radiotherapy treatments approximately two and a half times faster than if they were working alone, ensuring more patients can get treatment sooner and improving the likelihood of cure”. By outlining the organs in a process known as “segmentation” which usually takes doctors “between 20 minutes and three hours” per patient, the solution saves clinician time.

Case study: ReStart in the East of England

For more than 10 years ReStart has been working with NHS trusts in the East of England, including The Queen Elizabeth Hospital King’s Lynn NHS Foundation Trust, James Paget University Hospitals NHS Foundation Trust, East & North Hertfordshire NHS Trust, Norfolk & Norwich University Hospitals NHS Foundation Trust and Norfolk and Suffolk NHS Foundation Trust with specialist migration work to support the implementation of integration engines from third party suppliers.

Integration to support personalised care at Norfolk and Norwich University Hospitals NHS Foundation Trust (NNUH)

As part of the NHS Elective Recovery Programme, ReStart supported Norfolk and Norwich University Hospitals NHS Foundation Trust (NNUH) with the delivery of Patient-Initiated Follow-ups (PIFU). ReStart’s technical expertise was selected to support the NNUH in-house team with specialist integration work with Infinity Health and DrDoctor.

The approach aligned with patients having greater participation in their care and engaging in shared decision-making with clinicians. The integration of PIFU interfaces at NNUH went live in 2022, ahead of schedule. Currently 20,000 patients have access to the hospital’s patient engagement portal, which accounts for approximately 11 percent of follow-up waiting lists for PIFU. Adopting a collaborative approach enabled patients to manage appointments and communicate with their care provider, supporting the prevention of health condition development and, in turn, optimising clinician time to enhance elective care recovery. This achievement translates into enhanced outcomes, increased patient satisfaction and a significant reduction in Did Not Attends (DNAs).

A single source of patient information for Norfolk and Waveney ICB

In 2023 Norfolk and Waveney ICB selected ReStart to provide interoperability expertise for the first two phases of their Shared Care Record (ShCR) deployment. Integrating mental health data from Norfolk and Suffolk NHS Foundation Trust (NSFT), followed by the sharing of patient data from three acute trusts, James Paget University Hospitals NHS Foundation Trust (JPUH), The Queen Elizabeth Hospital Kings Lynn NHS Trust (QEH) and Norfolk and Norwich University Hospitals NHS Foundation Trust (NNUH). This latter stage also included the provision of documents from urgent care provider IC24 (Integrated Care 24), to the new Shared Care Record.

Stacey Cairns, Digital Project Manager, Norfolk and Waveney ICB explains: “With ReStart’s existing acute relationships, they were able to quickly get the integrations in place and support the flow of information for us. ReStart has saved the day for us on more than a few occasions.”

As part of the solution, ReStart helped each trust to prepare multiple backloads of historic data types (patient demographics, Discharge Summaries, ePrescribing etc) to populate the Shared Care Record at launch. This involved careful manipulation of the data flows to ensure the integrity of the patient journey within each healthcare setting was maintained, bringing messages in sync with real-time events. Over 10 million messages were successfully extracted from the individual trusts, queued in a central integration engine (CIE), before releasing securely to the Shared Care Record.

All of this was made possible by ReStart’s longstanding partnerships with the care providers as well as InterSystems, the supplier of the ShCR solution. Stacey further comments: “ReStart give us assurance about our data, making sure it is accurately labelled and available for InterSystems so they can display it correctly. They take their time with our partner organisations, during daily and sometimes nightly meetings.”

The interoperability is supported 24/7 with ReStart monitoring all clinical interactions across the individual integration engines in each care setting as well as supporting the CIE. Through proactive monitoring of heartbeats, message queues and more, ReStart maintains the ongoing health and performance of every organisation.

Interoperability and shared data for combined trust

In April 2020 the new Bedfordshire NHS Foundation Trust was formed following the merger of Bedford Hospital NHS Trust and the Luton and Dunstable University Hospital NHS Foundation Trust. The combined trust services include A&E, obstetrics-led maternity and paediatrics.

Core to the trust’s digital transformation was a single source of real-time information to support both clinical and administrative roles. Following a long-standing partnership with Bedfordshire hospital, the combined trust continued to work with ReStart to replace limited point-to-point integrations between systems with HealthShare Health Connect, trust integration engine (TIE). The TIE was expanded to include radiology, cardiology and pathology reports, as well as bi-directional interfaces between PAS for both ED and maternity wards. More recently, clinical documents and cancer data have been added. Over 40 systems are now integrated through the Bedford TIE.

The trust has also added ReStart’s interoperable clinical record to provide staff across the trust with rapid access to patient information.  The clinical record architecture is inherently scalable – with no need for an expensive or time-consuming data repository development, information is simply pulled on demand from various systems. This has enabled Bedford Hospital to add new systems rapidly to the clinical record and scale up to deliver a greater depth of patient information throughout the trust. Using the single-sign-on staff have access to up-to-date patient information throughout the trust – from test results to medication, outpatient appointments to consultant letters.

According to Dean Pates, IT Systems Integration Manager at the trust, “We are already sharing our pathology results from our TIE with East & North Hertfordshire NHS Trust and we are currently in discussion with some neighbouring organisations about data sharing to overcome cross-county border limitations to enable better shared service delivery.”

ReStart deliver integration and data migration projects for health and care; supporting a number of systems including Rhapsody, Ensemble and Health Connect integration engines. They have vast experience in developing data interfaces for systems such as Cerner, Lorenzo, McKesson, IPM, Epic, CaMIS and System C.  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 solutions connect healthcare leaders to support patient care across all regions.

Learn more about ReStart.

Health tech in the East of England: snapshots from the past year

Let’s take a look at some of the news and updates ICSs and trusts across the East of England.

From Bedfordshire, Luton and Milton Keynes, we reported on the news that Milton Keynes University Hospital went live with a new digital tool for jaundice and announced a new collaboration with Milton Keynes City Council, EXI, Apple and Loughborough University. This project aimed to help tackle diabetes through use of technology and financial incentives.

Over in Cambridgeshire and Peterborough, news from the last year has included a collaboration between Cambridgeshire and Peterborough NHS Foundation Trust’s Wellbeing Hub and game makers to develop a video game for an accurate representation of psychosis; whilst Cambridge University Hospital’s new strategy has highlighted the role of digital and tech in improving care and developing targeted services, virtual wards, patient portals, and more.

In Hertfordshire and West Essex, some of the top stories from the last year include the ICB’s work with Hertfordshire Local Area Partnership on a SEND (special educational needs and disabilities) Improvement Plan and digital dashboard on SEND provision and quality; the ICB’s award of a three-year contract for its digital mental healthcare service for children and young people; and Princess Alexandra Hospital’s award of a £28 million contract for the Cerner EPR system. We also covered the launch of a digital patient hub at East and North Hertfordshire NHS Trust; and a new AI assistant and digital library at Hertfordshire Partnership University NHS Foundation Trust.

For Mid and South Essex, we wrote about the commissioning of the new patient portal, and the publication of Mid and South Essex NHS Foundation Trust’s digital strategy at the end of last year. We also spoke with the chief executive of Mid and South Essex, Matthew Hopkins, on implementing a system-wide EPR; and with Preeti Sud, director of strategy and innovation at Mid and South Essex NHS Foundation Trust about her insights on change management and digital strategy.

From Norfolk and Waveney, we highlighted how the ICB announced plans to develop a new service to support digitally excluded patients and its inclusion in the second year of the Clinical Entrepreneur Programme Innovation Sites (InSites) programme, designed to bring together NHS provider organisations to test innovative ways of patient care and evaluate them in real-world settings. Norfolk and Waveney Acute Hospital Collaborative also announced procurement for its electronic patient record supplier across three acute trusts, whilst Norfolk and Norwich University Hospital went live with their new shared care record.

Finally, in Suffolk and North East Essex, we recently spoke to Stephen Bromhall, chief digital information officer at East of England Ambulance Service NHS Trust, to talk about recent digital projects and priorities and the way that digital is being used to make improvements across areas such as workforce, operations and patient engagement. The trust has also announced plans to launch a digital education management system to “improve the tracking, reporting and development of our clinical workforce”. Elsewhere in the region, East Suffolk and North Essex NHS Foundation Trust awarded a two-year contract for EPR implementation support in April 2024.

Do the 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 two of the six, Hertfordshire and West Essex ICB and Mid and South Essex ICB, have specific representation for digital and wider transformation.

For Mid and South Essex, chief digital and information officer Barry Frostick offers digital representation, whilst in Hertfordshire and West Essex, director of digital transformation Adam Lavington brings with him to his role on the board “20 years’s IT experience in a range of roles in the private sector and health and social care settings”.

Virtual wards

In terms of how each of the six ICSs in the East of England region are performing on virtual wards, we took a look at the most recent statistics for April.

When it comes to capacity per 100,000 of the adult GP registered population, Bedfordshire, Luton and Milton Keynes ICS is the top performer, with 31.8 virtual ward beds. Next up is Hertfordshire and West Essex ICS with 30.3; then Cambridgeshire and Peterborough ICS with 19.6.

Regarding occupancy rates, three of the ICSs reportedly have a rate of more than 80 percent, with Suffolk and North East Essex ICS coming in first with 88.8 percent; then Cambridgeshire and Peterborough ICS with 86.8 percent; and Hertfordshire and West Essex with 80.8 percent. Of the remaining three, Mid and South Essex ICS reportedly has an occupancy rate of 79.4 percent; whilst Norfolk and Waveney has 78.3 percent; and Bedfordshire, Luton and Milton Keynes has a rate of 70.8 percent.

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