Over the past weeks we’ve been exploring digital and data across each of the ICS regions – from the Midlands to North East and Yorkshire, East of England to the South West, London to the North West. Now, we’re concluding our series by focusing in on the final ICS region: the South East, consisting of six integrated care systems.
Buckinghamshire, Oxfordshire and Berkshire West; Frimley; Hampshire and the Isle of Wight; Kent and Medway; Surrey Heartlands; and Sussex all sit within this footprint.
Firstly, let’s take a look into strategies within the South East. How many of these six integrated care systems have a strategy in place that is publicly available and dedicated to digital?
Whilst a number of the ICSs set out some information with regards to their digital work and plans on their websites, only two of the ICSs appear to have a specific strategy dedicated to this area in the public space.
Buckinghamshire, Oxfordshire and Berkshire West’s ICS digital and data strategy was published in May 2023 and can be found here. It sets out five design principles: to be led by population health data in evaluating investments; to judge the success of the strategy based on the ability to meet end user needs, improve experience and provide digital access for all; to ensure open collaboration to improve collective digital maturity; to adopt common frameworks and standards across the ICS; and to use the ICS’s commercial leverage to deliver best value for money.
The digital strategy for Sussex ICS was also published last year and can be found here. It provides a roadmap of the ICS’s planned actions, with actions for 2024 including mapping unwarranted variation of inequality of digital access within the population and creating a plan to address it; agreeing a system-wide data, information and insight strategy; extending access and services offered through the My Health and Care patient app; and extending the digital service offering, including through use of virtual care tech, care planning, primary care accessibility and self-referral tools. For 2025 and beyond, Sussex aims to drive improvement across all partners with regards to digital maturity, cyber security and digital and data commitments; embed strong digital inclusion practice; co-design, develop and deliver common digital and data platforms and products; and ensure sustainability within the digital services model, working in partnership with communities, academia and the wider industry.
What do the digital priorities within the region look like, and what are some of the projects currently or recently taking place?
To explore these questions, we heard from Liz Pusey, communications manager for the digital team at Portsmouth Hospitals University NHS Trust, which sits under the umbrella of Hampshire and the Isle of Wight ICS. Liz shared that Portsmouth Hospitals University NHS Trust has “invested in a robust digital strategy that aims to deliver simple, secure and interconnected systems and tools that save time and effort, improving our ability to deliver excellent patient care”, with a focus on improving patient and staff experience and supporting the trust to work as efficiently as possible.
She highlighted a particular project in the Maternity Intelligent Automation Transformation Programme, which she said has “improved patient safety and experience when people come into contact with maternity services, delivering better outcomes, particularly in relation to the NHS Fetal Anomaly Screening Programme (FASP). Previously, we were offering combined tests on recommended dates to only 30 percent of women and now that figure is 98 percent.”
Using automation and an app, the trust has also “significantly reduced waiting times for appointments and reduced manual tasks to save approximately 18,000 staff hours per annum. Over 10,100 pregnant people have benefitted from this transformation of service and an average of 250 pregnant people or newborn babies a month have required emergency department care, which maternity services would not have previously been aware of.” This has also helped the staff experience, Liz noted, with staff feeling “better supported by technology, more fulfilled and able to spend more time caring for pregnant people and babies.” The project is currently shortlisted for a Parliamentary Award and since its implementation the maternity service has received its first ‘Good’ rating from the CQC, where the technology contribution has been highlighted as outstanding.
Looking to the future, Liz said that the trust is currently working through a “significant programme of digital improvement, driven by our digital business and digital health teams, which work with services to identify barriers to efficiency and opportunities for digital systems to save time and streamline processes.”
A particular project in progress is that of the patient engagement portal, which allows patients to securely access and manage their appointment information and complete assessment questionnaires, read pre-appointment information and access NHS health and wellbeing information. “Data has shown us that the system reduces call queues, reduces Did Not Attend (DNA) rates by increasing appointment capacity and reduces wait times, demonstrating positive improvements for patients and staff,” said Liz. “With a lot less letters to print, we are also reducing our environmental impact and contributing to the wider trust’s commitment to sustainability. We are working to bring all trust services on board and have had thousands of patients register so far.”
Within the ICB, the trust is also focusing on the national Frontline Digitisation programme, with Liz explaining: “For us this means introducing an EPR and working towards a single solution across all four of the acute hospitals in Hampshire and the Isle of Wight.”
Here at HTN we also recently shared our interview with Ian Roddis, director of digital, data and technology at Buckinghamshire Healthcare NHS Trust. He discussed digitisation at ICB level as part of his interview, saying: “From an ICB perspective, we have a digital team growing in experience of working with primary and secondary care providers. We ’re now starting to build a permanent team around the ICB. As well as the in-hospital journey of digitisation, the ICB will mature as well, which I believe will bring benefits – perhaps procurement advantages, for example.”
Whilst working in a previous role at NHS Digital, Ian was a product lead for a number of squads which included a mixture of data, digital and technology professionals. He explained how the roles tended to be at a high level, which meant they cost a lot. “I think the ICB will give you the ability to build design squads, and user researchers that work across the ICB. No single trust could afford that, but I hope the shared services model will start to bring capabilities and skills, that can be afforded across the ICB. I think increasingly we will see ourselves working as a system,” he said.
ReStart has been supporting health and care providers in the South East for over 10 years, with current projects supporting Hampshire and Isle of Wight, Surrey Heartlands and Sussex ICSs.
Maintaining data flow at Portsmouth Hospitals University NHS Trust
Like many NHS trusts, Portsmouth had a solid IT development team but were often constrained by the demands of maintaining real-time patient data flow between departments as well as external care sources. The Trust had a legacy integration platform which became unsupported so they opted to migrate to InterSystems Health Connect. With vast experience in similar projects, ReStart were selected for Portsmouth’s migration project over a 2 year period which included delivering over 30 interfaces as well as bespoke development.
Chris Pursey, IT Principal Development Consultant at the NHS Trust, said: “Some parts of the migration proved to be tricky, and it was great to be able to give ReStart a call and talk about the technical side of things. We’ve learnt a lot from them, and the more we learn the better we are as a development team. Overall, it’s been a great partnership.”
Sussex Community NHS Foundation Trust
In 2018 Sussex Community required a Trust Integration Engine (TIE) to support access to real-time data across the 6 sites of the Trust. ReStart provided the initial support to deliver the Qvera TIE and over the past six years has worked closely with the integration team on a number of projects.
One of the key projects was a bed management interface for TPP’s SystmOne – this integration enabled data to be extracted on the precise ward location for each patient as well as the tracking admissions and discharges. The Business Intelligence team at the Trust accessed this data to provide a feed to the bed management screens on the wards. This quickly delivered improvements and efficiencies across the Trust.
The TIE also handles data from a vast range of monitoring devices across the Trust including ECG, blood pressure monitoring, bladder scanner. Readings are transmitted in real-time to the TIE and delivered into SystmOne for clinical staff to review at the time of care. This saves time for care staff having all the data in once place and gives patients peace of mind knowing clinicians in the Community Trust as well as their own GP’s have a full view of their update to date health information.
ReStart a UK leading provider of data integration and interoperability to the NHS. Established 20 years ago, ReStart works with 50% of ICSs and provides 24/7 integration support to over 20% of NHS Trusts. With a highly skilled workforce of over 30 full-time technical staff located across the UK, ReStart staff are often embedded within NHS technical teams to support complex interoperability and data migration challenges. They are experienced with integration engines such as Rhapsody, Ensemble and Health Connect as well as developing data interfaces for suppliers’ systems including Cerner, Lorenzo, IPM, Epic, CaMIS, TPP and System C.
Now let’s take a look at some of the digital healthcare news that has arisen from this region over the past few months.
In January we shared that Buckinghamshire, Oxfordshire and Berkshire West ICS was inviting the public to provide feedback on its draft primary care strategy with an online survey provided to garner views. We also reported the announcement that Ronke Adejolu, previously NHS England’s national associate chief nursing information officer, would be taking on a newly developed role as joint CXiO for Buckinghamshire, Oxfordshire and Berkshire West ICB and the NHS South East region. Meanwhile, in December, Buckinghamshire Healthcare NHS Trust launched a new patient portal via the NHS App with the aim of supporting patients to keep track of appointments, clinical letters and pre-assessments.
Last September saw HTN cover the news that Frimley Health NHS Foundation Trust was leading a trial using artificial intelligence in radiology with the aim of enabling more efficient triaging and prioritisation of lung cancer cases, which the trust hopes will help in speeding up the cancer diagnosis pathway and improving patient experience.
From Hampshire and the Isle of Wight, Hampshire Hospitals NHS Foundation Trust’s chief clinical information officer and haematology consultant Dr Tamara Everington joined us last month for a panel discussion on how to take a pragmatic approach to digitising NHS records, where she shared insights into the trust’s digital journey and its role in the national GDE programme.
Looking to Kent and Medway; we were joined earlier this month by Sue Houston (associate operational commander OCC) and Sue Luff (associate director UEC and OCC) from Kent and Medway ICS, for a discussion on the creation of their operational control centre blueprint. Alongside the NHS England blueprinting team, they shared insights into the ICS’s journey in transitioning their COVID incident coordination centre to an operational control centre model, to support the operational response to emerging incidents across regional health and care providers. In November we also highlighted how 3D virtual tours of 13 neonatal units across Kent, Surrey and Sussex have been launched, with the aim of providing families with a way to virtually ‘walk around’, learning more about layout and equipment as well as gaining insight into the neonatal transport service.
From Surrey Heartlands, we noted that a contract with an estimated value of nearly £3 million was awarded in January for a virtual care digital platform solution across the ICS footprint. Also within Surrey’s footprint, in November we noted the announcement from Ashford and St Peter’s Hospitals NHS Foundation Trust that the new post of chief digital information officer would replace its director of digital position, with Dr Jason Bincalar joining the trust from January 2024.
Finally, with regards to news from within Sussex, we recently covered how University Hospitals Sussex has developed a digital system designed to record “comfort checks” for patients receiving end-of-life care, with 3,000 patients supported over the course of a 12-month study and results demonstrating “colleagues promptly and appropriately responding to symptoms and providing patients with an individualised, person-centred end-of-life care plans”. Other news includes Royal Sussex County Hospital launching a new Health Information Point pilot in April with the aim of providing free, confidential health information; and Sussex ICS launching a new digital discharge planner to provide multidisciplinary teams with “immediate access to health information” regarding patients leaving hospital.
According to our research, four of the six integrated care systems have at least one individual with a focus on digital transformation sitting on their boards. Buckinghamshire, Oxfordshire and Berkshire West ICS has chief information officer Victoria Otley-Groom; Frimley has chief transformation officer Sam Burrows; and Surrey Heartlands has ICS chief people and digital officer Michael Pantlin. Hampshire and the Isle of Wight, meanwhile, has two; chief strategy and transformation officer Caroline Morison, and non-executive member Martin Spencer, who brings a background of delivering “large digital and infrastructure programmes”.
Next, let’s look at each ICS’s virtual ward capacity per 100,000 GP registered population, bearing in mind that the original aim was for ICSs to have 40-50 virtual beds per 100,000 by the end of 2023. For this we used the data provided by NHS England here.
The ICS in the South East with the highest score in this area is Buckinghamshire, Oxfordshire and Berkshire West with a reported capacity of 26.9 virtual ward beds per 100,000 GP registered population as of May 2024, followed by Frimley with 26.6 and Kent and Medway with 26.2.
In terms of occupancy of virtual wards, the ICSs all score relatively highly; Buckinghamshire, Oxfordshire and Berkshire West again leads the pack with a reported occupancy of 90.3 percent, followed by Surrey with 89.2 percent, Frimley with 87.5 percent, Sussex with 83.6 percent and Kent and Medway with 77.1 percent.