NHS South West London (SWL) ICB’s latest board meeting for September has highlighted its “significant work” around bringing digital, workforce and estates together under a single Infrastructure Strategy, and shares updates on the finalised SWL Urgent and Emergency Care Winter Plan for 2024/25, the ICB’s plan for urgent and emergency care, and the Board Assurance Framework.
The plan sets out aims for this winter around increasing capacity, improving productivity, enhancing patient flow and outcomes, and continuing to develop services that “shift activity from acute hospital settings to settings outside an acute hospital” for unplanned urgent care needs.
For hospital at home and virtual wards, the plan puts current capacity at the equivalent of 415 beds over the winter period, with an aim of reaching 425 by March of 2025, covering both step up and step down pathways capacity. Challenges identified in this space the ICB notes include optimising bed utilisation and overcoming financial constraints for future need.
SWL plan for urgent and emergency care
Digital and data is interwoven into the ICB’s plan for urgent and emergency care for 2024 – 2026, which is centred around four themes: accessing urgent and emergency care, patient flow and discharge, supporting and developing the workforce, and productivity and efficiency.
In terms of access to urgent and emergency care, the plan highlights the development of the 111 service model, including the implementation of digital solutions to support call handling and enhance the booking of patients into the “most appropriate” services. ED front door steaming is also to be supported by digital tools to help staff book patients into alternative services.
On patient flow and discharge, digital is expected to help improve discharge planning by enhancing communication across system partners and helping staff access and capture patient information including Discharge Ready Date (DRD). Digital is also key in promoting patient choice, with digital tools hoped to support earlier discharge by ensuring the ability to assess care home capacity and packages of care “in a timely manner”.
For the workforce, digital technology and continued investment in digital tools is included as an “enabler” for access to services and “enhancing processes to assist the workforce in their roles”, improving efficiencies to help reduce stress and pressure, and allowing access to digital communications to support staff in their job roles.
As far as productivity and efficiency, the plan notes the need to develop a demand and capacity model to help ensure patients are treated in the right place and at the right time, considering how to maximise the use of digital tools and technological enhancements.
Board Assurance Framework
As part of the ICB’s Board Assurance Framework, the risk of interruption to clinical and operational systems as a result of a cyber attack is considered, with a high “inherent risk score” of 20 [/25]. Reasons given for this high score include insufficient resources to support monitoring and risk management, and the need for “a more defined cyber strategy” focusing on things like critical risks, vulnerability management, and “better oversight of supplier risks”.
Progress made to reduce this risk includes the completion of a system-wide cyber assessment to understand “the overall security posture of the providers and ICB GP IT”, the development of governance structures to support ongoing collaboration in identifying and mitigating cyber risks, and the appointment of an ICS-wide cyber lead to manage the implementation of risk reduction strategies.
The target risk score under this header is given as 6, to be achieved by 30 September 2025. The framework sets out required actions in order to meet this ambition, such as the development of a SWL ICS cyber strategy and implementation plan, the modernisation of cyber risk management, incident response and asset management practices, and the standardisation of cyber training and awareness across the system.
Another area where digital is to have an impact in SWL is in modernising and fully utilising estates, where the inherent risk score is also high, at 16. The framework highlights digital transformation as a way of reducing the need to expand the estate. To date, the ICB shares that an “effective data collection exercise is underway” to help understand priorities and requirements, including opportunities to make better use of digital technologies.
The role of data in SWL
Data is highlighted as a potential challenge within SWL ICB’s plans for the coming years, with winter preparations for same day emergency care affected by “ongoing issues with consistent data reporting” due to technical issues with hospital IT systems, and with preparations for patient flow affected by variability in data quality across the ICS, including “significant inconsistency in how data is recorded and reported”. The plan also states that there is “more to do” when it comes to data access to support discharges.
To read the board papers in full, please click here.
Digital transformation in the capital: spotlight on London
HTN has covered a number of different stories and updates from the capital over the last month or so, including the publication of a report from South London Listens, an initiative bringing together two integrated care systems across the capital as well as three NHS mental health trusts and a range of other partners, highlighting the role of digital in driving change to tackle health inequalities.
In North West London, the ICB’s commitment to start publishing monthly summaries identifying involvement with local residents and communities, including data on digital reach and health survey responses, has highlighted the “digital reach and impressions” of citizen engagement channels including the ICB website. North London Mental Health Partnership also shared plans to procure a digital local risk management and incident reporting system, with interested suppliers requested to complete a questionnaire by 18 September.
A new plan for collaboration is also underway between the Royal National Orthopaedic Hospital Trust and University College London Hospitals NHS Foundation Trust, who have announced plans to work together on Epic’s EHR, which is expected to be rolled-out at RNOH in November of 2025.
