The Northern Care Alliance NHS Foundation Trust’s latest board meetings in January and March, to see what insight they offered on ongoing digital transformation projects, digital priorities, innovations, challenges, and more.
Approving NCA’s EPR business readiness and business plan is listed in the trust’s objectives for the year, as part of the principal objective to prepare infrastructure, systems, and processes “that work towards improvement in population health and continue to work with partners to address health inequalities”. As part of the board assurance framework, the trust also sets out controls currently in place including an infrastructure remediation and an EPR transformation programme, and gaps in control that could be filled to mitigate risk associated with digital systems sustainability, noting the need for a “multi-year investment plan aligned to infrastructure and application roadmap”. Risk score here remains “high” at 20, with a target risk score of 9.
Andrew Stallard, senior responsible owner for the EPR programme, shared an update highlighting delays “primarily due to extended timelines for obtaining outline business case approval from NHS England” and concerns that these delays could “increase the overall cost and pressure on resources within the organisation”. Risks are also outlined around ensuring organisational readiness for “a complex digital transformation”, and limited capacity within the digital team. The programme’s current focus is on readiness activities, the update continues, to include mapping applications and aligning projects like the electronic document management system; whilst next steps involve refining the programme’s governance and ensuring “the readiness of key systems”.
In a programme update on NCA’s digital infrastructure remediation work, the trust shared that seven projects are “progressing well”, including working with suppliers to complete project phases prior to implementation. For Wifi optimisation, delivery is reportedly “well underway”, with hardware delivered to relevant sites for deployment; the business case for a project looking to make a strategic upgrade to Windows 11 has been approved and moved into delivery phase; a project looking to implement a new on-premises and cloud backup and recovery platform has been successful and is entering the closure phase; and work on platform re-engineering remediation has moved to a delivery phase.
The trust’s January meeting also shared a report from its research and innovation committee which highlighted challenges around recruiting and retaining clinical coders, an area where NCA is “hampered by digital limitations and the reliance on coders being on site due to the heavy reliance on paper systems”. Referring to this as “a developing problem”, the papers go on to note that whilst agency staff could be used to keep the trust moving, “as other trusts were modernising their electronic patient records, they were recruiting more coders”.
A challenge for the trust relating to the population health agenda, as brought to the board’s attention by Lorna Allan, CDIO at NCA, is reportedly that initiatives in this space require “a patient record on an effective digital footprint”. Whilst Lorna confirmed that “discussions were being held around the development of an appropriate data strategy and use of artificial intelligence”, she added that there was “significant work needed to progress this agenda”, suggesting a need to “revisit what could realistically be achieved in relation to the population health objective”.
Elsewhere, a report from the quality and performance committee noted the impact of a “lack of data and digital visibility” around dates of discharge on forward planning, with plans to discuss the potential for greater visibility to be achieved using current digital systems. And in a report from the research and innovation committee, the “age and scale” of the data centre server estate is listed as a “cause for concern” due to a third of 1,900 servers already being unsupported and a further third to “age beyond supported software versions each year over the next three years”.
A further update is also offered by the board in March around digital systems sustainability, with the trust sharing that good progress has been made, and that discovery work has been undertaken around enterprise architecture. Also, recruitment is ongoing for solution architects and data architects, although the expensive nature of this specialist skillset means the organisations is “exploring creative ways to onboard experienced and creative people into these roles”.
We covered NCA’s first digital strategy back in October, setting out plans up to 2030 for the future of digital within the organisation in areas in areas including self-care, remote monitoring and access to records. The strategy focuses in particular on the next three years, with the aim of establishing the foundations for a “safe and more effective NCA”. These foundations are to be achieved primarily through the implementation of a single EPR solution across all acute hospitals, with a targeted go-live in 2027. Additionally, NCA plans to establish a single community services EPR intending to strengthen NCA’s connectivity to its places; this programme aims to commence in 2025. Once these foundations have been achieved, the trust expects to gain “greater clarity regarding the transformational opportunities that exist and will form the basis of an iterative and evolving digital strategy”.
Digital progress and priorities from across the NHS
For a recent HTN Now webinar, we were joined by a panel of experts to discuss the role of digital in supporting NHS reform – modernising services, shifting from hospital to community, and supporting the move from reactive to proactive care. We welcomed Dawn Greaves, associate director of digital transformation at Leeds Community Healthcare; Ananya Datta, associate director of primary care digital delivery at South East London ICS; and Stuart Stocks, lead enterprise architect with Aire Logic. Panel members shared their insight and experience from a wide range of digital projects, highlighting what worked well and their learnings; how their organisations are currently tackling key challenges such as capacity and demand, and managing waiting lists; and balancing risk with innovation.
Developing digital infrastructure is a key facet of South West London ICS’s latest digital strategy for 2025 – 2028. It notes actions to be taken on digital infrastructure, to include establishing expert digital teams and developing digital competence, implementing systems and processes that are effective, and consolidating systems to reduce duplication. It adds developing a consistent, robust, and secure digital infrastructure to cover cyber security and effective information governance, and ensuring interoperability and value for money of system procurements, as well as levelling up provider digital maturity.
An update from Chris Ibell, CDIO at Staffordshire and Stoke-on-Trent ICB, highlighted the system’s focus on cyber security, outlining the cyber risk to its organisations, and sharing plans to focus on an integrated care system approach to incident response planning. The update follows a cyber crisis simulation event, ICB board development sessions and cyber security workshops over the past year. The cyber simulation event identified 22 actions, the update notes, focusing on processes, plans, and the need for colleagues to “continue to embed an ICS approach to threat mitigation and incident response”.
