Primary Care Region Series: Midlands
Welcome to our primary care region series, where we explore the latest on digital and data in primary care from each of the seven NHS regions in turn. In this instalment, we turn our attention to the Midlands region, covering digital strategy from integrated care boards, updates on recovering access to primary care, and insights from across the sector.
Access to primary care in the Midlands region
Birmingham and Solihull
Birmingham and Solihull’s board offered a PCARP delivery update in May, highlighting improvements made in modern general practice access, including with digital telephony, remote access, and automated call routing. 100 percent of practices are live with cloud-based telephony, the update states, which can be integrated with clinical systems to make tracking patient interactions easier and to improve workflows.
“Performance has been above plan since October 2024, providing assurance that the number of GP appointments delivered will remain above the planning target into 2025/26,” according to the update. Headline figures on appointments from April 2024 to February 2025 show 8,473,279 appointments against a target of 8,213,672 (3.2 percent or 259,607 appointments above plan). During the same period, 159,761 Pharmacy First consultations were completed across the region.
Black Country
An update from Black Country’s board in May noted ongoing work to continue to improve quality and access to primary care. An MDT approach is being taken to support practices with implementing the standards of modern general practice, it states, whilst further improvements have been made to underpin the processes for quality improvement.
“Good progress” has reportedly been made throughout the year on implementing modern general practice. According to the update, 43 percent of practices have now been signed off in line with local criteria, with the remaining 97 practices signing an MoU to agree to continue work throughout the coming year. 65 percent of practices have also successfully implemented online consultations throughout core hours.
The ICB shares plans for primary care in 2025/26 and beyond, outlining the intention to establish and develop the primary care workforce and transformation unit. The aim of the unit is to support new ways of working and deliver a work programme focusing on access, long-term conditions and unwarranted variation. A PCN estates programme for 2027/28 will look at reconfiguring space and maximising e-booking systems.
Coventry and Warwickshire
In November, a draft of Coventry and Warwickshire ICB’s Primary Care Strategy was presented to the board, reaffirming commitments to continue to support primary care and general practice resilience and to develop support offers for practices and PCNs. PCARP will be used to baseline activity and provide support, the strategy states, with reporting focusing on patient empowerment through the NHS app, self-referral pathways and community pharmacy. It also looks at implementing modern general practice access; building capacity; and cutting bureaucracy to reduce workload across the interface between primary and secondary care.
According to the strategy, a PCARP group has been established to ensure an integrated approach, reporting in to the ICB’s primary care group on key metrics and deliverables, as well as providing regular reporting to the finance and performance committee and to the board. This will allow all partners to be “sighted on the initiatives and progress identified but also the challenges and risks against the backdrop of sustained and significant demand”, it notes.
Derby and Derbyshire
In Derby and Derbyshire, the ICB shared in a performance report from March that PCARP work is “on target”, being combined with the new GP clinical model developed by General Practice and agreed by the ICB to create a sustainable model that will improve access for the long term. An accelerator programme has been launched and 13 PCNs have submitted applications for the programme (15 projects in total), with projects including long-term conditions coordination at scale, and work to minimise hospitalisation amongst the frail and elderly. “As of Month 10 there is a forecasted position of 96 percent spend against the ARRS budget for 24/25,” it states.
Herefordshire and Worcestershire
In a PCARP update contained within Herefordshire and Worcestershire’s Five Year Joint Forward Plan for 2025/26 – 2029, the ICB focused on key outcomes from year two. This included 80,000 more appointments per month being provided than pre-pandemic levels, 100 percent of practices having implemented the modern general practice access model, 100 percent of practices using cloud-based telephony, and online consultations averaging “around 70,000 admin or clinical contacts per month”.
Bureaucracy has been reduced as part of the “red tape challenge” event in December 2024, whilst a primary care liaison officer is in post to work across the system on any barriers to facilitate change and improve capacity and patient care, the ICB highlights.
Leicester, Leicestershire and Rutland
Leicester, Leicestershire and Rutland shared an update on PCARP in February, detailing impacts including a 184 percent increase in patients accessing digital services online, a month-on-month increase in appointments, and a recent scheme where the top ten practices in LLR for patient experience are buddying with practices that are not performing as well. Work is also ongoing with the communications and engagement team to educate the public about the digital offer, and “this now needs scaling up”, according to the update.
Over the coming months, the ICB plans to focus on improving the use of digital prescription ordering, with information on this service to be included in local authority newsletters sent out to all households.
Lincolnshire
Lincolnshire ICB updated on progress around PCARP in November, highlighting the rollout of digital telephone systems with advanced functions, improvements of GP practice websites, the development of online tools such as AskMyGP and AccuRx, work on modern general practice access, and support for PCNs on delivering Capacity Access Improvement Plans. Work has also been done on digital inclusion and the local rollout of Pharmacy First and extended community pharmacy services, it states. 100 percent of GPs now offer online repeat prescription ordering, online access to records, and online appointment management, the update continues, whilst 49 percent of the population are registered to use the NHS app.
Next steps include exploring the potential for a single telephony system county- and system-wide with a central call centre, sharing learning on total triage approaches across practices, the promotion of online opportunities to patients, the development of care navigation roles in practices, and work on a local impact assessment of the General Practice Improvement Programme aided by digital phone data.
Northamptonshire
An update from the board in June noted key achievements from PCARP in Northamptonshire, listing full achievement against Capacity and Access Improvement Plans, full compliance for online patient registrations, and a total of 7,111 Pharmacy First consultations for 2024/25. Plans to the end of year two include empowering patients by rolling out tools promoting self-management, implementing Modern Day General Practice, building capacity, and cutting bureaucracy.
Nottingham and Nottinghamshire
In February, a report on Access to General Practice prepared by Nottingham and Nottinghamshire ICB for Nottingham City Health Scrutiny Committee included an update on PCARP delivery to October 2024. This shared that 58 self-referral pathways have now been identified nationally to be explored locally. It also showed that over 95 percent of community pharmacies are now registered for Pharmacy First, all practices have made the move to cloud-based telephony and have an online consultation tool in place, and that online consultations increased by 39 percent over the 12 months prior.
According to its Delivery Plan 2025/26 shared in May 2025, by March 2026, the ICB aims to have a minimum of 80 percent of practices with more than 40 percent of registrations using the national online registration service, implementing modern general practice models, and achieving compliance with website national guidance. It also hopes to increase the number of online consultation and triage appointments recorded in GPAD.
Shropshire, Telford and Wrekin
An update on the year-to-date position and anticipated end-of-year position for PCARP was shared during Shropshire, Telford and Wrekin ICB’s November meeting. An increase of 260 percent on previous year-to-date figures was seen on NHS App record views, alongside an increase of 58 percent on NHS App repeat prescriptions. 90 percent of PCN practices were recorded as meeting CAIP payment criteria for implementing modern general practice access, and online registration was available in 100 percent of practices.
“From the information provided in this report it can be demonstrated that there have been significant improvements made by practices across the county in both the first and second years of the program,” the update states. “Appointment numbers have increased, more, different staff are available to patients and patients can use different ways of accessing and managing their care.” Areas of focus for the future are identified as self-referral pathway expansion and promotion, and the interface between primary and secondary services.
Staffordshire and Stoke-on-Trent
Staffordshire and Stoke-on-Trent ICB published a Recovering Access to Primary Care Improvement Plan in November 2024. It shares progress made on self-referral pathways and highlights figures including 96 percent of practices now using digital telephony systems, and GP practices achieving the 90 percent target for people accessing their own patient records, booking appointments and ordering repeat prescriptions through the NHS app.
Looking ahead, the ICB plans to focus on investing in its people and culture, building improvement capability and capacity, and embedding improvements into management systems and processes.
How Restore Information Management increased clinical space and enhanced patient care for practices
A key challenge often faced by staff in general practice is that of physical space. Appointments have been recorded manually on paper for many decades, and for busy practice staff, this can lead to the time-consuming process of having to visit a storage space to locate a particular patient record. Unstructured data is also an issue, which makes it more difficult for clinicians to access the information they need, when they need it, and detracts from the usefulness of data for things like population health management.
There can also be significant financial implications associated with this approach, with space within the practice used to store records when that space could be better used for caring, sometimes leading organisations to look at hiring physical storage elsewhere. This then leads to further costs relating to accessing and sharing files, which practices also need to take into consideration. There are challenges with the vulnerability of paper records, both physically given their delicate nature and in terms of security, with greater risks of GDPR breaches or loss of information.
There can be knock-on effects for patients, too, given the length of time that the retrieval of documents or information on a patient’s history can take, particularly if that information is currently held by a different provider. This can mean delays for patients, or errors in patient care in the event of a miscommunication; and there are additional financial and security implications from having to post papers securely to the appropriate location.
Oxfordshire (which has since formed part of Buckinghamshire, Oxfordshire and Berkshire West ICB) approached the Restore Information Management team with similar challenges.
Initially, the plan was to store the records at box level, capturing records in range order with a view to keeping the costs minimal. However, Restore Information Management identified that this method could lead to additional costs further down the line as a result of potential difficulties with maintaining a full audit trail. Following discussions to pinpoint the best and most cost-effective approach, Oxfordshire CCG opted to document each patient record individually.
Importantly for the organisation, records had to be retrievable at all stages. To minimise costs, practice staff boxed up the records, capturing the start and end range on each of the boxes before they were transported using one of Restore Information Management’s GPS-tracked vehicles to their secure facilities at Upper Heyford. A data capture of the box range on initial entry into the storage facility was performed, which allowed access during the data entry stage, and then Restore began the process of capturing the name, NHS number and date of birth of each patient, uploading the data to the Records Information System. Access to this was granted to each practice via Restore’s online portal, RestoreWeb, which allowed oversight of what records had been stored and enabled requests for retrieval.
The results? Processes and systems were set up within agreed timeframes, enabling practices to free up much needed space for patient care, and improving employee experience. Sarah Harwood, senior commissioning manager for primary care at the CCG, described how initial discussions enabled the development of a contract for the work to be undertaken, with Restore Information Management also contributing to a responding Data Protection Impact Assessment, supporting the CCG with information governance, and helping to identify risks. “They have been hugely accommodating,” said Sarah, “extremely responsive to any issues that have arisen and very easy to work with.”
In particular, Sarah noted: “Feedback from the practices who have been involved with the project has also been positive.”
Click here to find out how Restore Information Management can help free up clinical space in your practice >
Digital strategy for primary care
Birmingham and Solihull
The ICS’s March board meeting share key insights into progress and plans around the Shared Care Record, where the system celebrates reaching 100 percent of practices “who are now live across BSol and able to access the Shared Care Record”, and a focus in general practice on improving productivity “including use of digital”.
Coventry and Warwickshire
Coventry and Warwickshire ICS’s digital, data and technology aims to 2028 cover plans for streamlining efforts including a single EPR and standardised IT systems, along with a focus on removing barriers to digital inclusion. Ongoing work is also identified around equipping the local population with tools like the NHS App to help them stay well, and collaborating with GP practices on promoting digital access to health records for patients, online registration, and appointment bookings.
An update from May’s board meeting shares key priorities for 2025/26 such as continued investment in general practice leadership skills, support for service transformation, a greater focus on workforce planning, and ensuring general practice has the skills required to deliver both today and in the future.
Derby and Derbyshire
In January, Derby and Derbyshire ICB shared plans to implement digital triage in primary care, with procured framework suppliers and rollout beginning. The ICS’s March board meeting offered an update on progress and priorities for 2025/26, including a focus on opportunities for “sharing and learning about AI”, on digital inclusion, and around data sharing. It also highlighted progress made on the Empowering General Practice Programme, with the board acknowledging the need to work on population stratification, the PCN/LPA accelerator programme, and integrated neighbourhood and place working.
Herefordshire and Worcestershire
Digital work in Herefordshire and Worcestershire focuses on the Shared Care Record, the NHS App, and the “My Health and Wellbeing” patient portal. The Joint Forward Plan as set out by the board in May’s meeting identifies priorities around integrated neighbourhood teams, workforce, estates and technology investment at neighbourhood level, and creating conditions to better manage patient demand for primary care. In particular, it points to plans to engage in at-scale solutions to utilise digital technology in improving access, to target unwarranted variation, and to continue with left shift activity designed to remove unnecessary workload for GPs.
Leicester, Leicestershire and Rutland
Leicester, Leicestershire and Rutland ICB published an update on digital progress in the region, noting plans to publish a new digital strategy for 2025–2028. The potential for the LLR care record to ensure increased usage is also considered, whilst Ian Wakeford, CIO, notes, “there will be more data available for staff to access” to support patient care. Use of the NHS app has reportedly “reduced front door attendances within primary care”, with a trial of AI also taking place using digital champions within PCNs to help teams focus on equity of care.
In April, the board highlighted plans and progress around the WorkWell programme, designed to focus on early intervention and support, serving as a pathway to local services and reducing health inequalities through economic prosperity. In general practice, data sharing is listed as “a key area to address”. A total of 21 PCNs have reportedly joined the programme to date, with 19 of those already onboarded and a further two in progress.
Lincolnshire
In Lincolnshire, the focus is on ease of access, self-help and self-management, the increased use of technology to deliver effective health and care services across the community, and maximised uptake of Digital Care Records. A meeting of the board in May showcased current measures in place to ensure public involvement in the development of primary care services, including a co-production group and public engagement on an Enhanced Access Hub.
Northamptonshire
The board shared in February plans to review the ICS Digital Strategy in 2025 and listed some key priorities. This included “embedding AI and digital solutions to enhance efficiency and triage”, making full use of digital tools to drive the shift from analogue to digital, ensuring that all providers “proactively offer” NHS App communications, and that GP practices have enabled “all core NHS App capabilities”.
In June’s board meeting, an Operational Plan 2025/26 update noted key transformation priorities for the coming year to include continued primary care transformation and the development of neighbourhood models. A focus on improving access points to local plans to address unwarranted variation and targeted commissioning. Elsewhere, a bid with ECMA to pilot primary care triage has been approved with the aim of going live in September 2025.
Nottingham and Nottinghamshire
The Digital Notts strategy to 2028 focuses on collaboration and data, with objectives aimed at establishing a digital leadership programme, launching digital workforce passports, fully digitising social care, promoting the use of remote monitoring and virtual wards, and supporting AI innovation and the integration of AI-driven diagnostics.
In March, the ICB highlighted the need to further develop care navigation across primary care, whilst progress from 2024/25 was identified as including the deployment of cloud-based telephony and the piloting of robotic process automation (RPA) for document management across primary care. A reported 99 percent of practices are now enabled with online consultation tools, whilst 75 percent are enabled via the NHS App. Record access has been 100 percent technically enabled across primary care, with 78 percent of practices reporting that record access is now allowed for 90 percent or more of their patients.
Shropshire, Telford and Wrekin
Shropshire Health and Wellbeing Board published an update on progress toward the ICS’s digital strategy, highlighting “key accomplishments” since March 2024, such as all GPs successfully implementing the EMIS clinical system and efforts to upgrade critical network infrastructure.
In March, a meeting of the board shared ongoing work around piloting a connection between EMIS and the ICB’s operational pressures escalation levels platform (SHREWD) to provide an automated feed of data and present a “more dynamic” understanding of the pressures in primary care. April’s board meeting reaffirmed primary care access as a main priority for the ICB, also noting the aim to work with primary care to provide a more appropriate service offer to patients other than the ED by November 2025.
Staffordshire and Stoke-on-Trent
Staffordshire and Stoke-on-Trent share through a dedicated webpage details on work on digital across the ICS, outlining digital initiatives including EPR, cyber security, infrastructure, digital learning, digital inclusion, automation, and more.
As part of March’s board papers, a chair and CEO report shared the impact of multidisciplinary primary care acute urgent access hubs, which have reportedly provided 2,600 additional urgent appointments per week since December 2024. In January, a board meeting highlighted that a proposal for locality and neighbourhood development with the involvement of PCNs, the development of integrated neighbourhood teams, and the intelligent use of population health management and other data, had been “progressed through various Boards and is supported by the VCSE and local councils”.
News on digital in primary care
For HTN Now we considered how general practice, PCNs, and ICBs can utilise data and leverage technology to support operational efficiencies and improvements across primary care. Panellists included Kathryn Salt, assistant director of primary & community care, data and analytics for the Transformation Directorate, NHS England; Dr Shanker Vijayadeva, GP lead, digital transformation for the London region at NHS England; Dr Sheikh Mateen Ellahi, GP and practice partner at ELM Tree Surgery and South Stockton Primary Care Network; and Max Gattlin, digital consultant at X-on Health.
HTN’s Primary Care Awards celebrated innovations, solutions, case studies, collaborations and projects helping to shape future services and systems across health and care. The awards highlighted excellence in digital primary care across four categories: Partnership of the Year, Digital Solution of the Year, Case Study of the Year, and Improvement Initiative of the Year. A digital awards ceremony announced winners and runners up across each of the categories.
A recent poll on our LinkedIn page asked the question, what do you think should be the biggest priority for digital primary care – patient-facing digital tools, interoperability, funding to support innovation, or back office efficiencies? With 39 percent of the vote, patient-facing digital tools came out on top. Coming in a close second was interoperability with 38 percent of the vote, with interest from GPs, practice managers and pharmacists.
NHS England has opened a preliminary market engagement notice, inviting suppliers to take part in introducing a market to digital primary care, offering solutions for procurement by ICBs and approved agencies across the UK. Part of NHSE’s Transformation Directorate, it follows the previous engagement for the GP IT Futures Framework, with the aim to ensure “streamlined access to innovative digital solutions” within healthcare. Proposed solutions should be “reflective of healthcare professionals’ needs”, as shown through research and user engagement, while also enhancing current solutions in development or those that are “already assured for marketing on the DSIC catalogue”.
Over 1,000 GP surgeries are set to receive a share of £102 million as part of the government’s Primary Care Utilisation and Modernisation Fund, the first national capital fund for primary care estates since 2020, and part of a series of measures announced to increase support for primary care. According to the announcement, the funding will support primary care to either enhance the use of existing infrastructure or to create additional capacity. It notes, “from creating new consultation and treatment rooms to making better use of existing space,” it states, “these quick fixes will help patients across the country be seen faster.”
