Primary Care Region Series: East of England
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 East of England region, where we cover digital strategy from integrated care boards, insights from professionals in the region, and market trends.
Digital strategy for primary care
Bedfordshire, Luton and Milton Keynes
In March, BLMK ICB shared that the ICS’s data and digital strategy is set to be reviewed and approved by the board in September 2025. The ICB noted the importance of digital tools such as the NHS App in empowering patients, increasing engagement, and streamlining bookings. In June, the ICB also highlighted that bonus capital of up to £1.5 million is expected to be received “following submission of a balanced budget”, with the draft plan for allocation of these funds to a range of GP and IT estates projects endorsed by the Primary Care Delivery Group and Primary Care Commissioning and Assurance Committee.
The board noted some important takeaways for primary care from the draft BLMK Infrastructure Strategy in June, which focuses on seven priority areas including hospital and primary care estates and digital infrastructure, “emphasising maximising existing assets and securing external funding where available”. Also included are plans to revise primary care prioritisation criteria, developed with population health intelligence, which will “guide project selection based on need, achievability, and equity”.
Herts and West Essex
Herts and West Essex ICB plans to deliver on its ambitions to 2029 by strengthening professional development and career pathways for AHPs in primary care and “continuing to embed new models into business as usual”. On referral optimisation, the aim is to develop a referral management service or process designed to improve patient access to planned care specialties. It also highlights the need to focus on reducing digital inequalities and to support patients in self-managing health concerns using signposting of relevant services, the NHS App, and websites.
Cambridgeshire and Peterborough
Cambridgeshire and Peterborough’s Joint Forward Plan for 2025-2030 outlines the ICB’s plans to harness digital tools to improve access, efficiency, and self-management, to mitigate against digital exclusion, and to make better use of data for population health management. A digital software solution called JOY will form a central hub for services, enabling choice and ensuring access for everyone to “good quality information and training”. Remote care and links to community, primary and secondary providers’ EPRs is hoped to further empower patients to own their own healthcare journey. The ICB also pledges to support the partnership model of general practice to allow “agility and early adoption” of innovation.
In March, the Cambridgeshire and Peterborough board shared the draft outline business case for the Digital Enablers Programme (Digital Front Door), citing intentions to align with the 10 Year Plan and to tackle digital exclusion by providing equipment to the public where required. It highlights that capturing access to primary care will be a “key measure” of performance, and that the programme has been designed to be “complementary and aligned with the NHS app development”.
Mid and South Essex
In January, an update from the Mid and South Essex board offered highlights from the Primary Care and Alliance Report noting “significant rollout of increased digital tools” that support the total triage approach. It also noted “significant progress” in the use of digital tools in general, with “136/145 practices using Accurx (including 65 percent using Floreys, 90 percent using SMS and 48 percent using booking functions)”, and with “the majority of practices” in the region regularly using tools such as eConsult and Patchs. The report also pointed to plans for a promotional campaign which will commence shortly to help boost public awareness of Modern General Practice, total triage, and self-referral.
In May, the ICB shared findings from its 10 Year Plan Insight Report, which included feedback from focus groups on the move from analogue to digital. These reportedly indicated general support for the integration of digital tools in the region to enhance accessibility and convenience. Increased use and functionality of the NHS App was also “welcomed in general”, although the ICB noted concerns around AI, data security, and digital literacy. Priorities for the ICB following this feedback cover the implementation of an EPR with standardised access, AI integration for diagnostic support and data analysis, robust security and privacy measures, and a “multi-channel communication system” to support diverse access needs.
Norfolk and Waveney
Norfolk and Waveney’s board shared its Joint Forward Plan for 2025/2026-2029/2030 in March, outlining primary care resilience and transformation as one of its core ambitions for improvement. The vision for future primary care includes plans to build on Pharmacy First, using available data to understand and prioritise population needs, identifying opportunities for working at scale, and sharing systems and processes. The ICB also highlights upcoming work to explore the potential for digital solutions to help improve the collaboration between primary care and hospital specialists to promote timely and effective referrals.
Suffolk and North East Essex
In the most recent meeting of the Suffolk and North East Essex board in March, the region’s Digital Monthly Bulletin offered insight into ongoing projects and priorities across the system. Pilot areas for EpicCare Link in primary care have been agreed, and go-live preparation is underway. According to the programme timeline, the testing and readiness phase should be completed by June 2025, with training due to take place from July to September, followed by go-live in October.
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 >
News on digital in primary care
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”.
NHS England has announced the approval of a core primary care clinical IT system through its Tech Innovation Framework. Marking “the first of a new generation” of EPRs for GPs, Medicus Health has been approved with more supplies expected to be approved imminently. The suppliers in the programme are said to deliver cloud-based solutions, that can be used on a variety of different devices, with an aim to help to integrate primary care with other care settings. To be approved through TIF also requires the solutions to integrate with the NHS App, the e-Referral service, and the electronic prescription service.
A large-scale public engagement report commissioned by NHSE on building and maintaining public trust in data use across health and care has been published, focusing on the approach to creating a single patient record and the secondary use of GP data. Policy recommendations around these findings state that decision-making should move to “a model that balances the need for national consistency and regional responsiveness”, with participants given clear insight into how decisions have been made and with voices of lay people, experts in data security, and GPs represented in the decision-making model.
Patients Know Best (PKB) has announced the national launch of GP data integration with its single patient record platform. The development enables every adult patient in England to store in their PKB personal health record, a copy of the data their GP has released. Following a soft release in May, over 900,000 patients have chosen to store their GP record in PKB, the company stated, adding how this “underscores significant public demand for having their health information in a single, unified record”. The service, accessible via NHS login, helps to empower patients by bringing together their health data into one secure, patient-controlled record.
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. It’s the first national capital fund for primary care estates since 2020 and forms 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.”
A panel discussion in January 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.
In June, HTN was also joined by a panel of experts from across the health and care system to discuss how best to harness data for total triage, covering successes, challenges, learnings, and best practices. Panellists included Ananya Datta, associate director of primary care digital delivery at South East London ICB; Asad Ashraf, GP and digital clinical lead at North East London ICB; and Devin Gray, GP and clinical lead for digital first programme at Wandsworth GP Federation.
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.
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.
Access to primary care in the East of England region
Bedfordshire, Luton and Milton Keynes
The Bedfordshire, Luton and Milton Keynes (BLMK) board summarised progress highlighting that all 84 practices would have cloud-based telephony installed by the end of the year, and the successful launch of Pharmacy First with over 33,000 consultations being delivered since January 2024. Work is still underway, according to the board, on increasing NHS App registrations, with 53 percent of residents currently registered against a target of 60 percent.
The ICB is undertaking a “proactive practice visit programme”, visiting each of the system’s 84 practices to provide support for transformation efforts, and reviewing elements of quality and safety, leadership and culture, and activity and outcomes data. “More than 50 percent of practices have now launched versions of ‘Total Triage’ with the remainder planning to launch by 31st March 2025,” it states. “Early feedback is positive from both residents and the workforce.”
In June, the board noted progress with making more appointments available and expanding capacity with the help of Pharmacy First, discussing the need for continual improvements in triage and further integration of community pharmacy to “ease general practice pressure for low acuity and complexity presentations”.
Herts and West Essex
The Herts and West Essex ICB Primary Care Committee shared an update on PCARP delivery in November 2024, citing more than 60 percent of practices hitting the milestone of having more than 90 percent of their patients with online access and records access enabled; rising to 83 percent of practices who report more than 80 percent of patients have online access.
Reportedly, 62 percent of the population aged 13 and over have an NHS App account, and logins were placed at 1,501,859 in October 2024, an increase of 88 percent on October 2023. For Pharmacy First, the ICB states that 97 percent of community pharmacies have signed up to provide services as of 6 November 2024.
Cambridgeshire and Peterborough
An update on PCARP was offered by the Cambridgeshire and Peterborough board in November 2024, covering Q1 and Q2 of 2024/25. The ICB reports that NHS App views are “increasing week-on-week”, with monthly views of 543,070 in September and monthly prescription orders of 70,109. Although more work is deemed to be required on self-referrals, it states, “benchmarking against a self-referral rate per 100,000 population per month, NHS Cambridgeshire and Peterborough ICB rate of 559.7 is 109 above the national rate of 450.7.” For registering with a GP online, the ICB reported that over 80 percent of “appropriate” practices were registered for the online service, but 18 practices had yet to sign up.
A “positive trend” in the number of patients managing appointments online was highlighted, with a 14.6 percent increase since the beginning of 2024. On the primary – secondary interface, the update noted the need for further work on a directory of community services for all providers to improve referral pathways into the community, with the Digital Enablement Group to lead on this work to ensure links with relevant IT systems. On discharge summaries and outpatient letters, it states more work is required on standardisation and making digital platform processes “more consistent, failsafe and enabling”.
In an accompanying board report the ICB also summarised: “Nationally, in 2023/24 all 11 commitments were achieved and for 2024/25 the 10 commitments are on track, there are some areas where there is more to do including pharmacy first and digital infrastructure. Online registration is at just over 60 percent and CBT and digital telephony there is a focus on quality improvement of data going forward.”
Mid and South Essex
In Mid and South Essex’s meeting of the board in March, the ICB offered an update on primary care, indicating that a new primary care strategy is expected later in 2025, and committing to actions including continued focus on PCARP and on supporting practices to use digital tools and new triage approaches. “The Connected Pathways Team continues to make significant progress in the implementation of the Primary Care Access Recovery Programme,” it states. “Progress has been made on the use of digital tools with the majority of practices in Mid and South Essex regularly using tools such as Accurx, eConsult and Patchs. The ICB Executive Team recently approved the continuation of investment in these tools, which are critical to delivery of modern general practice, via digital access funds.”
In the ICBs Primary Care and Alliances Highlight Report, three areas of PCARP were marked as “achieved”: cloud-based telephony, self-referral pathways, and total triage. Communications, digital tools, patient experience, pharmacy/optometry/dental, and staff satisfaction are marked as “on track”. All practices have a cloud-based telephony system in place, with 142 practices regularly using one or more digital tools to support patient management, and utilisation of these “significantly” increasing in 2024/25. The development of “Frontline”, a tool to help direct patients to other local services that may better meet their needs, is also highlighted, with the ICB sharing that in January 2025 it supported the signposting or referring of more than 3,000 patients.
Norfolk and Waveney
A report on PCARP and the primary-secondary care interface was offered by Norfolk and Waveney ICB during its May meeting, reviewing progress at year end. Key findings include that 58 percent of GP patients aged 13 and over have now registered to use the NHS App and “a significant increase” in appointments booked via the app in January. “The range in appointments being booked via the app by GP surgery is extensive,” it notes, “with 3 surgeries showing 0 appointments, to a surgery that has seen 37,605 appointments booked since the NHS App functionality was implemented.” In March, there were 1,009,983 logins for the NHS App, and it was also used to order 114,162 repeat prescriptions. All practices are using the national online registration system developed by NHSE, and two are taking part in an automation pilot for online registrations to test direct integration between the “register with a GP surgery” service and GP IT systems.
Other updates offered include for Pharmacy First, where the ICB reports seeing a 145 percent increase in the use of the service since February 2024, and 167 of 170 pharmacies signed up. For cloud telephony, it highlights that 30 GP practices have moved from “sub-optimal phone systems” to cloud-based telephony, with a further 20 receiving feature upgrades to their existing digital or cloud-based systems to comply with requirements, and 36 migrating to the GP Voice platform. As of March 2025, all practices had enabled prospective records access.
Norfolk and Waveney also outlines next steps, indicating that in line with the GP Contract 2025/26, 19 of 20 PCNs have declared their online consultation forms are available for patients to make admin and clinical requests “at least for the duration of core hours”. The Primary Care Commissioning and Digital Teams will work together to identify gaps in delivery and support practices to deliver contractual requirements around functionality of GP Connect. This includes allowing read-only access to patient records, and enabling community pharmacy registered professionals to send consultation summaries into the GP practice workflow.
Suffolk and North East Essex
In November, the ICB outlined plans for 2025/26 around community pharmacy, looking to “facilitate a wider provision and greater activity of clinical services through local community pharmacies, with a particular focus on increasing the availability and uptake of the Primary Care Access Recovery Plan services; Pharmacy First, Blood Pressure Check & Contraception services”. It set out the aim to have over 90 percent of the region’s community pharmacies providing these services each month.
