Hertfordshire and West Essex ICS’s digital strategy is available in text and video format, covering their visions, goals, digital strategy mission and actions for the future.
The strategy opens with a comment from Dr Jane Haplin, CEO and SRO For Digital Transformation Hertfordshire and West Essex ICB. Dr Haplin highlights the ‘What Good Looks Like’ framework in developing their strategy and states: “Better and faster sharing of information between residents, patients and care staff gives residents a better experience and also helps us make services more efficient. Digital tools that capture information or carry out analytical tasks will help increase safety and quality… Our digital strategy is ambitious and forward looking – and we don’t expect the journey to be easy to deliver. It will give us the base to build better pathways for residents now and in the future.”
Visions, goals and principles
The document lays out what the ICS digital strategy focuses on, namely supporting ICS transformation initiatives as needed with ICS-wide solutions that remain consistent with place level; making a measurable difference to the collective health and care provision across the region through common approaches to digital technology; improving the commonality of digital solutions and their interoperability; driving digital maturity; and securing the best value for the ICS through digital investments.
The overall vision is for the ICS to work together for a healthier future, in which teams “come together to deliver an effortless, integrated digital experience without boundaries to improve health and care outcomes for all people”.
The strategy sets out a number of digital principles, split between investment and delivery.
Under investment, it lists a need to prioritise the things that residents and staff need; projects at ICS level should focus on benefits to residents and staff, with benefits explicitly demonstrated and competing projects evaluated against these. Getting the best out of digital suppliers is another priority, with a need to develop and maintain strategic supply relationships at ICS level along with using the same solutions where procurement rules allow and where it makes strategic sense. The ICS pledges to set clear, realistic goals; to ensure the primary aim of digital investment is realistically achievable. Finally, it notes a priority to invest in a dedicated, cross-functional ICS team to maintain focus on the vision and ensure learning and approaches are coordinated.
Under delivery, the principles are to think long-term and deliver in the short-term; to test, measure and learn, with focus placed upon innovating locally and blueprinting models and technology approaches; to set rigorous delivery assurance against business cases and outcomes; and to address digital inclusion and exclusion, adopting a benefits realisation framework and develop digital capability for residents and staff.
Digital strategy mission
The mission is categorised under collaboration; platforms; direct care; innovation; and skills.
Collaboration
Here the ICS states a goal to work together to maximise opportunities to coordinate system-wide solutions, providing the right care at the right time through multidisciplinary teams. “To achieve this,” the document states, “we will work together to adopt a coordinated health and care needs led approach to digital that focuses on local demands, but which is coordinated through place-based digital and care professional networks”. This will include care representatives closer to the resident such as GPs, social workers and pharmacists. “This will enable a broader and more holistic approach to digital.”
Actions already taken include empowering clinical leaders to drive transformation and benefits; investing in time for national Digital Academy training; establishing an ICS clinical reference and practitioner group; and securing an ICS Programme Management Office to oversee clinical workstream programmes.
Plans for 2023 into 2024 include investing in a sustainable and multidisciplinary “office of the CCIO” at ICS level to bring together CCIO professionals and knowledge. The ICS will also invest in digital board education and in digital clinical fellows at ICS levels, along with care professional digital leads for all organisations within the ICS. Finally, they will introduce a quality improvement/benefits realisation method in order to support identification of digital initiatives.
Platforms
The goal is to bring together the “essential connectivity, information, intelligence and data for all care settings”. The ICS plans to build then enhance and optimise key strategic digital platforms that are either needed once at ICS-level, or else will provide a “fully joined up, interoperable landscape of local platforms”.
The ICS states that it has developed a shared care record and continues to evolve it, and delivered high speed connectivity for GPs in collaboration with the Digital Innovation Zone. Other achievements include developing a plan for a system-wide data platform, developing a Child and Adolescent Mental Health Services access point, and designing West Essex and East and North Hertfordshire Care Coordination centres. In addition, West Hertfordshire Teaching Hospitals NHS Trust has implemented an EPR.
Work on a shared care record and interoperable EPRs is set to continue until 2027. In 2023 to 2024, the ICS plans to dedicate attention to shared data platform and population health management technologies, resident access platforms and care coordination centres. Looking to the next decade, the ICS will focus on ensuring that core infrastructure is unified across all health and care in the region.
Direct care
Sharing their goal to use digital technology to keep people well in their homes, offer choice and improve overall life chances, the ICS states: “To achieve this, we will use digital technology at scale to bring care closer to our residents… We will focus on engagement with our users internally and residents in the co-creation of new ways of digital working and make solutions easy to use and with a consistent look and feel.”
The ICS has already mobilised a Digital First for Primary Care programme, piloted virtual chronic kidney disease support for primary care clinicians using digital technology, and is running a number of virtual wards with widespread use of online consultations.
Plans for 2024 and 2025 included developing early assessment and practical support around residents with severe mental illness who may be suffering from dementia; this will take the form of an early memory diagnosis and support service, and remote monitoring for patients with severe mental illness. The ICS lists an ambition for Adult Social Care Falls Prevention to be used to protect 20 percent of care home residents by 2024, and also aims to support better diagnosis for community nurses through a wound care digital app.
Further ahead, the ICS aims to improve resident outcomes and reduce system pressures through expansion of virtual ward and hospital programmes, to further expand online consultations, and to facilitate secondary care advice for primary care clinicians caring for residents with multiple long-term conditions.
Innovation
Here the ICS notes that they will “strive to lead digital innovation partnering with AHSNs, universities and the private sector, to identify and adopt new technologies that offer scalable benefits to support our ICS challenges and workstream priorities”. This will include piloting innovation at smaller scale where there is potential to grow, and prioritising learning from others around technologies such as AI, precision medicines and robotics.
With regards to actions already taken, the ICS shares set plans to invest in a digital innovation team. A rapid review process for research and innovation has been developed. East and North Hertfordshire NHS Trust has also supported a national Health Data Research UK programme in the creation of a Gut Reaction Data Access model using AI and machine learning approaches to enhance drug discovery.
Ambitions for 2023 into 2025 include establishing links with the wider NHS, universities, AHSNs and others, and supporting new remote monitoring pathways. In 2026 and beyond, the ICS aims to eliminate time-consuming manual tasks through robotic process automation, support clinicians to identify and grade cancers through development of AI in diagnostics, and develop genomic treatments to support cancer patients.
Skills
The final goal is to improve inclusion in accessing digital health and building a digitally confident and skilled workforce. The document says: “we will develop a coordinated approach with third sector partners and others to address barriers to accessing health and care services digitally, providing access to technology, information and navigation to those least able to access digital services.” In addition, they will support and train staff to develop confidence and skills, particularly at the frontline, and will “strive to build trust in digital solutions”.
Actions to date include developing the ‘WeAreDigital’ primary care digital inclusion assessment which involved surveying residents on access to primary care, and supporting digitally excluded service users through the third sector by providing recycled IT equipment.
Future plans include progressively moving services to accessible digital platforms for most of the population whilst ensuring that the digitally excluded remain supported (2023 – 2027). By March 2025, the strategy states that all constituent organisations of the ICS will have established digital, data and technology talent pipelines and improved digital literacy among leaders and the workforce. Finally, 2025/2026 will see the ICS focus on supporting people without access to technology to gain access and the skills needed to interact with healthcare services digitally.
To read the strategy in full, please click here.
