What’s happening in digital and data across the Midlands?
Our next edition in the HTN regional ICS feature series, exploring the role of digital and data in integrated care systems across England, focuses on the Midlands.
Here, we take a look at the digital strategies of the ICSs within this region, their key focuses, the work they plan for the future and the digital work that they have already undertaken.
There’s plenty happening within the region – last November we covered the launch of a new digital pathology platform across four NHS pathology networks in the Midlands including Black Country Pathology Service; Birmingham and Solihull; South Midlands Pathology; and North Midlands, South Cheshire, Shropshire, Telford and Wrekin. A couple of months earlier, there was the news that Birmingham and Solihull ICS, Coventry and Warwickshire ICS and Herefordshire and Worcestershire ICS joined forces to deliver shared care records, covering 365 GP practices, hospital trusts, mental health and community trusts, local authorities, an ambulance trust, hospices and a prison service.
There are 11 ICSs in total within the Midlands. We’ll look at each ICS one-by-one and see what’s happening in terms of digital.
Nottingham and Nottinghamshire
Alexis Farrow, programme director for Digital Notts, shared with HTN: “Across Nottingham and Nottinghamshire we are currently reviewing our digital strategy, putting engagement and user-based design at the centre of their approach. Over the last year active engagement sessions have been held in order to obtain significant insights into operational and business need in order to help shape the next iteration of the digital strategy. Through this review we are wanting to ensure that our strategic direction and plans continue to have clear expectations, sustainable delivery and good governance.”
Priorities, based on the feedback from engagement sessions and aligned with national expectations, are to empower the population with effective public-facing digital services; to support the population and the workforce to improve digital inclusion; to give the workforce the tools they need through provider digitisation; to improve care provided by sharing data through better interoperability; and to support intelligent decision-making to tailor resources effectively.
Alexis adds: “It is important that our digital strategy is person-centred and operationally-driven in order to provide the best value to our system and the people of Nottingham and Nottinghamshire; for this reason, we have developed a set of approaches in which we will apply in order to ensure that people are provided the opportunity to help shape and drive forward the digital agenda across.”
Alexis shares some examples of projects taking place across the region. “A key focus of the digital and social inclusion workstream continues to be embedding support within local communities to enable more proactive and timely intervention for those who struggle to access health and care services online and mitigate against digital-related inequity of service,” she says. “We’re also continuing to collaborate with CVS organisations through providing funding for development and roll-out of digital inclusion initiatives, and over the coming months are looking to onboard new organisations to the scheme. Mansfield CVS are currently mid-way through their second six-month delivery phase and have already supported 78 people as part of the programme.”
As part of the digital inclusion project, they have recruited a number of PCN digital inclusion co-ordinator roles to work alongside GP practices, encouraging wider adoption of digital health tools whilst offering support to those struggling to help them get online and develop their skills and technology. Over the past three months, the digital inclusion co-ordinators have delivered 145 support sessions, supporting 9,454 people.
Alexis continues: “Through the use of technology, we have been undertaking remote monitoring of asthma patients using the NHS App, Patient Knows Best and peak flow devices. Patients are encouraged to record their daily peak-flow readings in a personal Self-Management Plan which also includes a small library of helpful information, such as inhaler technique videos.” The project has seen over 60 percent of participants achieving complete avoidance of hospital admissions, Alexis shares, where previously they have had to attend A&E multiple times due to exacerbations of their condition.
Contents
- Nottingham and Nottinghamshire
- Coventry and Warwickshire
- Lincolnshire
- Black Country
- Case Study: Lantum on creating a robust workforce equipped to provide care in the Midlands
- Birmingham and Solihull
- Leicester, Leicestershire and Rutland
- Northamptonshire
- Derby and Derbyshire
- Herefordshire and Worcestershire
- Shropshire, Telford and Wrekin
- Staffordshire and Stoke-on-Trent
Coventry and Warwickshire
In Coventry and Warwickshire, digital work focuses are aligned with wider ICS priorities: enabling residents to keep well by making healthy choices and providing services that prevent illness, promote wellbeing and reduce health inequalities; working together to tackle the underlying causes of illness; providing the best possible care within resources close to home, joining up care around people and communities; using technology to improve services and improving access via digital means; and supporting staff to work flexibly. The ICS also places particular focus on improving maternity services through digital transformation, with a newly-released digital strategy focusing on this area.
In the integrated care strategy for Coventry and Warwickshire, digital, data and technology are also highlighted as key enablers to “proactive, seamless and person-centric care, and to the collective stewardship of public funding for health and care to meet the needs of the population. It is crucial to facilitating evidence-led decision-making in the commissioning, planning, design and delivery of care, with insights from data used to improve quality, efficiency, population health outcomes and to tackle health inequalities.” The ICS emphasises the importance of keeping digital transformation “central to our decision-making, resources and partnerships” in order to promote continued development of leadership, culture, people and processes.
The strategy goes on to share information about the key areas of integration activity planned for the future. The ICS is “using new technology and innovative digital solutions to enhance services for patients and citizens through consistent digital front door and virtual health and care possibilities”. They will be focusing on digital literacy, ensuring that health and care services suit all literacy and digital inclusion needs whilst working collaboratively across their partners to build digital skills.
The strategy shares plans for Coventry and Warwickshire to build on their electronic patient care initiatives, shared care record and platform, and services that support research and innovation across providers in the area. They also intend to implement a local population health management digital platform “which will provide a near real-time linked data set across all Coventry and Warwickshire ICS data systems and analytical tooling, enabling more targeted and proactive care”.
In addition, ICS partners are to work together to create digital, data and infrastructure operating environments “that are reliable, modern, secure, sustainable and resilient”, including ensuring robust digital assurance such as information governance and cyber and clinical safety.
University Hospitals Coventry and Warwickshire, has shared an update on the digital work at her trust. She says: “We are making great progress in implementing our integrated EPR which will bring benefits to patients, our staff and the whole system. Having medical records in one place will enable our staff to spend more time caring for patients and being able to access records through dedicated mobile devices means that care can be delivered more timely and effectively. There is also great work happening around the development of the future patient portal which will empower patients to have visibility of their health record and have control over their care. Our virtual ward team is working closely with our EPR implementation teams to ensure a seamless transition of the service into the new EPR system and the continuation of the high quality service provided to our communities.”
Penny adds: “Innovation never stops at UHCW as we are completing the roll out of our digital dictation and speech recognition solution across the trust with plans to integrate this into our new EPR system.”
Lincolnshire
In Lincolnshire, the integrated care partnership strategy was published at the start of this year. As a wider priority across the system, the ICS notes a need to focus on training and developing digital skills in residents and in staff. Other key areas of focus within Lincolnshire include enhancement of shared decision-making and digital development with regards to wellbeing, social prescribing and community-based support. On improving their community engagement and involvement, the ICS notes the innovative digital solutions brought forth by the pandemic and states a desire to build on this by helping communities to become stronger and more self-sufficient, developing a better understanding of where communities are well-placed to meet needs, understanding gaps in provision, and improving access to community-level expertise to help the ICS make informed decisions and better design services.
Data and information systems are highlighted as a key enabler for Lincolnshire’s strategy. This is split into two sections, supporting people and supporting staff. On the first, the ICS shares priorities around enabling access to care records and improving self-management through digital means, bettering communication and engagement with professionals, and accessing information online. For professionals, the ICS will focus on work around population analytics; population segmentation; performance analytics; service user identification; server user registry; care planning; intervention management capability; delivery analytics; and remote monitoring capability.
A few weeks ago, we highlighted how Lincolnshire ICB has launched an app capable of providing citizens with live waiting time information and queue numbers for urgent and emergency care services, along with alternative treatment options, available pharmacies, distance to travel, and the services available at each site. Claire Raybould, director for system delivery, said that the app “can help direct people with less serious conditions to alternative sites where they can be treated more quickly, which in turn will help to reduce pressure on our urgent and emergency care facilities.”
Maz Fosh, CEO of Lincolnshire Community Health Services NHS Trust, recently provided an update on virtual wards in the trust, noting that it currently has virtual wards for heart failure, frailty, respiratory, children’s complex neurology and same-day emergency care. Within the first ten months, 120 had been admitted to the heart failure virtual ward, with patients reporting that they felt “safer in the knowledge they will be monitored following discharge from hospital” and how it is “reassuring knowing that someone is looking at your numbers”.
Lincolnshire Community’s virtual ward for heart failure helps bring together staff from primary care, community services and hospitals in the area. It launched in January 2022 to provide another option for patients if they want to receive care at home.
Black Country
Elsewhere in the region, Black Country places emphasis on digital in its initial integrated care strategy for 2023-2025, currently in place whilst the ICS develops a longer-term ten-year strategy. “In our partnerships we are committed to leading on sustainability of our communities, families, and individuals as well as resources through a ‘green’ agenda,” the ICS notes. “We also want to be innovative and make best use of digital technologies… Therefore, we will embrace opportunities such as those found in digital resources which improve standards of care assistance.”
Additionally, in October, two trusts within the Black Country ICS – Royal Wolverhampton NHS Trust and Walsall Healthcare NHS Trust – published a joint strategy, sharing their priorities for the next five years. HTN examined the role of digital in the strategy here. In particular, the trusts noted their ambitions around improving remote monitoring, and facilitating research and innovation to make advancements in patient care.
In March 2023, we shared how Black Country Healthcare NHS Foundation Trust has expanded its EPR programme with an investment of £4.1 million to bring in new capabilities. The capabilities include MS Teams/VOIP functionality, EPR electronic document distribution, scanning historical records, a document API and scanning historical records bulk document upload.
A little further back, in March 2022, we published news on the delivery of a shared care record across Wolverhampton, Walsall, Dudley, Sandwell and West Birmingham, covering 1.5 million residents. The delivery came with plans for the ICS to connect its shared care record with neighbouring counties such as Shropshire and Staffordshire once complete.
Case Study: Lantum on creating a robust workforce equipped to provide care in the Midlands
The Midlands is a diverse and fast-evolving region with a unique range of needs. Large geographical spread, a wide range of settings, and a rapidly expanding population play their part in its complexity.
You need to find a way to provide local service at a regional scale – but where do you start?
Understanding the needs of local organisations
While each ICS is unique, there are common issues across the Midlands.
When working outside of a larger system, locums feel increasingly marginalised and disconnected. Isolation means they don’t feel the same level of support as permanent staff, which can lead to low morale, high turnover, and less continuity of care.
A unifying solution can bring your ICS together, but that’s not always easy to find. You need to be able to flexibly access a number of critical services from a central location, and while a flexible staff pool is a great solution, everyone needs access for it to be truly transformational.
Delivering local solutions with Lantum
Getting everyone, from locums to leadership, on the same page is essential. Building a single source of truth requires a system that’s accessible, flexible and intuitive. The key is to bring everyone into the process so they feel invested in it.
Something as simple as connecting your flexible staff pool initiative to Training Hubs forms the foundation for future engagement initiatives. New staff become easier to attract to the region thanks to the benefits and opportunities on offer. This, in turn, reduces the strain on everyone already working in the ICS.
Lantum’s ConnectedTM Scheduling solution brings staff from all ICS organisations together in one place, including locums and multidisciplinary roles. Lantum can deliver actionable insights about the state of your workforce and provides all staff with more opportunities for flexible work.
With rostering solutions connected to an organisation-wide staff bank, Lantum allows leaders to measure and track goals. The result is an open, transparent and collaborative tool that allows everyone to focus on what they do best: patient care.
Enhancing Birmingham and Solihull ICB with Lantum
Birmingham and Solihull ICB was tasked with creating a flexible staff pool in just six weeks and turned to Lantum for expert guidance. Not only did they need to go live before the deadline, but they also wanted a future-proof solution that delivered better outcomes for patients.
Getting everyone to buy into the process was key to their success. At Birmingham and Solihull ICB, leaders used the flexible pool scheme they developed with Lantum and their local Training Hub to build a network of quarterly educational sessions their locums can access, alongside mentorship and peer support.
“If we’ve gone to the trouble to recruit 483 full-time equivalent roles and 120 pharmacists, it’s really important we retain them,” says Ravy Gabrria-Nivas, Head of General Practice Sustainability for Birmingham and Solihull ICB. “The whole model of our ICS is to create closer community care, but you need people to do it.”
At Birmingham and Solihull ICB, Lantum wasn’t a bolt-on solution – it was an integral improvement to the care framework that made sure staff were eager to stay and work in the region.
Using Lantum as a holistic solution
Lantum attracts interest as a way to quickly roll out flexible staff banks, but it offers so much more. It’s a total solution for the issue of staff mobility on an organisational scale.
Connected SchedulingTM helps you understand staff working patterns and vacant shifts at a glance, gives you access to reports to better understand staff behaviour and identifies new actions that need to be taken. Plus, greater visibility into vacant shifts and opportunities gives staff access to new career pathways within your system.
Across your ICS, Lantum’s Connected SchedulingTM platform can help you build a flexible staff pool that:
- Provides a single source of truth for rota management across multiple sites
- Unlocks extra locum support from Lantum’s network of 30,000+ vetted clinicians
- Simplifies and centralises clinical governance documentation for salaried and locum staff
- Offers attractive perks to staff like free next-day payments with Rocketpay, free DBS checks, and automated admin
19 ICSs, 300+ PCNs and 1-in-2 practices across England already use Lantum for their flexible staff pools.
Birmingham and Solihull
Birmingham and Solihull ICS is in the process of developing an integrated digital, data and technology-enabled care strategy “that will identify a roadmap of work being undertaken across the system”, adding that it will “allow for a clear line of sight on what is happening” and encourage sharing of information and assessment of digital impact.
In January, Professor Dave Rosser (previously CEO of University Hospitals Birmingham) took up a new post as strategic director for digital health and care, with the aim of “linking public sector digital, technology and data programmes across the local area.”
In February this year, we covered how University Hospitals Birmingham joined the the AI Centre for Value Based Healthcare consortium of clinical, research and industry partners. The AI Centre provides support for AI applications within trusts, and Birmingham’s addition marks the first trust outside of the South East to join the group. Simon Ball, the trust’s chief medical officer, said that joining the consortium will “accelerate the adoption of AI applications within University Hospitals Birmingham Trust. AI can transform the way we deliver care and the treatment we provide – we are committed to working with our new partners to explore its full potential.”
Last year, HTN shared how Birmingham Women’s and Children’s NHS Foundation Trust is trialing virtual reality technology in the hopes of helping to reduce anxiety during medical procedures for young people and children. In November last year, the trust also announced that they are using portable phototherapy blankets to aid recovery for premature babies with jaundice, with the aim of reducing length of hospital stay and preventing readmission.
Leicester, Leicestershire and Rutland
The digital strategy for Leicester, Leicestershire and Rutland runs until 2025. The document shares long-term strategic priorities, including having a clear and empowered governance structure; levelling up all partners to achieve a consistent level of digital maturity; for the ICS to have digital capacity and capability to support future digital needs; to improve data quality so that it can be used for secondary purposes such as population health management; to consolidate duplicated systems into a cohesive digital ecosystem; and to support the transformation of care pathways including maternity, end-of-life and long-term condition with digital enablement. In addition, University Hospitals of Leicester NHS Foundation Trust is to implement “a mature EPR system with tight integration to niche departmental systems, capable of sharing data with the shared care record.”
In November, we covered how the ICS adopted AI technology to support its process of diagnosing suspected skin cancers and prioritising patients. Clinicians in dermatology services have been using a tool called DERM to analyse images of suspected cancer legions, which supports them in identifying cases which could need priority investigation. The ICB said that 41 percent of patients were discharged from the service or referred to other dermatology departments, following five months of the tool’s use. Speaking on the tool’s use, Dr Pawan Randex, GP and the ICB’s clinical lead for cancer, said: “It speeds up the diagnostic process for suitable patients and helps to ensure that they are only seen in our cancer diagnosis clinics if really necessary. This means that waiting times are reduced for those who need to be seen and treated quickly.”
Also last year, HTN shared how the ICS scaled up its virtual ward programme and at-home long-term condition management with plans to introduce 16 digital pathways, covering 1.1 million patients and involving 132 GP practices, University Hospital Leicester and Leicestershire Partnership Trust. The pathway areas included heart failure, frailty, respiratory (COPD, bronchiectasis, asthma), colorectal cancer, haematology, end-of-life care, diabetes, COVID-19 and obstructive jaundice. Dr Caroline Trevithick, chief nursing officer and deputy chief executive, said that having the right technology in place “is crucial in a successful virtual ward to keep everything running smoothly and ensure patients, relatives and health professionals feel supported and confident at all times.”
Northamptonshire
Northamptonshire’s digital strategy also runs until 2025. It lists the ICS’s digital transformation themes: integrated health and care services (joining up services through integrated digital systems, improved information flow and collaborative working); empowerment and access to services (providing digital access to services that are personalised, accessible and support proactive self-management); digital culture and leadership (cultivating a culture that champions digital change, drives collective ownership over digital delivery and promoting a digital-first mindset); and digital workforce and expertise (expanding on core capabilities to embed digital and data expertise, defining clear paths to formal accreditation, and integrating specialist functions).
In addition, development of a sustainable and resilient ecosystem is noted as a theme (investing in secure, sustainable digital tools to manage risk and minimise environmental impact), along with data analytics and intelligence (leveraging their power to redesign innovative pathways, track outcomes and support data-driven decision making).
In December, we published an update from Northamptonshire ICS on their Elective Care Collaborative, which aims to bring together the organisations involved in planning care so that health outcomes can be improved through a collaborative and patient-centred approach. The ICS shared how they have worked together as a system to manage waiting times through investing in digital transformation, with developments including an outpatient management system, increased digital patient communication, a waiting list management tool and digital platforms for patient consent and pre-operative assessment.
Derby and Derbyshire
Joined Up Care Derby and Derbyshire published their digital and data strategy in October 2021. In it, they highlighted a number of strategic priorities, including the usual – to provide new digital services that improve the patient experience, transform delivery models and reduce care costs; to deliver and extend their shared care record programme; and to support citizens and the workforce in the use and adoption of digital services.
In addition, the ICS will develop their ecosystem of digital products and services, with particular focus on promoting the NHS App as a ‘digital front door’ for citizens across the region, support partners to develop their digital capabilities, and design ICS-wide architecture for technical services with utilisation of internet-first and cloud-first principles.
Other priorities include delivering a system-wide approach to the delivery of population health intelligence and implementing a system-wide health and care analytics function to advise on the health needs of the population and support multidisciplinary working across places, networks and systems. Derby and Derbyshire also seek to strengthen leadership to drive their data and intelligence strategy, along with providing an active learning and development environment for future data scientists and the existing analytical workforce, and developing system-wide data architecture and reporting capabilities including integrated data sets.
Herefordshire and Worcestershire
The most recent digital strategy for Herefordshire and Worcestershire spanned 2019 to 2022, though some of the planned actions within it are given timeframes until 2024. The primary priority in this document is to allow integration by sharing care and wellbeing information and intelligence. Herefordshire and Worcestershire also state their aim to provide “a 21st century setup to aid our ambition of digitally enabled care”, which involves establishing a programme to improve infrastructure, including improving connectivity in rural areas, and agreeing to a minimum level of online growth for all constituent organisations. In particular, the ICS shares a hope for all organisations to achieve Healthcare Information and Management Systems Society (HIMSS) Level 5 or equivalent by 2023.
Other priorities include promoting and assisting with self-management, implementing intelligence-led and data-driven care (with particular focus on population health management, commissioning, clinical surveillance and research and development), creating a learning community and a culture of innovation, and working on attracting inward investment and maximising internal resource to deliver change.
In terms of current programmes, ICS has opened the CO-LAB Digital Innovation Hub, based in the community, as part of their ambition to become a leader in developing new health and care solutions. Mike Emery, founding chief information officer of the Hub, says that it is “very much intended to be a centre in which we can bring clinicians and local entrepreneurs together to try and focus on potential solutions for the health and care sector in the future, but also importantly show young people some of the opportunities around using new technologies.” The hub puts out an open call for anyone working on digital technology projects to improve health and care, encouraging them to get in touch to discuss how the team can assist.
They also have a Health and Wellbeing App Library, developed in partnership with ORCHA, which contains hundreds of independently reviewed and clinically accredited apps. We covered news of the library here.
Shropshire, Telford and Wrekin
Moving onto the interim integrated care strategy shared by Shropshire, Telford and Wrekin, innovation, evidence and research form one of the ICS’s six priorities. This “should be at the heart of our approach to the challenges we face and the opportunities to deliver,” the ICS says, adding that they seek to “maximise innovation and digital opportunities” and “adopt an intelligence-led population health management approach.”
As they develop the final version of their five-year strategy, the ICS notes a need for a number of enabling strategies, including digital, population health management, workforce and communications and engagement. Within that digital strategy, they plan to focus on their shared care record, care delivery systems, remote monitoring, population analysis and artificial intelligence.
In December, the ICS launched a winter control room to manage demand and capacity across the county: the control room uses multi-agency data to support the region’s response to pressures across the system, and matches staff with demand to support capacity.
Also in December, Shropshire, Telford and Wrekin announced plans to launch a new electronic eye-care referral system between optometrists and ophthalmology service providers, set to go live across the integrated care system early in 2023. Following its launch, the ICS has said that it will view data from the system and identify trends with the aim of addressing any areas of inequality.
Staffordshire and Stoke-on-Trent
Last but not least, we come to Staffordshire and Stoke on Trent. On their website, they share their digital vision: “By 2024, Staffordshire and Stoke-on-Trent will be nationally recognised as an exemplar of digitally enabled transformation due to the significant impact that technology and culture have had on the quality, effectiveness and cost of health and care delivered.”
Their priorities include leading on Your Care Connected, a new digital shared care record linking NHS and local government organisations; plans to develop a set of digital standards to enable efficient and equal access to health and care; focus on improving frontline services through use of apps and technologies; development of a “robust, future-proof and state-of-the-art information technology infrastructure”; and their plans to develop a Staffordshire and Stoke-On-Trent informatics network to share best practice and improve services.
At one of our HTN Now events in October, we were joined by a team from North Staffordshire Combined Healthcare for a discussion on accessing mental health data to deliver quality care and enable ICSs to perform analysis. The team shared how they are producing Health Equity Assessments for each of their primary care network areas to identify health inequalities, along with exploring the wider determinants of health. “We use a wide range of data sources including GP data and Census data,” said Vicky Boswell, associate director of performance. “We build a picture of need according to the primary care networks, so we look at what is happening in terms of deprivation within certain areas. We can also look at our service usage and then we can assess whether that is comparable to the population or whether we’ve got higher incidents of severe mental illness or substance misuse in certain areas.”
Last March, we covered the news that a digital heart monitor scheme had been rolled out to 151 GP surgeries across the Staffordshire and Stoke-on-Trent area; following that, in October, innovative technology was launched across Staffordshire with the aim of diagnosing heart problems that could cause a stroke along with remotely monitoring heart health.
