Digital and data across ICS regions: South West

For the next instalment of our ICS regions series, we’re heading over to the South West region, to take a deep dive into some of the latest developments, insights, and strategies around digital and data.

The South West region is home to seven integrated care systems: Bath and North East Somerset, Swindon and Wiltshire; Bristol, North Somerset and South Gloucestershire; Cornwall and the Isles of Scilly; Devon; Dorset; Gloucestershire; and Somerset. We’ll look at each of these in turn, exploring their digital strategies and updates, highlighting commentary from key stakeholders, and covering some of the news shared over the last year.

Insights from the South West

We caught up with Kelvyn Hipperson, CDIO at Cornwall and the Isles of Scilly ICB and CIO at Royal Cornwall Hospitals and Cornwall Partnership Trust, who shared some insight into digital transformation in the Cornwall region. “The stunning geography and scenery in Cornwall and the Isles of Scilly draw in huge numbers of visitors each year, with the tourism industry making a huge impact on the region’s economy,” he said. “However, that geography also means that many of our residents find it harder to travel for appointments and access health care. Our coastal communities have additional challenges of housing and job opportunities, both of which play a key part in affecting people’s health and wellbeing.”

Digital transformation, according to Kelvyn, is helping to break down those geographic and economic barriers and “enabling us to shift some of the care we provide from hospitals to the community as well as adopting digital innovations to improve how we deliver healthcare”. Examples of this include initiatives like community skin imaging clinics, which bring diagnostics and services closer to people’s homes, and virtual wards, which allow patients to receive hospital-level care at their place of residence. On-site pilots like the silent hospital project are also testing smart technology to make hospital wards “a quieter, calmer environment for both patients and staff”, helping to improve experience and making receiving healthcare more accessible.

“We’re also embracing digital to provide patients with a more seamless experience of care across our health system, embarking on one of our biggest and most complex transformation programmes implementing a new electronic patient record (EPR),” Kelvyn said. “It’s a vital piece of the jigsaw for whole system transformation, as until we bring our acute hospital digital and paper-based systems into one, its very difficult to interoperate digitally with all of our partners, not only in health but also social care and the third sector.”

Other digital and data initiatives forming part of the wider transformation roadmap, Kelvyn shared, include a patient portal which gives patients control of their appointments along with NHS App integration. This, he says, has “challenged assumptions on digital inclusion with high levels of adoption across age groups and in some of our most deprived areas”. The shift to local care through Integrated Neighbourhood Teams is also being supported by AI-based assessment of individuals at risk of hospital admission, which is allowing targeted interventions for admission avoidance. And the Federated Data Platform is being adopted to join up data locally, regionally and nationally.

“Delivering large-scale change can never be viewed in isolation. Five years ago we were establishing our programme in the midst of Covid and now progress needs to be maintained whilst responding to the increasing efficiency/productivity challenge,” Kelvyn considered. “Our health system shared service, Cornwall IT Services (CITS), has provided many years of continuity for both change and operational service innovation, such as a 24/7 helpdesk and a Cyber Security Operations Centre for all partners. Further consolidating our provider digital and IT teams in CITS was a long-held goal, which is now being realised just at the time we need it most. This is possibly the most important aspect of change, to keep it moving, as you will never quite know when everything will come together or just how much you might need it.”

EPR hosting in the South West: Why trusts should think beyond the EPR provider 

As South West NHS trusts progress on their digital journeys, electronic patient records remain a central focus. However, many trusts still assume their only option is to host their EPR directly with the vendor – an assumption that could be limiting flexibility, integration, and cost-efficiency. 

HTN spoke with Matt Moore, director of health and public sector at Rackspace Technology, to explore alternative approaches and why a third-party hosting model might be a better fit for many trusts. 

“Globally, many healthcare organisations don’t host EPRs with the software provider,” Matt explained. “Instead, they use third-party hosting, which improves integration, cuts egress fees, and brings greater control over data.” 

The case for independent hosting 

According to Rackspace, working with an experienced third-party cloud provider can reduce costs by up to 20 percent, while also unlocking a range of additional benefits – from improved interoperability to access, to specialist hosting expertise. 

Despite this, many trusts are unaware they have hosting options at all. “Often, trusts are presented with a quote for technology and hosting from the EPR vendor, and assume that’s the only route,” said Matt. “But there are alternatives – ones that can be better aligned to digital maturity goals.” 

Regional EPR strategies: ICB-level considerations 

With many South West trusts pursuing EPR implementation at ICS or regional level, Rackspace recommends clear decision-making structures and a collaborative approach that leverages best practices. Key questions include: 

  • Who leads and makes key decisions? 
  • How can each trust benefit individually within a shared strategy? 
  • How can resources and knowledge be shared across the system? 

Often, the largest trust in a region can act as an anchor to accelerate progress for others. 

Supporting trusts at every stage 

Rackspace Technology brings both EPR and UK sovereign cloud expertise, with a UK-based platform purpose-built for the NHS. From infrastructure to deployment, they provide pre-accredited solutions that reduce time, risk, and cost – helping trusts avoid starting from scratch. 

Matt noted: “We help remove barriers to progress – whether it’s digital maturity gaps, legacy tech debt, or simply the uncertainty around what’s possible.” 

To learn more, please click  here. 

 

Digital strategies

 

Cornwall and the Isles of Scilly Joint Forward Plan to 2029

In Cornwall and the Isles of Scilly ICS’s Joint Forward Plan covering 2025 to 2029, the ICB highlights the role of digital in supporting the system to overcome challenges around operational recovery, improving value, and transforming care to “respond to changing needs”. As well as outlining how the ICS plans to focus on its involvement in research and innovation, the ICB shares intentions to develop digital opportunities for its workforce.

On operational recovery, the ICB notes digital improvements such as the move to cloud-based telephony for all system practices, along with call-queuing and call-back functionality, and improvements to websites. For the workforce, there’s a focus on improving digital literacy and skills to support staff in working with digital solutions. On an ongoing basis, the strategy outlines work on the Devon and Cornwall care record and patient portal which it states is “one of the first to integrate with the NHS App”.

When it comes to transforming the system and improving value, the ICS shares that there are “several hundred projects” looking to improve quality and value for money across the ICS, covering “every aspect of services from behind-the-scenes digital infrastructure modernisation to new frontline patient services such as Silvercloud”. Major digital transformation programmes are also underway, it continues, including the procurement of the Royal Cornwall Hospital NHS Trust’s EPR, the digitising of social care, the modernising of data platforms, and integrating with third sector partners.

Bath and North East Somerset, Swindon and Wiltshire Partnership’s Digital Strategy to 2028

The board highlighted in March strategic initiatives such as the move to a single EPR as part of the ICS’s operational planning for 2025/26. An updated implementation plan for 2025-2027 sets out how digital innovation and modern technology will support the transformation of care, noting achievements in 2024 including the implementation phase of the EPR programme bringing the ICS’s three acutes onto a single digital system; an increased number of partners using the shared care record; increased use of the NHS App; and the creation of a “system-wide Cyber Tactical Advice Cell (CTAC)” for cyber security.

Next, the implementation plan shares, the ICS will be focusing on refreshing its digital strategy to align with national priorities and to ensure a joined-up approach to population health management. Further work will be done to explore the use of AI tools in settings like primary care, the use of the NHS App will be expanded, and the ICS will reportedly continue to work on maturing the system’s cyber capabilities, refreshing its cyber strategy, and learning from ICS wide cyber exercises.

Bristol, North Somerset and South Gloucestershire Digital Strategy

A quarterly digital strategy update made by the BNSSG board offered insight into progress around the ICS’s ambition to increase the uptake and usage of the NHS App, with key findings that although take-up in BNSSG is slightly above average, “only a relatively small number of people” have notifications turned on, meaning the system is “not maximising the opportunities of the app”. The update also points to “significant variation” in uptake at practice level, ranging from 94.6 percent to 21.9 percent. Steps recommended to address this include a local comms campaign, a support toolkit for practices, work with the VSCSE Alliance to engage with target underserved groups, and the rollout of best practice guidance on “how to improve messaging and minimise fragment size/cost”.

Devon ICS Digital Strategy

The ICS’s refreshed Joint Forward Plan for 2025 – 2030 was presented by the board in March, and aligns with many of the digital strategy’s goals. This includes embracing digital innovation and making improvements to infrastructure, ensuring that people in Devon will “only have to tell their story once”, and that clinicians will have access to the information they need when they need it through a shared digital system across health and care.

On clinical service change, the board also highlights the importance of providing interoperable digital solutions, enabling seamless information sharing, and making improvements in productivity and service efficiency. “Citizens will be able to engage digitally through simplified channels”, it states, and “staff will be empowered with active notifications and workflow at the point of care”. Remaining core health and care organisations will be connected to the Devon and Cornwall Care Record by March 2028; a reprocurement of GP EPR is also to be completed by this date; and an ICS data platform is to be developed, linked to EPR implementation, during 2026.

NHS Dorset Infrastructure Strategy for 2025 onward

According to the NHS Dorset board in September, a digital strategy is under development, with a draft completed and distributed to a closed group of stakeholders for “first pass review”. In the meantime, the ICB’s infrastructure strategy, published in January 2025, covers digital technology as one of four areas of focus, alongside estate, workforce, and sustainability. A large part of the focus is preparing the estate to ensure that the region is able to take advantage of developments in digital technologies, and improve digital services and pathways for its citizens.

On “aligning our digital and infrastructure ambition”, the ICB offers insight into eight digital ambitions. This includes the move to a cloud-first strategy, the expansion of virtual care, enabling flexible working, delivering care close to home, promoting citizen and patient access to “robust digital systems”, ensuring infrastructure is “future-proofed”, and optimising current estate and enabling new developments.

In particular, the strategy looks at digitally enabling health and care, expanding digital access and empowering citizens to access their information, including with the Digital Access to Services at Home programme (D@SH). It also highlights the shared care record, interoperable EPR, and virtual wards. The ICB will need, according to the strategy, digital booking platforms, additional digital capacity to accommodate hardware, and to understand the electricity requirements to power digital architecture.

One Gloucestershire Digital Strategy

More recently, the ICB shared its upcoming Data Strategy in a meeting in March, which it states will “further improve” the system’s digital maturity. The data strategy reportedly looks to “complement and extend” the ambitions set out in the 2022-2025 digital strategy, such as improving digital infrastructure, embedding a digital-first culture, and “enhancing citizen and staff experience through technology”. It sets out further aims to use data to improve citizen facing care; to empower the workforce, in support of the digital strategy’s goal of “having a workforce that is digitally enabled”; working together with transparency, in support of improving the digital maturity of all organisations; innovating for the future, “fostering innovation and growth in digital healthcare”; and transforming how care is delivered.

NHS Somerset Digital, Data and Technology Vision & Roadmap

NHS Somerset ICS’s Digital, Data and Technology Vision and Roadmap was presented to the ICB in September 2024. The vision sets out five principles and enablers for change, concentrating on creating person-centric digital services that “focus on people’s needs”, collaboration across the system, developing digital services that are inclusive, ensuring digital projects and investments “work together across the ICS”, and using digital technologies in an ethical and responsible way.

The roadmap highlights three missions: working together, improving lives, and navigating support. Under working together, it presents outcomes across facilitating communication and the exchanging of information amongst teams, creating communities of practice, and establishing the right governance for digital, data and technology for the partnership. Outcomes for improving lives cover connecting data to collect insights on population wellbeing, segmenting the population to identify and reduce inequalities, and identifying data trends to support the development of preventative measures. And for navigating support, the focus is on user-need driven digital service development, digital navigation tools, and signposting to local offer.

Health tech in the South West: Snapshots from the past year

Kelvyn Hipperson, CDIO at Cornwall and Isles of Scilly ICB and the Royal Cornwall and Cornwall Partnership Trust, joined us for a panel discussion about adding value to the EPR last year. It focused on sharing insights and experience on the EPR optimisation process, considering factors such as planning, technical capabilities, workforce, culture, leadership and what ‘good’ looks like for an EPR.

Kelvyn said that he had “seen both extremes”, in terms being either overcomplicated or “instances where something’s been designed locally by clinicians because they feel really confident about what they’re doing, and it’s really lightweight”. On balance, he conceded, “there tends to be more of a pressure towards overcomplicating these things. I feel strongly that a multidisciplinary approach to asking those questions is of benefit, because of the strength in a group of people deciding things. The alternative is somebody feeling all of the accountability and that driving them towards going overboard with it.”

We were joined in October by Deborah El-Sayed, director of transformation and CDIO at BNSSG, for a panel discussion on the topic of digital integrated care, including approaches to tackling challenges from an ICS perspective; new models of care and pathway transformation; the role of technology in supporting the move from reactive to proactive care; and how a system approach can accelerate preventative care.

“We’ve been using our PHM data to understand the cohort of patients who haven’t been using their prescribed medication and have gone on to have a secondary cardiac event,” Deborah told us. “We’ve then used that data for our insights and behavioural teams to go and have a look, and have found some very simple things that need to change, such as patients not realising they need to return to their GP for a second round. From that, we understood that we needed to put some mechanisms in place to communicate better with those patients.” She highlighted the importance of data in driving that kind of work forward, commenting: “We need to look at where we can use our data to understand patterns in our population, so we can achieve prevention for the individual, the family, and the community in a way that will lead to population improvement.”

Digital strategy list

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