Digital and data across ICS regions: London
In this latest edition of our feature series exploring the digital and data landscape of each ICS region in England, we’re turning our attention to London.
There are five ICSs in total within the London region: North Central London, North East London, North West London, South East London, and South West London. We’ll take a deep dive into their digital strategies, taking a look at priorities for each of the systems, before moving on to share insights and snapshots from the past year. We’ll also hear from Rackspace Technology on their work to support health and care transformation in the London region and beyond.
Insights from the London region
The ICS highlighted work on two other programmes: the SEL part of the London Care Record and the London and SEL Data and Analytics developments. “In January 2025, SEL set a record of over 690,000 visits to the London Care Record by health and care professionals in a single month,” the ICS notes, “and there are multiple projects which have contributed to delivering this achievement including secure and direct connection between electronic record systems and the London Care Record for 126 GP practices, 31 community pharmacies, 33 care homes, and all six SEL Local Authority adult social care teams.” It now has new real-time data feeds from Guy’s and St Thomas’ NHS Foundation Trust, King’s College Hospitals NHS Foundation Trust and Royal Brompton and Harefield Hospitals’ Electronic Health Record system.
SEL is reportedly already seeing the benefits of this, “with hundreds of hours saved by clinicians not having to request, provide or chase up information. Gaining these time efficiencies has resulted in frontline staff spending more time with their patients/residents rather than carrying out administrative tasks. Using models from the University of Belfast, the volume of visits to the London Care Record by SEL health and care staff in October 2024 alone would reflect over 817 weeks of time for frontline staff saved, at a minimum cost saving of nearly £920,000.” Importantly, it’s also a much better experience for the patient/service user. SEL is now encouraging practices and partners to sign up to share data with the London Secure Data Environment, which incorporates the London Data Service and London Analytics Platform.
Alongside this, the London Data Service developments, which SEL are a key partner of, will see the establishment of a Londonwide integrated health and care dataset, which the ICS hopes will “enhance SEL’s population health management capabilities and support the development of services and integrated neighbourhood working”. Care professionals, and those supporting service re-design, will have access to useful tools and easy-to-use dashboards as well as key insights into the populations being cared for. “We will be able to spot gaps in care, identify those affected by the greatest inequalities, as well as identify opportunities to do things differently or more proactively. The data services will also support health service and care planning, and research in a controlled and approved way.”
A spokesperson from Central London Community Healthcare shared some insight around the trust’s current digital strategy, which “is focused on enabling clinicians and support staff to change how they deliver care and make best use of systems, technology and data”. According to the trust, the strategy recognises that “data and systems will be at the heart of the care we provide, changing the clinical workflows, culture and delivery as a driver for change rather than merely supporting clinical services”.
Beatrix Fletcher, senior AI programme manager at Guy’s and St Thomas’, also offered some details around current projects with the trust’s Clinical Scientific Computing team and some of the wider digital priorities. “The current focus is on data access, data interoperability, utilisation of AI to improve workplace efficiencies, and improving health equity,” Beatrix’s update shares, as well as being “increasingly focused on prevention and population health, which is reflected in our investment in data-driven problem-solving”. The trust has three teams working on different aspects of digitisation and digital health technology utilisation. While Beatrix’s team focuses on “software as a medical device and clinical AI”, other teams are working on “data access and standardisation, as well as automation using simpler, less computationally intensive tools”.
The trust is also exploring “commercial solutions for clinical problems which are appearing on the market at this point in time”, Beatrix shared, “particularly in ensuring our recent move to a single Electronic Medical Record system (EPIC) is being utilised to the best of its capabilities. This means we’re evaluating the solutions that are natively in-built into the system to ensure we’re not duplicating efforts and can achieve benefits in the shortest possible time.” Her team is working with the trust’s data teams to “standardise, optimise, and protect our patient data”, and “as an institution, we are working towards being early adopters of AI and digital health technologies, which presents both opportunities to innovate and challenges in setting up and testing new ways of working where exemplar models of integration do not yet exist,” she said. This includes “how technologies such as large language models or ambient AI can be safely and effectively implemented in clinical settings”.
Her team works hard to “raise the collective understanding of clinical AI across the NHS”, including hosting training programmes for students, interns, and trust staff, Beatrix said. “We will be running an AI Summer School for NHS colleagues…and we run the national NHS Fellowship in Clinical AI, which addresses the knowledge gap of clinical staff in the safe implementation of AI,” she told us. “We’re working on comprehensive approaches to fairness in AI…leading by example to inspire other NHS trusts to invest in dedicated in-house AI teams.” Projects already making an impact, she went on, include an AI tool delineating internal organs in 3D images such as CT and MRI for radiotherapy treatment planning, and the team have built an AI training pipeline “that enables rapid development of bespoke segmentation models tailored to specific departmental needs”. The team has also developed an AI tool for scaphoid fracture detection in x-ray imaging, an in-house developed natural language processing tool designed to read endoscopy and pathology reports; has piloted a tool for generating 3D models of kidneys and lungs to assist with tumour removal planning; and is evaluating a tool for incidental pulmonary embolism detection using AI.
“We have also rejected or discontinued several projects,” Beatrix shared, adding: “These lessons were perhaps even more valuable than the successes, as they helped us understand why digital projects fail. Common challenges include not having sufficient data for AI to solve the problem, data complexity being too high for AI to handle effectively, data fragmentation limiting AI usability, clinical teams not having the time to engage with the project and provide necessary subject matter expertise, the necessity of local champions and effective change management — just because a technology is deployed does not mean it will be used unless local staff trust it and see direct benefits.”
Looking ahead, “digital health in our region will continue evolving in response to new technologies, lessons learned elsewhere, and newly identified clinical problems that can be addressed using data and technology,” Beatrix considered. “For example, a few years ago, AI innovation in healthcare primarily focused on predictive modelling using past data to help plan future workloads. Today, the focus has shifted toward large language models and their applications in natural language processing to streamline administrative and data processing burdens.” The largest digital projects across the NHS currently involve the development of secure data environments, she continued, “that will facilitate treatment development, intervention design, and emerging population health trend analysis. We are also seeing an increasing number of AI-hosting and AI-training platforms, though their long-term utility remains to be fully assessed.” And finally, she observes, “there is a growing recognition of the limitations of AI in real-world clinical practice. As academic research continues to transition into clinical care, we are refining our understanding of our own processes and the areas where AI can provide the most value.”
The case for a complete hybrid cloud strategy and highlights from CNWL
We spoke with Rackspace Technology to explore how hybrid cloud can support health and care transformation, and its potential to improve digital maturity, security, cost and productivity optimisation. Here, we look into some of the considerations for NHS organisations and share practical advice for moving to the cloud and reassing your cloud investment.
“Some organisations are looking only for a hosted environment for their electronic patient records (EPR), some view the deployment of one cloud-based SaaS solution as being their cloud strategy, and others assume hosted cloud options are always public,” the company said.
Rackspace Technology notes the case for a complete hybrid cloud strategy to encompass:
- Audit readiness for transformation improving rank on the CQC Digital Maturity index
- Improving security posture, sovereignty, critical application resiliency and business continuity
- Doing more with less to support cost and productivity optimisation
- Supporting AI and advanced digital technologies
- Making data sharing, convergence and interoperability between trusts and the ICB possible
The company added that they “meet organisations wherever they are on their cloud journey, working as an extension of their teams to assist with everything from hosting their EPR to a complete data centre exit.”
CNWL customer story
At HETT, HTN took the opportunity to sit down for a chat with Owen Powell, ICT director at Central and North West London NHS Foundation Trust (CNWL), during which Owen shared his experience of the trust’s move to cloud infrastructure with the support of Rackspace Technology; his advice for other trusts embarking on or considering a similar undertaking; and what cloud means for healthcare and innovations in the future.
Central and North West London NHS Foundation Trust successfully migrated to cloud in 2020. In doing so, the trust has positioned itself to meet the future demands of NHS and new models of care, reducing complexity and improving security and scalability.
Moving to the cloud: advice for other trusts
Reflecting on CNWL’s experiences, Owen said that other trusts should make sure that they have considered every element of their organisation that will be impacted by the move to cloud.
“You need to know that your infrastructure suits cloud; if you are running too many legacy systems, for example, then it is going to be very costly and challenging to migrate over. Trusts should undertake an initial assessment to check whether their systems are ready for cloud, or whether there is preliminary work to be done to get them to that point.”
Another factor to take into consideration is what the cloud provider is offering, Owen continued. “That includes making sure that the provider can offer the assurances and accreditations the trust requires; that your cyber posture is in a fit state, and what they offer in terms of security.”
The third key consideration involves taking the time to examine the financial elements of migrating to the cloud, including the costs and the revenue model. “Trusts undertaking this journey need to be very comfortable with having their revenue models in place,” he stated.
Ultimately, Owen said, his experience of migrating to the cloud “has been a very positive one. These elements I’ve mentioned are the key factors, and if you can check them off and cross those hurdles, I would tell them to go for it. Don’t think twice.”
Working in partnership
CNWL and Rackspace Technology worked closely together in order to navigate the trust’s migration to the cloud. During his HETT presentation, Owen highlighted the cloud expertise that the Rackspace team brought to the experience. Is there anything in particular he learnt from the collaboration, and anything he believes Rackspace learnt from working with the trust?
“We’ve learnt a lot about hybrid cloud from Rackspace,” Owen said. “People talk about ‘the cloud’ but it’s not really a thing in itself. There are so many different types of clouds and there are different toolings within the cloud, and different cost benefits to each. So from Rackspace I would say that we have learnt that it isn’t one size fits all; and that the optimisation process for your own specific organisation is key.”
To learn more about options for cloud transformation with Rackspace Technology, please click here.
Digital strategies
North Central London
North Central London ICB’s Digital Diagnostics Strategy for 2025 – 2030 outlines plans to upgrade infrastructure, digitise workflows, equip staff with “intuitive tools”, and leverage AI and advanced analytics. The ICB presents a roadmap for delivering digital diagnostics, with focuses for year one including single order comms for pathology and radiology, extended community order comms for pathology, the NMR Digital Registry, connecting private providers into data flows, and providing an image sharing repository. This will be built on in years two and three with the digitising of workflows and reporting, read access to NCL’s PACS hospital record, early AI use for smart pathways, and the contractual obligation for private providers/suppliers to integrate data.
At its latest meeting, the ICB discussed its Community Transformation Programme, which it states is “improving access to care and tackling health inequalities through its system-wide ‘core offer’ of community services”. A £57 million in investment has been put into the initiative over five years, it continues, boosting productivity by introducing digital solutions such as Doc Abode, which reportedly led to a “71 percent increase in patient contacts and preventing unnecessary hospital admissions”. The ICB also notes the role of digital in supporting patients to be more empowered and active in their own care.
North East London
North East London ICS’s Joint Forward Plan Refresh from 2024 highlights the need to strengthen “key enablers” including digital infrastructure, as part of securing the foundations of the system and the potential role for technologies such as AI to play “a major role” in determining workforce needs over the next ten years. Digital will also reportedly help improve service provision around community health services and to enhance access via tools like the NHS App.
In primary care specifically, the strategy focuses on personalised, digital-first health services and modernising primary care provision using digital tools. Providing patients with access to their information and granting them the ability to interact digitally with health and care providers, and expanding the NHS App’s functionality to digitally enable patients and free up resources, also feature under the header of “digital”.
And digital also features heavily in the strategy’s section on personalised care, including a digital template for social prescribing, supported self-management and digital enablement through Patients Know Best, and the standardisation of personalised care and support planning “including increasing use of digital tools” such as Patients Know Best and the Universal Care Plan.
North West London
In January, North West London shared the ongoing development of the ICB’s cyber strategy, continued progress around the London Shared Care Record, and optimisation work around its acute provider EPR. Community and mental health trusts are working together on the development of a “common digital strategy”, the report outlines, whilst the “exploitation” of the Federated Data Platform is said to be underway across all of NWL’s acute trusts. Work is underway to address latency issues in the feed from EPRs to the Federated Data Platform; on understanding Integrated Neighbourhood Teams’ “requirements for multi-disciplinary record sharing”; and the review of governance around AI by the Acute Provider Collaborative, “to be extended to ICS as a whole by end 2024/25”.
In a more recent meeting in May, the ICB published its draft refreshed Joint Forward Plan for 2025/26, highlighting plans to use digital tools for triage and appointments, for the NHS App to be used for self-booking and patient portals, and for the scaling and embedding of AI. AI tools that demonstrate potential in areas like dermatology and ambient listening will be piloted, whilst an AI and digital working group will be set up to explore tools for clinician productivity, access, and effectiveness. Also noted are commitments to begin to roll out discharge tools to local authorities and to create a monitoring dashboard for demand and capacity; to pilot a tech solution to optimise discharge coordination and to begin a data quality programme “with a QI focus”.
South East London
South East London ICS’s Digital, Data and System Intelligence Strategy for 2024 – 2027 centres around the vision of enabling the delivery of high-quality care for the people of South East London “through digital innovation and data-driven intelligence”. It outlines four objectives around empowering people to manage their health and wellbeing, making the care record available to care providers at the point of care to support decision-making, using information collected to generate data-driven insights into population health and proactive care, and supporting service transformation with innovative digital and data products.
At an ICS level, achieving these objectives will require partnership working, the strategy states, with the need for the ICS to provide leadership and resources to support the system, to ensure digital strategies and plans are in place, and to invest in digital and data initiatives. The system has established a Digital Committee to take responsibility for agreeing with partners on ways to connect health and care services, for approving plans to use digital and data to understand local priorities or track delivery, and for approving arrangements for “ensuring appropriate safekeeping and confidentiality of records and for the storage, management and transfer of information and data”.
The ICS also shares focuses around the London Care Record, using data to undertake demand modelling, and ensuring system resilience and cyber security, where it sets targets to review digital infrastructure, aligning with the DSPT, and ensuring that critical systems are available to support care delivery and business continuity. It commits to innovation, targeting the increased use of AI and automation to improve efficiency within clinical and administrative workflows, and identifying opportunities to scale innovation across the system. The workforce will be offered training opportunities to promote their development, whilst the ICS looks to partner across London to develop a Digital, Data and Analytics workforce plan “to attract and retain the people the NHS needs now and into the future”.
South West London
South West London ICS’s latest digital strategy for 2025 – 2028 centres around five digital priorities: digital infrastructure, integrating systems, data strategy, empowering citizens, and innovation. Noting the organic growth of SWL’s current digital infrastructure, the plan cites the need to create a “robust and secure digital platform across SWL, ensuring comprehensive cyber security, system and data availability, data quality and appropriate governance”. Moving forward, the ICS commits to establishing expert digital teams and developing digital competence, implementing and consolidating systems, improving capacity management, ensuring digital procurements are interoperable and represent value for money, and levelling-up provider digital maturity.
SWL’s strategy shares that the levelling-up of information systems across the region will play a part in helping to integrate systems, in turn improving information flow and continuity of care. “Enhancing the functionality of the London Care Record” will also remain a “key priority”, according to the publication. The strategy goes on to outline four programmes of work designed to tackle challenges around interoperability and information sharing: preparing a strategic outline case and approach to the development of a Longitudinal Health and Care Record, supporting the deployment of Cerner to Epsom and St Helier University Hospitals and the strategic outline case for Kingston and Croydon, enhancing the usage and deployment of the SWL Health Information Exchange and London Shared Care Record, and reducing the number of EPR support solutions.
Over the next year, the ICS aims to optimise its analytics and business intelligence team, as well as to build “a community of data specialists” and to change the culture of “how we use data in SWL”. And the strategy highlights patient portals and the NHS App in helping empower patients and support informed decision-making, outlining work completed since its last strategy and current or continuing work across primary and secondary care. Work is currently underway, it states, to promote the use of the NHS App across primary care, with the help of four digital care coordinators who will be recruited and deployed to work in GP surgeries.
Health tech in the London region: snapshots from the past year
An expert panel joined us to discuss whether the reality of AI will live up to the current hype and how to manage bias in healthcare data, including Shanker Vijayadeva, GP lead and digital transformation for the London region at NHS England. “We have a whole spectrum of workforce,” he said, “and those of us in this webinar are probably not representative of the whole NHS workforce because we have a particular interest in AI. There are many sections of our workforce who probably have very limited awareness of AI or even the scope or definition of AI, which is a huge challenge.” Shanker also considered that the real success of AI may be after “the hype dies down”, adding: “I think AI will be successful when we don’t refer to it as AI, but just as something that we are doing, something we are used to. It’s not an AI tool, it’s just a tool. These are the simple things that we need to do to bring it down to a level that our staff can engage with.”
Ananya Datta, associate director of primary care digital delivery at South East London ICS, formed part of a panel discussion in January of this year focusing on digital in supporting NHS reform, modernising services, shifting from hospital to community, and supporting the move from reactive to proactive care. Ananya shared some details of her role at SEL ICS, as well as some of the key projects underway in the region around community pharmacy, interoperability, digital platforms, digitising adult social care, and more. “Lots of digital transformation is going on in SEL as part of the reform,” she said, “and we’re focused on that, as well as supporting our population, which is now almost 2.1 million.”
Ananya joined us again for a discussion around harnessing data for total triage in primary care, where panellists shared details on current uses of data for total triage, discussing key successes, challenges, learnings, and best practice. There has been “great success” to date in a number of practices, Ananya told us, particularly in Greenwich borough, where they have started getting a better understanding of those who need continuity of care and those who have low acuity so can be triaged to other areas. Feedback has been “quite positive”, Ananya said, “and one of our GPs provided feedback saying that whereas before he’d work until 8.30pm after finishing his day, now he’s able to go home at six, or six thirty, instead”.
Panellists including Beatrix Fletcher, senior programme manager (AI) at Guy’s and St Thomas’ NHS Foundation Trust, took part in a webinar debating some of the practicalities of AI technologies, including implementation, adoption, the role of data, policy, regulation, evaluation and best practices. “We need to look on an organisational level at what our appetite actually is for risk, how soon we want this, what work we’re willing to put in toward an organisational and cultural shift; this is not something that a separate team can just decide about – everyone has to come on the journey,” she shared. Part of that is changing the ways we think about the tools we use in practice, she went on, “and with a lean approach, you don’t want to be automating or using AI for a singular part and then ignoring the downstream impact”. This is especially true for tools that offer prioritisation, she said, “because we often find that in, say, radiology, that may have some impact on speed, but the impact is seen where they’re now referring those patients to; we should ensure those departments are ready for their referrals to be increased by tenfold”.
