Digital and data across ICS regions: East of England
For this instalment of HTN’s feature series exploring the digital and data landscape across regions, we’re headed across to the East of England, to take a look at current digital strategies, insights, and snapshots from the past year. We’ll also hear from Rackspace Technology, who share how they work to support health and care transformation in the East of England region and beyond.
There are 6 integrated care systems in total across the region, including: Bedfordshire, Luton and Milton Keynes, Herts and West Essex, Cambridgeshire and Peterborough, Mid and South Essex, Norfolk and Waveney, and Suffolk and North East Essex.
Insights from the East of England
We reached out to Mid and South Essex (MSE) ICS, who shared with us some of the system’s main digital priorities around building stronger digital foundations, enhancing system integration, empowering residents, leveraging business intelligence, and driving innovation. “We are improving cybersecurity, ensuring interoperability, and delivering our new unified electronic patient record (EPR) to standardise systems and simplify our digital estate,” MSE shared, “and we are expanding data sharing across health and social care through our Shared Care Record, with a key focus on moving from a ‘view to do’ approach— enabling professionals to act within systems, streamlining workflows, and improving care coordination.”
Other priorities include improving digital inclusion and supporting patient access to health tools such as the NHS App and Patients Know Best, shifting towards predictive analytics and population health management, and ensuring data is used effectively to support planning and service improvements. On innovation, MSE is reportedly developing AI and automation capabilities, modernising processes, and establishing a centre of excellence for innovation, “ensuring we continue to improve efficiencies and service delivery across the system”.
The MSE Shared Care Record is a key digital initiative currently underway in MSE, with the ICS highlighting that since its launch in August 2024, it is “already delivering significant system-wide benefits as its first phase nears completion”, being accessed 455,800 times by 8,456 users, and enabling the retrieval of over 694,200 documents and additional information from across the East of England and Greater London on 64,485 occasions. “This innovative digital solution brings together key information from various health and social care records into a structured and easy-to-read format,” MSE shared. “So far, Mid and South Essex ICS partners have started to realise a number of significant service improvements and benefits, along with providing time savings that are contributing towards the identified £3.6 million of annual savings across all care settings.”
The system’s digital patient portal, powered by Patients Know Best (PKB), launched in February 2023 to empower patients with access to their health information and the ability to engage with services online. Accessible via the NHS App or a web-based portal, it enables patients to view appointment details and letters, test results, and discharge summaries from Mid and South Essex Foundation Trust (MSEFT) and Essex Partnership University Trust (EPUT). Since launch, MSE reports that 232,200 patients have registered, with 457,500 appointments, 236,500 radiology results, and 101,100 documents integrated into the portal. “Engagement has been high,” MSE continues, “with appointments accessed 941,900 times by 133,500 patients, highlighting how digital access is transforming the patient experience.”
Looking ahead, the focus for MSE is on the delivery of a new unified EPR, a collaborative initiative between MSEFT and EPUT. “This £65m investment will create a single, first of type EPR system, replacing multiple legacy systems to deliver modern, joined-up care across hospitals, mental health, and community services,” the ICS notes. “This will be a game-changer, reflecting our vision to create a digital infrastructure that removes organisational barriers and delivers truly patient-centred, coordinated care across Essex.” Expected to go live in 2026/27, MSE hopes the EPR will “improve efficiency, reduce duplication, and enhance the patient experience—eliminating the need for people to repeatedly share their medical history when receiving care from different providers”. By working collaboratively on its design and implementation, both trusts are reportedly ensuring the system meets the needs of patients, healthcare professionals, and wider partners, “supporting a more connected, data-driven approach to healthcare in mid and south Essex”.
Hertfordshire Community NHS Trust also shared details of current programmes and priorities, including work with operational services to innovate and implement new digital solutions in line with the “analogue to digital” assertion within the Darzi review. The trust continues to use Robotic Process Automation (RPA), has set up a working group to understand the opportunities in exploiting Artificial Intelligence (AI), and is focused on improving patient access through its digital front door, “a one stop referral page to access all our services”. It has commenced a Waiting Well initiative to allow patient and carers to use its material for self-help and prevention, and digital inclusion is outlined as “an essential element” of Hertfordshire Community’s digital strategy. “We are developing our clinical system to make it more intuitive and allow our clinical colleagues tools to capture information,” the trust notes.
The trust’s work in digitising the referral process to the Children and Young People’s Integrated Therapies service resulted in it being shortlisted for an award, whilst its Digital Referral in and Automation to SystmOne project was named as the winner of an award for driving change through AI and automation.
“Our Integrated Referral Management Programme has since been revised and expanded to cover five project workstreams to capture and improve the complete end to end patient referral journey including Primary Care Referral Pathway, All Other Referral Pathway, Referral Registration Automation, Outcome Decision Automation, and Outbound referral co-ordination & process improvement,” the trust shares. “The aim is to improve the HCT referral processes replacing manual paper referral forms with bespoke user-friendly digital forms to allow external parties to submit referrals online at any time. Mandated fields and validation rules mean referrals are submitted with accurate and relevant information to enable the clinical triage decision.”
Also underway is a complex pathway redesign within Hertfordshire Community’s MSK service, “consisting of four phases some of which are carried out by a human, and some by the robot worker”. On this, the trust shares: “Creation of a Referral Outcome Decision S1 Template allowing clinicians to complete the referral triage whilst ensuring an accurate & robust reporting mechanism for the future. Including a revised list of intervention reasons in line with the Community Services Data Set with plans to standardise and simplify the configuration options across the trust and reduce variation.”
The HCT Digital team are also reportedly supporting the Systemwide initiative for the CYP Neurodiversity project, leading on the establishment of a single point of referral for neurodiversity (ASD and ADHD): a single referral logging function for ENHT and HCT. “This is the first step in mobilisation the countywide ND pathway with the development and implementation of a new Neurodiversity S1 unit being established alongside improving the overall quality of patient referral data and providing a seamless end to end process,” the trust states. And a proof of concept for the dental service using AI for clinical note taking has been agreed to test the software during face-to-face clinical appointments for nurse-led assessments.
Building a strong digital foundation with cloud to bolster security and get more value from data
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 investigate some of the considerations for NHS organisations and share practical advice for moving to and optimising the cloud for the NHS.
“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, 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 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”.
The NHS cloud-first strategy is often interpreted as the use of public cloud, but Rackspace Technology highlights that without proper consideration, this introduces additional data sovereignty and compliance risks. They state: “A healthcare-specific hybrid solution may be the best option. A fully hosted private cloud achieves the efficiencies of outsourced data centre management whilst also assuring data sovereignty. When located adjacent to a public cloud solution, the hosted private cloud can securely leverage public cloud tools for data analysis and business intelligence, without exposing sensitive data to the public cloud environment. And, by leveraging managed services, organisations can take advantage of dedicated security expertise as well as always-updated AI and automation tools to detect and prevent attacks.”
Common pitfalls associated with traditional private cloud include a large upfront investment in capacity, with additional capacity bought in large units, and no ability to scale down capacity in-line with usage. This can lead to lots of unused capacity, and lots of associated stranded cost. Rackspace’s “public cloud like” approach can mitigate the need for a large upfront investment in capacity, additional capacity can be bought in exact units, and that capacity can be scaled up or down in-line with usage, offering a truly flexible model. This helps health organisations to avoid unused capacity and stranded costs, and Rackspace works with each trust to develop the right cost model for them based on their funding sources.
“Because we understand that NHS providers are managing stringent budgets, Rackspace addresses financial sustainability from multiple angles, including by drawing on decades of experience in managing cloud migrations across many sectors to help organisations select the services they need — and avoid those they don’t — to build efficient technology frameworks. Rackspace technology works with trusts to build a cost structure that works within their cost model, which can include capex and opex. Our experts plan cloud migration correctly the first time, to prevent missteps and expensive rework. Organisations can count on consistent, forecastable pricing for the duration of their contracts, with no hidden fees, increases or variations. Rackspace Data Freedom reduces costs (like egrees fees) and avoids data silos by storing data centrally, outside of any particular public cloud. Data is transported via our private, fast and secure global network backbone, whilst ensuring data is available in any cloud service.”
Another consideration for those planning to make the push to public cloud is data sovereignty. When dealing with the level of patient-centric data the NHS holds on behalf of the UK population, it is critical that access to this data is appropriately managed and that the platform it sits on is designed with that data in mind. Rackspace offers end-to-end data sovereignty, with its Sovereign UK Healthcare Cloud solution built specifically to meet UK security and compliance needs, delivered in air-gapped management environments and serviced entirely by UK sovereign teams.
Workload placement is key to any migration. Not every workload will perform best in a public cloud, and for certain critical applications, especially those which use a lot of data, a private cloud is likely more efficient. Rackspace Technology stressed the importance of considering a hybrid cloud strategy, combining the best parts of a public cloud like Azure and a private cloud. “The key to designing this is looking at your environment as a whole, and the outcomes that need to be delivered to your internal and external stakeholders,” the company stated. “A cloud strategy should not be set to a single point in time, but should consider future needs and be a platform to take advantage of future technology like AI.”
If you would like to find out more about how Rackspace Technology can support your organisation, please click here.
Digital strategies
Bedfordshire, Luton and Milton Keynes
BLMK’s latest board meeting in March shares that the ICS’s data and digital strategy is set to be reviewed and approved by the board in September 2025. They note the importance of digital tools such as the NHS App in empowering patients, increasing engagement, and streamlining bookings. And the board touch upon primary care transformation and progress toward the National Primary Care Strategy, highlighting work around total triage and cloud based telephony, where it states that “by the end of the month, all 84 practices will have this technology to help streamline calls and get the patient to the right person efficiently”.
The board also detail headline initiatives from 2024/25, including around the establishing of the Population Health Information Unit (PHIU), which the board states is delivering “system-level analytical outputs using healthcare activity and outcome data”, and a pilot involving “the efficiency and automation of HR process to improve employee experience at work”.
An update on the transformation portfolio from the board’s March meeting highlighted the diabetes transformation work underway and the value attributable to it being clinically led, also noting further opportunities identified for digital and remote monitoring with Hospital at Home. A HR virtual assistant AI tool is reportedly being considered to support the workforce, with business cases being prepared to “ensure further progress and sign up”.
Cambridgeshire and Peterborough
The latest ICB meeting, an update on the digital front door programme highlighted results from engagement with local residents, stakeholders and suppliers, and further engagement work to be undertaken to inform the development of a data strategy and digital roadmap, to develop strengthened data and digital governance, and to ensure alignment with the 10 Year Health Plan.
The ICB’s Joint Forward Plan refresh published with March’s board papers, outlines work to be done to improve data and the use of digital in the region, including delivering a unified EPR, implementing a Shared Care Record, developing a patient engagement portal, introducing new technologies supporting service transformation, and continuously improving data capture and data technologies. A board meeting from January similarly shared updates on the completion of a cyber security deep dive and potential savings from Shared Care Records, which have “increased to £2.1 million”.
Highlights from the ICS’s latest board meeting identify aims to implement digital tech in elective recovery, with a patient engagement portal being rolled out across all three hospitals, an online platform introduced to facilitate communication between patients and healthcare providers, a shared EPR to allow clinical teams improved access to patient information, and expanded use of the NHS App. The focus to March 2026 will be on rollout and development of these technologies, with future plans in this domain to include the piloting of AI tools to reduce DNAs, expanded portal functionality, virtual consultations, and AI decision support tools. A full system review of digital innovations is then planned for 2030, with findings to inform the development of future digital strategy.
A meeting of the board offered an update on the ICS’s DDaT work, noting a focus on developing a system-wide cyber strategy and developing an agreed system response procedure, having one EPaCCS system in place across the whole of the system, developing a single approach to virtual wards, integrating all patient engagement portals with the NHS App, and ensuring all care providers have a digital social care record and are connected to the Social Care Integration platform to be interoperable with the Shared Care Record. “Parked” programmes awaiting further development are also listed, covering integrated neighbourhood teams, an ICS approach to AI and automation, system architecture and standards, minimum digital maturity standards, and vision of the ICS-wide platform.
Health tech in the East of England: snapshots from the past year
We were joined by an expert panel including Cambridge University Hospital’s Wai Keong Wong, director of digital and consultant haematologist, to explore strategies for empowering a digital workforce, and how to develop workforce technology literacy through scalable and effective digital learning and support programmes. Wai Keong said: “I do think we are a very highly digitised organisation – all aspects of care are covered in some form by digital and there is very little paper to be seen. We are digitally optimised and things feel efficient and safe. Does it feel like a digitally transformed organisation? I would say that we have a good foundation to build towards that goal. We haven’t yet experienced that big step change, but we are on that journey.”
Chris Johnson, chief medical information officer at Royal Papworth Hospital NHS Foundation Trust, participated in a panel discussion looking at how health and care can tackle interoperability, talking over some of the key challenges and how to overcome them in the future. Noting how Royal Papworth has worked toward overcoming these challenges, Chris talked about the importance of “meticulous planning”, stating: “That’s where we have disparities between developmental roadmaps of products, disparities between vendors, and the like. It can lead to compromises in the technology that we use, and a difficult mixed economy in your systems. That can make the application of business analytics, for example, really challenging. You might want to use data for population health planning or research, but sometimes your data is there and sometimes it is not. But I think pushing for that future vision and really putting the time in with planning is the way forward.”
Ciara Moore, unified EPR programme director at Mid and South Essex and Essex Partnership University, took part in a HTN Now panel discussion on approaches to EPRs, which covered next steps following initial implementation, as well as what the future holds for EPR best practice. “Our aim is to take our ten EPRs, seven in mental health and three acute, and turn those into one unified EPR,” Ciara said. “We’ve got our Nova branding and our memorandum of understanding, which I always refer to as our prenup agreement; and we’re at the implementation stage of our programme, so really ramping up the change and engagement, and getting people on board to start doing those all important current state reviews and future design.”
