ICB Region Series: Midlands
Welcome to the next instalment of our region series for 2026, where we take a deep dive into what’s happening with digital and data across the Midlands region. We’ll explore pilots and innovations, strategies, case studies, and insights from the sector.
Digital strategy, digital plans and priorities
Five-year strategic commissioning plan reveals ambitions for shared care records, AI, remote monitoring at Shropshire, Telford and Wrekin ICB
Publishing their five-year strategic commissioning plan in line with the NHS England medium-term planning requirements, Shropshire, Telford and Wrekin ICB has shared ambitions for shared care records, AI, remote monitoring, data, digital diagnostics, and more. For electives and diagnostics, the ICB notes ambitions to incorporate digital pathway optimisation, increased use of remote monitoring, and strengthened digital interoperability to allow for results from Community Diagnostic Centres to flow seamlessly into primary and secondary care systems. The Care Coordination Centre will play a central role in digital transformation, it continues, by taking responsibility for this interoperability and the transfer of patients into the right services at the right time. For long-term condition care, the focus will be on the expanded use of remote monitoring, virtual consultations, and data-driven insights, including the use of remote clinical tools like digital blood pressure monitoring to help patients self-manage at home. Across all pathways, digital solutions will support earlier intervention, improve care continuity, and reduce duplication, including digital triage and access to online information.
My NHS GP will be delivered to use AI-enabled triage and data-driven clinical pathways in primary care, whilst patients will be given a single digital space to manage all appointments, referrals, diagnostics, and communications, and ambient voice tech will be deployed to reduce admin burden and free-up clinical time. By 2031, the ICBs outline ambitions to have expanded the Shared Care Record, integrated it with the NHS App, and deployed the FDP to provide “real-time, linked datasets across health and social care”. Data sharing arrangements will be strengthened, system analytical capability and competence will be developed, outcome dashboards and predictive analytics tools will be rolled out, and population health management tools will strengthen system-wide intelligence. Data architecture, co-designed digital solutions, automation of repetitive tasks, virtual wards, and cyber security will also be areas of focus.
Strategic commissioning plan for Leicestershire and Northamptonshire ICBs notes digital to transform population health, neighbourhood health, and prevention
Leicester, Leicestershire and Rutland ICB and Northamptonshire ICB’s latest five-year strategic commissioning plan to 2031 highlights the move from short-term recovery to longer-term transformation, outlining the role of digital and data in areas such as population health, neighbourhood health, and prevention. The ICBs also share that a new digital and data strategy is expected in September 2026, with a data quality strategy to follow by March 2027. Core commissioning ambitions include improving access and flow for elective care, urgent and emergency care, and neighbourhoods, the ICBs state, modernising pathways, reducing variation, and relying on digital connectivity and shared care records to help deliver care closer to home. Digital and data literacy will be enhanced across the workforce to support a “digital by default” approach to commissioning, and digital tools and real-time data will help promote proactive care.
Under the neighbourhood model, the ICBs commit to increasing access to digital tools to support people, putting in place shared digital records and interoperable systems to enable better integration, and providing a single point of access for service navigation and triage. Given the variations in digital maturity and capability that exist across providers, the commissioning approach is designed to prioritise the development of strong, shared digital foundations. Digital will be embedded within commissioning intentions and business cases, ensuring digital requirements are identified early in the pathway design process, and with “active involvement” from digital and data leads. Better use will be made of linked data to inform commissioning, evaluate impact, and support population health management, according to the ICBs. Priority cohorts will be identified with segmentation and risk stratification approaches, variation in data quality and information sharing will be addressed, and digital inclusion and accessibility will be required considerations in service specifications. From a funding perspective, the ICBs plan to incorporate digital funding within pathway redesign and service transformation, using business cases to articulate digital dependencies and risks, and prioritising solutions that offer benefits for commissioning and population health.
Derbyshire, Lincolnshire and Nottinghamshire ICB shares five-year strategic commissioning and population health improvement plan
The Derby & Derbyshire, Lincolnshire, and Nottingham & Nottinghamshire (DLN) ICB cluster has published a five-year strategic commissioning and population health improvement plan, detailing the role of digital in supporting system ambitions to 2031. DLN notes a “decisive shift” from traditional commissioning to a “should cost/should deliver” model with focuses on the three shifts toward prevention, care closer to home, and digital. High-level focuses include the provision of remote monitoring and virtual care options, the use of population health data to target support, joined-up information across partners to support care, and modern digital access routes such as the NHS App. Digital and data systems and approaches will be modernised, it continues, and headline deliverables cover the shared care record, NHS App, Federated Data Platform, and AI and automation.
By 2031, all referrals will be made using standardised digital referral systems, reducing paper referrals by 25 percent, DLN shares. Primary care providers use of technology for digital triage and ambient voice will have been optimised, digital maturity and resilience will be improved system-wide, and interoperable health records and shared care records will have been embedded with >90 percent of GP practices sharing records with neighbourhood teams and >75 percent of health, local government and VCSE connected. Digital referral, triage, and advice systems will have been embedded, the ICBs continue, whilst “clinically meaningful” dashboards and performance intelligence will be in routine use by leaders and those on the frontline. Digital capability will be built into neighbourhood and place-based working, and 80 percent of neighbourhoods will have a delivery plan for digital inclusion. Transformation will be accelerated through innovation, according to DLN, with new models of care, digital solutions, and transformational approaches to be readily tested and scaled. Here, the ICBs note that they will “balance ambition with assurance” to enable innovation and deliver measurable impact, resulting in faster transformation, improved productivity, and more responsive services for communities.
Green Plan from Coventry and Warwickshire ICB sets out ten digital transformation objectives to 2028
Coventry and Warwickshire ICB’s latest green plan has been published, listing ten digital transformation objectives and a timeline for their delivery to 2028. In 2026, all new digital supplier contracts will include sustainability criteria, requiring carbon reporting and alignment with NHS Net Zero targets; and 100 percent of trusts will have completed a Digital Maturity Assessment, focusing on identifying sustainability improvements. The ICB also hopes to explore the implementation of a “PC power down” pilot scheme by October 2026. December 2026 is the deadline given for exploring the potential to migrate NHS-hosted digital services to more environmentally friendly options, with Coventry and Warwickshire’s board looking to audit existing digital hosting providers and consider opportunities for low-carbon cloud services or green datacentres. The same deadline is offered for a reduction in paper usage by promoting digital approaches, virtual consultations, digital letters, and use of the NHS App. High paper-use processes will be identified, and digitised where clinically safe, the ICB continues.
Black Country ICB notes need to be ambitious around digital shift
Black Country ICB has shared a series of digital updates around its work across digital and data, including AI, shared care records, a digital strategy refresh, and the secondary use of data. Results from the ICB’s latest digital maturity assessment were discussed, with the board noting that “the ICB has a central position in terms of both the Midlands region and the whole of the NHS”. A working group is now being set up to produce an action plan, and outcomes will be worked into the ICS’s digital strategy, which is due to be refreshed. A vision, a set of principles, and a high-level milestone plan have been agreed for the Black Country IT Service. Leads have been identified from across the system for different tasks to help promote ownership from partners, and focus areas include the alignment of contracts and infrastructure, proposals for a single IT service, cyber, digital inequalities, digital sustainability, and AI.
On work on bids for NHSE capital funding, the ICB shares: “We have been clear in that to articulate 10-year plans for digital transformation is virtually impossible.” Plans have been submitted covering the continued growth of the shared care record, digitising social care, aspirational AI, AI dictation, upskilling staff in AI, e-triage UEX, digital data transformation, digitising pathology, community EPR, and data warehousing. The One Health and Care Shared Care Record programme is supporting the delivery of joined-up data from across the ICS, the board highlights, to inform clinical decision-making and planning. “There is a responsibility to apply for a section 251 in order for the data in the shared care record to be used for secondary purposes i.e. PHM & analysis,” it notes. That application is now recorded as having been submitted.
Digital inclusion delivery framework for Nottingham and Nottinghamshire ICB outlines priority themes and roadmap to 2030
Nottingham and Nottinghamshire ICB’s Digital Inclusion Delivery Framework has outlined a “bold and unified vision” for tackling digital inclusion, based around five themes: connectivity and access to devices and data; digital accessibility and information literacy; workforce digital skills and confidence; partnerships; and digital inclusion knowledge and expertise. The ICB commits to using analytics to better understand digital inclusion barriers and gaps, both in the workforce and wider population. User-centred design and co-production will inform all digital projects to ensure accessibility and usability, and a focus will be placed on those experiencing the greatest health inequalities. Improved digital connectivity and accessible public services will add to economic prosperity and social equity, it continues, and clear and inclusive communication will help improve understanding of digital health capabilities and benefits.
By March 2027, all organisations across the system will have a digital inclusion action plan in place and collaborations will have begun with external partners on building workforce expertise, the ICB’s roadmap shares. By 2030, the ICB hopes to explore options for device hubs in community settings, consider options for device recycling to support local communities, map the digital support landscape, have in place tiered approaches to digital skills development, and become a “national exemplar” for digital inclusion.
Joint Birmingham and Solihull ICB and Black Country ICB cluster board agrees on digital first for integrated pathways as one of six strategic anchors to guide decision-making
A joint meeting of the Birmingham and Solihull ICB and Black Country ICB cluster board has agreed upon six strategic anchors to guide decision-making, with digital first for integrated pathways being one of the areas of focus to be highlighted. According to the board, this will cover priorities including driving the adoption of NHS App capabilities and digital triage; embedding implementation of remote monitoring, patient-initiated follow-up, and AI-assisted access; and the Federated Data Platform. Success will be measured through the percentage of pathways including digital triage and with the adoption of NHS App features, it continues.
Digital in Coventry and Warwickshire ICB and Herefordshire and Worcestershire ICB cluster’s five-year strategic commissioning plan
Coventry and Warwickshire ICB and Herefordshire and Worcestershire ICB have highlighted the role of digital in the ICB cluster’s five-year strategic commissioning plan. The ICBs look to embrace the shift from analogue to digital through clinically-led digital transformation, the targeted use of AI to drive efficiency in clinical pathways and especially in assessment processes, and scaled use of tech investments like the NHS App and Shared Care Record. The ICBs further commit to delivering the right digital infrastructure, enabling integration and automation of data and systems, and increasing the number of self-serve solutions. Collaboration will also be pursued with providers around reducing the administrative burden.
Restore Information Management on tackling the shift to digital, future-proofing information strategy, and realising the benefits of digitisation
We caught up with Simon McNair, head of business development at Restore Information Management, who shared insights from his work helping NHS organisations to tackle challenges around managing legacy records and making the transition to digital. “We particularly look to offer support in using technology to extract better value from the data held by NHS organisations, which can be critical to clinical decision-making,” he explained. “Also, with the shift to prevention, through access to the data, particularly as it’s being centralised around the Single Patient Record and national document repositories.”
Reflecting on the change happening within the healthcare sector at the moment, Simon talked about the “clear direction” set out within the 10-Year Plan from analogue to digital, structural changes being made to how funding is distributed, and the more complex landscape for ICBs in terms of delivering care to patients. Recent progress on digitisation doesn’t detract from the fact that some of the processes involving paper records that it is replacing have been in place for decades, he considered, “and I think the challenge is in that transition from a paper way of working to a digital way of working, benefitting from the technology and platforms now available offering better communication, better visibility, and better ways for patients to manage their care”.
For ICBs, the key is “understanding what you have, minimising your holding in terms of records and data in line with retention programmes, and then enabling clinicians to access the information they need efficiently to improve patient care,” Simon told us. “It’s also about a level of system or centralised support, for example going out to practices to support with information management, compliance, and so on.” There has been significant investment at national and regional level in technology that can help NHS organisations particularly in the primary care space to operate more efficiently, he continued, “a good example would be the National Document Repository, which has created a central database for GP and primary care records that the whole network can access”.
Effective ICB estates strategy
Central considerations for ICBs looking to develop estates strategies include consistent funding, gaining an understanding of real estate footprint and the costs associated with current records management practices, and exploring how digitisation could reduce that burden. “The byproduct of that is reducing operating costs,” said Simon, “or reusing and repurposing real estate in a more efficient way”. Progress on frontline digitisation, ensuring every organisation has an EPR, and the subsequent availability of data to improve patient outcomes has meant not only less paper records, but also more compliance, and better access to data when it’s needed, in the format it is needed, for clinicians.
“For NHS organisations that may have offsite warehouses and different medical records stores, coming out of those sites offers a reduction in ongoing operational cost, because you’re no longer paying the rent, the rates, etc.,” Simon considered. “We know the NHS is operating under huge space constraints, so if there’s a chance to repurpose the records room in a GP surgery into another consulting room, for example, there’s benefit there, which is multiplied up again if you look at that at a large trust.”
Future-proofing information strategies and moving toward a hybrid model
It’s becoming increasingly important to future-proof information strategies to make room for emerging technologies like AI, Simon noted, and the opportunities they may offer to increase productivity and patient choice. “It’s about using technology in a way that allows for more effective information management,” he said, “particularly where that information is hybrid – how do you apply automated retention processes, how do you manage requests to access that information, and how can you surface what you need quickly and easily?” Used properly, technologies such as AI can help improve retention practices and compliance, reduce administrative burden, free-up both clinical and operational time, and extract greater value from data, he added.
“Whether records and information are in paper or digital format, the key piece is having a really effective policy in place that is deployed consistently across the organisation,” Simon told us. “At a foundation level, it’s about having a robust approach to managing information, information governance, and programmes around compliance.” He suggested designating information asset owners, and ensuring clear cybersecurity protocols are in place, whether information is being managed or held within the NHS or with the involvement of third parties.
Best practices and key considerations
Moving on to think about what ICBs should consider when shaping their information strategies, Simon highlighted that there remains “quite a bit of work to be done” on addressing core foundations of how physical and digital records are managed. “In a significant number of projects we’ve done across both primary and secondary care involving large-scale uplifts of records, digitisation on demand based on patient need or patient appointment, as opposed to trying to just digitise everything, has worked more effectively,” he shared. “Having a clear plan and a roadmap, with funding in place, has led to greater success, in our experience, and having a single system to manage the patient record, along with a single view of the patient record, is a good starting point.”
For Restore Information Management, it’s about getting organisations to a point where they have minimised their records holding, are digitising based on an intelligent view of what’s required by clinicians, and making sure that’s accessible on platforms and systems in use across the NHS, Simon explained. “Our role, and where that’s worked well, is where those programmes are funded and very joined-up, because it’s part of a much bigger transformation programme – the part that we do often enables some of the effective investments in systems and a single view on the patient record, and those major EPR investments that the NHS has made.”
Talking about the positive direction set out by the 10-Year Plan, Simon considered how Restore Information Management is well positioned to offer at-scale, secure, and experienced guidance. “We can bring our expertise to focus on a task that the NHS essentially doesn’t have the bandwidth or the resources to do itself,” he said. “When it comes to the aims of the 10-Year Plan, and particularly moving from analogue to digital and getting a single view of the patient record, we can help tackle what is still an enormous challenge, despite sizeable process being made over the last three years or so.”
These challenges are already being addressed in practice. A recent programme delivered with NHS Birmingham & Solihull Integrated Care Board shows how a system‑wide approach to information management can support the transition from paper to digital at scale. By securely digitising over one million patient records across 160 GP practices, the ICB was able to improve access to information, strengthen governance, and support more joined‑up care across the system.
Insights from the Midlands region
AI strategy, implementation, adoption, opportunities
HTN was joined for a deep dive into AI strategy, implementation, adoption, and opportunities by Neill Crump, group associate director of innovation & partnerships at The Dudley Group and Sandwell and West Birmingham, and Pip Hodgson, group digital transformation specialist at University Hospitals of Leicester and Northamptonshire.
“I actually think the procurement commercial models are a major determinant of whether AI adoption is going to succeed in the NHS,” Neill considered, “and we need to be thinking about how we work together in order to do that – a lot of current frameworks focus on traditional software which doesn’t change much over time; AI is evolving rapidly, so we need that continuous evaluation.” Dudley and Sandwell have just completed a regional procurement for AVT, he continued, which allowed greater testing of the market, a comparison of suppliers, and better cost efficiencies. “It’s important to evaluate multiple suppliers so you can benchmark their performance,” he suggested, “and if we coordinate, rather than having hundreds of separate buyers within the NHS, we can negotiate better and reduce duplication, which will allow for standardisation, sharing learning, and evaluation.”
Pip talked about going straight from paper to AVT in some scenarios, and needing to take a step back to look at what was realistic in terms of what UHL and UHN needed from the technology. “I really encourage people to think about that early on,” she said. “What capabilities do you need? Is it a standalone system or will it be integrated? We’re obsessed with open standards in the NHS, but the reality is that just looking across my own patch we have multiple, multiple different systems.” Drawing up a heat-map of different solutions and suppliers, as well as what they offer and what the organisations’ needs are, before moving on to think about scale, is key, she went on. “AVT for us is anywhere that generates a conversation output, and predominantly the business case focused on outpatients.”
EPRs, lessons learned, optimisation, opportunities, and the future of EPRs
Sally Mole, senior digital programme manager – digital portfolio delivery team at The Dudley Group, joined our panel for a webinar focusing on EPRs, exploring lessons learned, optimisation, opportunities, and the future of EPRs. Dudley’s EPR went live in 2017, Sally shared, and whilst initially the plan was to go with a “big bang” approach, “that quickly changed once we realised it was far too ambitious and the organisation wasn’t ready – we started breaking down the programme into more individual deliverables across electronic observations, sepsis, order comms, referrals, ePMA, and so on”. To date, the team has had a multitude of different modules released within the EPR, a series of major releases, and an update to infrastructure to move to the cloud.
Ensuring that the EPR is clinically-led is key, Sally told us, “as although the IT team have the technical ability to implement and make changes, it’s the clinical team that need to assess things like impact on other services, and the things that the IT team might not think of in the first instance in terms of clinical safety”. Dudley has always done a clinical safety review after the design and implementation process, she went on, “so we have multiple touch points where we’re designing-out clinical safety risks before we get the the point of implementation”. A key improvement has been the work done to engage with the organisation and make sure the right people are involved, so that the EPR can be owned by there services, and not by IT.
Sally’s team has also been focusing on benefits realisation, as funding often requires that you’re able to demonstrate what the return on investment is. This has involved a lot more upfront planning and time-in-motion studies, which makes it easier to anticipate benefits and then monitor those post-implementation. “We’ve really embedded our governance processes so the organisation knows how we deliver projects, which makes it a lot easier because we’re no longer spending the time talking about all the boring stuff in the background. We’re actually now able to really focus on the outward design of the solutions.”
The CIO role now and in the future
Ravi Sahota Thandi, interim operational CIO at The Dudley Group NHS Foundation Trust, joined our panel for a discussion looking at the CIO role now and in the future. Thinking about what the CIO role looks like at the moment, Ravi highlighted how stressful it can be with the changes that are happening in terms of the group-level working across the NHS and the sheer speed with which new technologies are being adopted. “I think the role has changed,” she acknowledged, “because it used to be fine to sit in a CIO role and be a subject matter expert, but that’s no longer the case. You need to be so much broader now, to have that strategic intent and understanding of what’s happening in your organisation.”
There’s also the need to think about your personal responsibility as a leader, according to Ravi, including looking after your team and their development. “That’s been the real shift, as it’s been really easy for people to get into a role and then stay in it, but now there’s more cognisance of impact and leaving your organisation in a good place. We’re moving more into soft skills and talent strategy, looking at how you lead workforce transformation and embed digital literacy.” In the future, there’s likely to be a shift to working more broadly across the system and becoming an “orchestrator of digital, data, and tech, at scale,” she added.
Demand is currently outstripping capacity for digital teams, Ravi told us, so prioritising what is important to your organisation is key. “We’ve done a lot of work to understand what digital investment means to the organisation, costs avoided, and so on, and having that ability to track those benefits is central to achieving the visibility and transparency that is important in being a leader.”
