NHSX Delivery Plan

Published 1 December 2021


Digital transformation in health and care

The digital contribution

During the pandemic digital transformed the delivery of care. The opportunity now is for the health and care sector to build on this, and use the potential of digital to help the NHS address both its long term challenges and the immediate task of recovering from the pandemic.

In practice this means:

  • better outcomes and experience for people - a more personalised experience for people, new ways of accessing care and helping them stay healthy
  • better experience for staff - information available for use by staff and citizens, reducing the time spent chasing referrals or test results, and staff can work more flexibly
  • more effective population health management - ICSs understand the needs of their populations, and reshape their services to meet them

How we will achieve it

Our strategy

Digitise services, connect them and drive transformation.

Digitise

We will support local health and care systems to raise their digital maturity, and ensure they have a core level of infrastructure, digitisation and skills.

Connect

We will support services to connect, enabling health and care providers to share information with one another safely for both direct care and for population health.

Transform

Through the platform of a digitised, connected health and care system we will enable services to be delivered more effectively and productively, with citizens at the centre.

NHSX led investment in the health and social care system - the NHSX Delivery Plan

Introduction

NHSX, as a joint unit of NHS England and NHS Improvement and the Department for Health and Social Care, commissions and oversees a portfolio of digital transformation programmes. The activity is driven by the priorities of the NHS and the care sector.

The work is funded jointly by allocations from the Department and from NHS England and NHS Improvement, and described in this Delivery Plan. We work in close partnership with NHS Digital as the national delivery partner, safe haven of data, and builder and operator of live services.

Purpose

The purpose of the NHSX Delivery Plan is to describe what NHSX has commissioned, and what is being delivered when. This should enable frontline leaders to plan with confidence, with an understanding of the change being undertaken centrally.

Scope

This Delivery Plan describes the change programmes funded by NHSX that make up its Technology Transformation Portfolio. It describes what has been commissioned, the delivery approach, the outcomes and major deliverables it is working to achieve and the timescales for delivery.

Also included are new programmes that have only been commissioned recently and are still developing their delivery plans. This Delivery Plan will be updated as these programme delivery plans are approved.

Duration

The NHSX Delivery Plan was intended to look ahead for the next 3 years. But the single-year Comprehensive Spending Review in 2020 meant that current funding allocations are limited to the 2021 to 2022 financial year. As a result the delivery commitments set out in this plan are mainly focussed on the year up until the end of March 2022, and dates and deliverables beyond March 2022 will be subject to change.

Once the outcomes of the 2021 Comprehensive Spending Review are known the plan will be updated to reflect both the funding allocations made and the duration of the settlement.

Change to plans

As the past 18 months have vividly demonstrated, the needs of the NHS develop over time, sometimes at short notice. And best practice for technology development often involves agile methodologies which entail rapid iteration, making it difficult to set out precise milestones years in advance.

NHSX recognises this in the way it operates, and is moving toward agile methodologies and flexible prioritisation, to ensure it is responsive to changing needs. This means that the activities and associated commitments in this plan are always subject to review and change.

Digitise - overview

Currently, only 21% of secondary care providers are digitally mature and 10% continue to rely heavily on paper.

We will continue to work to level up digital maturity across the system by helping local organisations and ICSs reach a universal baseline level of digital maturity, including digitised health records, cyber security, skills and connectivity.

The programmes in this section detail how we will address these challenges and drive forward the digitisation of NHS services.

Frontline digitisation

Background

This programme will provide national support to enable locally led, digitally enabled transformation change programmes.

NHSX will define the digital baseline that systems and providers should aim for. We will provide funding, advice and support and make sure that suitable governance and oversight is in place to account for the central money invested and increase the likelihood of successful delivery.

Local teams will design, procure and implement their digital solutions. They will be responsible for making sure the right digital leadership is in place and that the planned benefits are achieved through local service transformation. The centre will provide support, including procurement frameworks and sharing of best practice.

Delivery approach

Our ‘What good looks like’ framework describes the smart digital foundations that we want to establish as a baseline for all secondary care providers and ICSs.

Investment from NHSX will be targeted to where it is needed the most. This means working with all sector teams, regional and integrated care systems to identify the investment they need.

Acute trusts will continue to be supported by the Digital Aspirant programme. We currently have 36 full Digital Aspirants and 25 providers with seed funding to develop their plans. We aim to start working with at least another 15 full Digital Aspirants over the course of the 2021 to 2022 financial year.

Acknowledging an historical imbalance, we aim to provide equitable funding to address the gaps. We will make sure that community, mental health and ambulance services have a fair share of funding and that their delivery plans are specific to their sector.

In particular in the coming year we will invest in mental health organisations to make sure they all have access to full electronic prescribing.

All central funding comes with a strong obligation to collaborate and share learning. NHSX will achieve this commitment by working with organisations we fund being required to capture learning in the form of one or more blueprints and contribute to learning networks established around areas of shared interest that NHSX will facilitate.

NHSX will:

  • develop a pipeline of investment to support organisations throughout the investment lifecycle
  • prioritise strategic multi-year investments over tactical in-year priorities
  • promote a steady flow of digitisation projects to prevent bottlenecks
  • make multi-year funding allocations as early as possible to avoid last-minute scrambles

We will invest in trusts that have approved business cases to support delivery. Trusts that do not have approved business cases will receive seed funding from NHSX to develop their strategy and business case.

Trusts will be encouraged to develop a considered and timely approach to planning so that they are allowing sufficient time to develop business cases ahead of periodic releases of funding.

We are simplifying our funding routes as much as possible and will provide a single mechanism for systems and providers to bid for funds. This will be from one pot with a single proportionate assurance regime.

Commitment milestones

A single mechanism for systems and providers to bid for funds established, with a unified investment pot and single joined up proportionate assurance regime.

Date: July 2021 (complete)


Round 1 (existing commitments) funding has started to be issued to systems and providers, with evidence of delivery to date, as defined in the approved interim funding request.

Date: November 2021


Prioritisation and the identification of the pipeline of investments for the 2020 to 2021 financial year has been completed.

Date: November 2021


Formal onboarding to the Digital Aspirant programme cohort 3 (2021 to 2022 financial year) completed.

Dates:

Wave A - December 2021

Wave B - February 2022


32 Digital Aspirants supported to continue their digital journey through the programme.

25 organisations have received seed funding.

15 further Digital Aspirants have been on boarded onto the programme.

Date: March 2022


Using the outputs from the assessment of providers against the What Good Looks Like framework ‘Smart Foundations’ and ‘Supported People’ modules to inform future investments

Date: March 2022


By March 2025, 95% of NHS secondary care organisations will have achieved foundational digital capabilities or be a Digital Aspirant / Global Digital Exemplar / Fast Follower

Dates:

40% by March 2022

65% by March 2023

85% by March 2024

95% by March 2025

The new hospital programme

Background

NHSX is leading the development of the digital blueprints for the New Hospital Programme (NHP) that will be created through the health infrastructure plan. This will make sure that participants in the programme are aware of the potential that digital capabilities have to offer, that they plan to deliver these capabilities and fully realise the benefits associated with them as the next generation of hospitals is built.

As well as expert advice, NHSX has developed a digital blueprint to steer the design of digital hospitals and is developing cost and benefit models to support business case development. The guidance builds on past work on programmes such as the Global Digital Exemplars and brings in experience from around the globe. Further guidance will be developed to reflect the emerging needs of the trusts involved in the NHP.

NHSX is also working with the NHP on the assurance of digital plans and delivery for each new hospital. The NHP team will oversee delivery of the programme and NHSX will make sure that the building embraces all the mandatory digital capabilities defined by the programme and that all relevant digital standards are adhered to. This assurance runs throughout the lifetime of the programme from conceptual design through to post build optimisation.

Delivery approach

The detailed timetable and programme plan for new hospitals is currently being defined. Work with the first 6 pathfinder trusts will help refine the support offer for all subsequent builds.

What good looks like

Background

The pandemic enabled us to achieve a level of digital transformation that might have otherwise taken several years. As we move into the recovery period, it is critical that we build on the progress we have made and ensure that all health and care providers have a strong foundation in digital practice.

The What Good Looks Like (WGLL) programme draws on local learning. It builds on established good practice to provide clear guidance for health and care leaders to digitise, connect and transform services safely and securely. This will improve the outcomes, experience and safety of our citizens.

WGLL is directed at all NHS leaders, as they work with their system partners, and sets out what good looks like at both a system and organisation level. It describes how arrangements across a whole ICS, including all its constituent organisations can support success.

WGLL is included in both the ICS design framework and the NHS Operational Planning and Contracting Guidance, reflecting the expectation that the standards in the WGLL framework will be used to accelerate digital and data transformation.

The WGLL framework has 7 success measures:

  1. Well led.
  2. Ensure smart foundations.
  3. Safe practice
  4. Support People.
  5. Empower citizens.
  6. Improve care
  7. Healthy populations

Delivery approach

In August 2021 NHSX published What Good Looks Like, setting out a clear and common vision. The next stages of WGLL delivery for the 2021 to 2022 financial year are as follows.

Creation of an assessment framework so ICSs and constituent organisations can:

  • understand their levels of maturity against the WGLL success criteria
  • identify strengths and gaps
  • prioritise areas for improvement when creating local digital transformation strategies and plans

Assessments will be based solely on a combination of independent assessment and peer review and will be repeatable so progress can be tracked year-on-year.

Development of a support offer to support local digital transformation, What Good Looks Like will provide a customisable support offer. This will include:

  • access to people and digital and data expertise
  • an easier way to access trusted information - this will include blueprints, standards, templates, real-life examples and best practice from their peers
  • creation of community of interest groups and peer support networks

Our goal is to ensure that frontline leaders have the right information, tools and support to digitally transform services and provide better care.

Commitment milestones

What Good Looks Like Guidance published

Date: August 2021 (complete)


Approach for the What Good Looks Like Assessment Framework created and agreed

Date: September 2021 (complete)


Initial Support Offer for local ICS / NHS organisations available

Date: December 2021


Results from first What Good Looks Like Assessments received and analysis complete

Date: January 2022

Who pays for what

Background

The Who Pays For What (WPFW) framework identifies the barriers to investment in digital health technology and how we will start to fix them in 2021 to 2022 and beyond.

In the 2021 to 2022 financial year we will consolidate national funding for transformational technology projects into a single fund. From the 2022 to 2023 financial year, we propose to start to move away from central funding of frontline technology and health and care providers will increasingly be given control over the resources with which to deliver their technology plans.

In addition, to support better digital investment NHSX will:

  • improve the timeliness, usefulness and reliability of digital metrics available for benchmarking (including, for example, the creation of a ‘digital backlog’ calculator)
  • provide tools and case studies to help ICSs to model and track benefits from tech investments
  • revise national policies to better support digital investments

We are keen to receive feedback on these proposals.

Delivery approach

NHSX is working with NHS England and NHS Improvement (NHSEI),regional and local teams to improve and finalise the proposals and will continue to do so throughout the programme. Their input is key to identifying and implementing the appropriate level of oversight for digital investment as ICSs are given more control over funding.

We will also work closely with ICSs and their constituent organisations to develop and implement the programme to make sure it meets their needs.

A document setting out our thinking was published in August 2021, including proposals for how we can move from the current state to our vision for the future state.

Consultation on the document is underway, and will be reflected in the final WPFW approach. This will be available in time to feed into the 2022 to 2023 financial year operational planning guidance.

Commitment milestones

Engagement document released online to help system leaders understand the direction of travel for funding their digital and technology spending.

Date: July 2021 (complete)


Final list of requirements have been collected, and the metrics have been defined for the Digital Backlog Tool.

Date: July 2021 (complete)


A proposed approach to allocations tested with national finance teams and proposed to local teams.

Date: November 2021


A prototype of the Digital Backlog Tool has been designed and is ready for testing by a small cohort of CIOs.

Date: December 2021


Information Management and Technology and Digital Data and Technology metrics refreshed in Model Health System.

Date: December 2021


Reimbursement models, allocations and/or other changes to support national policy to support digital investment included within the NHS England and NHS Improvement Operational Planning Guidance for the 2022 to 2023 financial year.

Date: December 2021


The first Beta version of the tool is launched to the system.

Date: January 2022


Trial of reimbursement models and other national policy levers that are aligned to support different categories of tech investment so that adopting and spreading technologies that benefits patients and/or saves the National Health Service money is made easier.

Date: April 2022

Cyber security for health and care

Background

Significant progress has been made in recent years to improve the state of cyber security in the NHS and social care. However, significant vulnerabilities remain. Many NHS organisations are still struggling to get the basics right, carrying outdated infrastructure unprotected by vendors and lacking suitable backups to protect against ransomware. This is exacerbated by lack of central visibility beyond the desktop estate and lack of capability to prevent a breach in one organisation affecting the wider system. More work is needed at both a national and local level to bring the sector to a more acceptable level of cyber resilience.

In parallel to the delivery activity outlined, a robust evidence-based bid to HM Treasury will also be prepared for the next Spending Review period. This will set out how the health and care system should continue to improve its cyber maturity and stay ahead of the evolving cyber threat.

Delivery approach

A combined team of NHS Digital and NHSX supported by the National Cyber Security Centre (NCSC) will assess needs across health and social care and distribute capital funding to help organisations to address some of their biggest risks. This funding will be distributed through the Unified Tech Fund.

The teams will work through NHS Digital’s regional security leads, who act as the conduit between the national bodies and localities. They will make sure that bids represent regional views of relative priority and fit with local digital transformation. The NHSEI regional teams will continue to act in their leadership role within their regions, making sure that the right level of assurance and support is on offer to drive forward cyber security performance.

For adult social care, interventions to support care homes and other care providers will be undertaken with the Care Providers’ Alliance (CPA) and in partnership with the Local Government Association (LGA) and the NHSEI Ageing Well programme.

The Cyber Associates Network (CAN) will:

  • engage with health and social care organisations and security professionals to test ideas
  • receive feedback from regions and local organisations
  • promote uptake of NHS Digital services
  • act as a mechanism for benefits realisation

Commitment milestones

Leaders in healthcare organisations are provided with a minimum viable product (MVP) of cyber risk metrics for the top three cyber vulnerabilities in the NHS

Date: August 2021 (complete)


Vision and priority guidance produced for local adoption on how to avoid having unsupported devices and ensure all devices have proper lifecycle management embedded is produced

Date: September 2021 (complete)


An asset discovery solution and approach for delivery has been agreed.

Date: October 2021


100% of available capital infrastructure funds distributed to the system for priority organisation.

Date: February 2022


Long-term system wide Security Operations Centre (SOC) strategy to support local, regional and national needs is published.

Date: March 2022


The riskiest 15% have received support around most critical vulnerabilities

Date: March 2022


At least 3 incident response exercises with national and local bodies have been delivered.

Date: March 2022


The future strategy for cyber security across the system is published.

Date: March 2022


A tripling of the number of adult social care providers completing the DSPT (Data Security and Protection Toolkit) to at least Approaching Standards status, from 14.3% to 43%.

Date: March 2022

Digital and data for integrated care systems

Background

The vision for integrated care has been around for a number of years. The COVID-19 pandemic has been a significant turning point and has highlighted the importance of joined-up, integrated care and the need for collaboration across the health and care system enabled by digital and data foundations.

The Integrated Care Systems: design framework (PDF, 404KB) guidance outlines the digital and data requirements that ICS bodies need to have. ICSs are expected to:

  • have a renewed digital and data transformation plan - that is embedded within the ICS NHS body plan and details the roadmap to achieve ‘What Good Looks Like’
  • have a named SRO on the ICS board that has clear accountability for digital and data - enabling a cross-system approach to transformation and system recovery
  • invest in levelling-up and consolidation of infrastructure, linked to the future ICS reference target architecture and data model
  • implement a shared care record that allows information to follow the patient and flow across the ICS to ensure that clinical and care decisions are made with the fullest of information
  • ensure adherence by constituent partners to standards and processes that allow for interoperability across the ICS
  • enable a single coordinated offer of digital channels for its workforce and for citizens across the system and roll out remote monitoring technologies to help citizens manage their care at home
  • cultivate a cross-system intelligence function to support operational and strategic conversations
  • agree a plan for embedding population health management capabilities and ensuring these are supported by the necessary data and digital infrastructure

NHSX in support of NHSEI will help prepare Integrated Care Systems (ICSs) for their establishment in April 2022. We will do this by providing digital experts to support them, provide clarity on what will be developed as national capabilities and what will need to be done locally and develop a plan with them to improve their digital maturity towards the standards set out in What Good Looks Like. This will be based on an understanding of local system’ data, digital and technology needs and how they use that data to respond to population needs and underpin integrated care models.

Delivery approach

To determine what this support offer should be, NHSX commissioned research to:

  • develop use cases around best practice for ICS and collaboration across the system
  • map user journeys to understand pressure points and improvements.
  • produce a gap analysis of national and local products and services.
  • develop a user centred ICS target architecture based on capabilities.

This feeds into:

  • the support offer for the ‘What Good Looks Like’ (WGLL) framework
  • ICS target architecture work
  • the NHSEI ICS intelligence function support
  • the full range of NHSX programmes which will impact ICS development
  • the NHSX data strategy
  • the configuration of new and existing services that NHSX commission NHS Digital to deliver
  • ICS service patterns/blueprinting and contributing signposting to knowledge sharing networks
  • a clear programme charter of national and local digital programmes to support ICSs and partner organisations

A digital and data steering group has been convened to shape and govern development of deliverables, informed by the ICS development steering group and the ICS digital and data forum, composed of local digital and data leaders from the 42 ICSs.

Commitment milestones

Discovery to understand the digital and data needs of ICSs completed. Identifying digital capabilities for ICSs; determining digital persona journeys across an ICS system; defining user centred architecture for ICSs; and scoping key programmes (inflight and new) and delivery level (local and national).

Date: May 2021 (complete)


An agreed process and strategy between NHSX and NHS Digital to transition from the existing use of ODS codes to a framework model which will be fit for purpose for all NHS organisations to work.

Date: November 2021


A digital people strategy for the workforce which recommends the utilisation of existing, nationally provided tools that enable cross-organisation working, reduces the burden on frontline staff and allows staff to work more efficiently and flexibly.

Date: January 2022


A target architecture will be developed which will enable providers to develop and refine the capabilities required to deliver services which will help to reduce inequalities, enhance efficiency and productivity and value for money.

Date: January 2022


Through collaboration with NHSEI, ICSs will use Population Health Management analytics to make data driven decisions to support COVID recovery and future system planning which will reduce health inequalities.

Date: February 2022


ICSs are provided with a place support offer to help them implement the What Good Looks Like guidance and produce a 3 year digital transformation programme.

Date: March 2022

GP IT futures

Background

The GP IT Futures framework will create a new environment for the supply of clinical IT systems to general practices that will support GP Federations, enable new care models and help local partnerships transform their services.

The overall goal is to encourage the best technology companies to invest in the NHS primary care systems market supporting the creation of a world leading health ecosystem and underpinning the requirements set out in the NHS Long Term Plan. The initial stage of providing continuity of procurement for GP IT systems is complete and in the 2020 to 2021 financial year the programme is focused on transforming the commercial, technology and data architecture for Primary Care General Practice.

Whilst delivering safe, resilient and functionally rich clinical GP systems, the most important and urgent change is to make sure that patients and the NHS can safely and securely access and share primary care data in real-time. This data connects patient care across care settings, provides the insight to allow the NHS to be more efficient and enables progress in medical research.

GP IT Futures programme will deliver:

  • a new GP IT Futures framework to succeed the GPSoC Framework that will provide the opportunity for safe and secure GP systems that are modern, resilient, interoperable, and offer more relevant product options to meet the needs of the service
  • a set of common and open technology and data standards for clinical IT systems, delivered by suppliers, to meet the emerging and future demands of GPs, primary care networks and new care models - these standards will enable all parts of the NHS to become connected, enabling better information for clinicians and better care for patients
  • a new digital marketplace, the digital buying catalogue, that will provide an online platform to search and compare approved suppliers’ solutions on the framework and procure clinical IT system capabilities
  • supplier technology platforms that meet the NHS’s needs for greater access to GP Data and the flow of digital information between care settings

Delivery approach

Over the next year the programme team will work with local health and care systems to identify potential early adopters at ICS level to work with new market entrants in the design and delivery of their new products. CCGs and regions will be supported by the NHS Digital team with purchasing through access to the online buying catalogue, buyers guide and other associated documentation.

CCGs receive an annual budget allocation to cover their GP IT Futures requirements. Once budget allocations are confirmed, CCGs manage the budget and find alternative funds for any overspend, re-compete to achieve a discount, or cancel some services. Assurance will be required against the allocation spend.

In the 2021 to 2022 financial year and beyond, we will:

  • make sure CCGs are supported to use the contractual arrangements to provide practices with the GP IT systems they need to deliver services and preserve continuity
  • work with existing and new GP system suppliers to provide a wider choice of systems to stimulate the market, encourage innovation, increase functionality and improve value for money
  • work with emerging ICSs and new GP IT system suppliers to identify local systems who are ready and equipped to jointly test and develop new solutions and accelerate development of their products to meet the evolving needs of primary care
  • continue to support CCGs and their constituent practices to make informed buying decisions on the products available to them through the GP IT Futures frameworks, that best suits their current and emerging requirements in light of the changing primary care commissioning landscape

Commitment milestones

Local competitions for foundation system solutions can commence at scale.

Date: April 2021 (complete)


CCGs and GPs beginning to purchase non-foundation solutions at scale.

Date: April 2021 (complete)


One new market entrant foundation solution onboarded, and compliant with modern technology standards, enabling more choice for local commissioners and users of the foundation solution.

Date: March 2022


The primary care buying environment simplified for local commissioners and suppliers to support more efficient commissioning of Primary Care solutions.

Date: March 2022


GP IT futures systems and services delivered, with transition to Live Services for ongoing management.

Date: March 2022


A new market entrant foundation solution deployment started, signalling the first live deployment of a new foundation solution to compete with the incumbent market in more than 20 years.

Date: April 2022

These milestones are awaiting formal sign-off from the programme board and are therefore subject to change.

Digital support to pharmacy, optometry, dentistry, ambulance and community services

Background

The future of the NHS is one where local systems have the tools and infrastructure necessary to work across boundaries.

Through extensive engagement, NHSX have identified the sector specific digital priorities covering the financial years 2021 to 2024 for:

  • community pharmacy
  • optometry
  • dentistry
  • ambulance services
  • community services

This will provide the digital platforms and services that enable these services to integrate better with the rest of the health and social care sector.

Cross-sector collaboration will improve outcomes for patients by delivering improved care, with smoother, more efficient pathways. It will also support improved health, with organisations able to work together to prevent illness and address the causes of ill-health.

A safer, more effective experience

With greater access to shared clinical records, professionals will have accurate information about medication and other key elements of a patient’s clinical history. This in turn is more clinically effective by supporting pathway optimisation across sectors. Ultimately, this leads to a better patient experience with greater opportunity for remote appointments and support at home using digital tools and applications.

Our intention is to substantially reduce end-to-end referral times, reduce unnecessary referrals by providing the capability to request advice and guidance and diagnostic workup.

The quality of clinical care will be improved by access to healthcare records and images at the point of care and improved communication and understanding between clinicians across sectors. Time will also be saved by the removal of unnecessary steps in processes.

These are the top 4 themes we recognise as being important to these providers:

1. The desire to ‘feel part of the family’

Providers see the opportunity to use digital technology to support cultural change and to feel more a part of the health and care system. Having access to shared care records and a greater ability to communicate with colleagues across sectors is fundamental to them.

2. The need to align the approach to support

Some pockets of innovation have been accelerated as a COVID-19 response, and there is a real commitment not to ‘go back’. There is a need to align the approach to scale change across England.

3. Recognising market complexity

The size and maturity of providers is variable. This creates a challenge for how to set minimum digital standards and support suppliers to meet them. NHSX recognises the need for clarity on funding availability for digital technology across different sectors.

4. The human factor

We know it is not just about technology. There are other barriers to digital adoption. Patients have very different degrees of digital literacy, knowledge and confidence. Staff too may have these, on top of training, information governance, security challenges and financial constraints.

Delivery approach

The programme will produce a direct time saving for practitioners in 12,000 pharmacies, 6,000 optometry practices and 8,500 dental practices, 10 ambulance trusts and 1,650 community providers, from the removal of unnecessary manual and automated process steps, enabling them to apply more time to direct clinical work. This will allow the practitioners in these care settings more time to spend with patients and take on additional activities to relieve pressure across primary, acute and urgent care settings.

Commitment milestones

Discovery and engagement across all sectors for the development of the strategic delivery roadmap complete.

Date: June 2021 (complete)


The outcomes from the PODAC Digital Service Design Requirements Research have been evaluated, work package complete.

Date: July 2021 (complete)


Three-year digital roadmap for each of the PODAC care settings approved.

Date: December 2021


PODAC care settings and system suppliers will have increased the use of digital technologies to provide more joined up care having linked with the wider health and care system to deliver better outcomes for patients.

Date: March 2022


PODAC care settings will have expanded access and the sharing of direct, appropriate and accurate clinical information held within NHS systems, improving patient safety, care and staff productivity.

Date: March 2022


PODAC care staff will have streamlined access to key systems and increased automation of manual processes, improving staff experience.

Date: September 2022


PODAC care settings will have scaled the use of digital referrals and booking processes across primary, elective and urgent care, improving patient care experience.

Date: September 2023


PODAC care staff will have increased use of data, improving the delivery of care, the commissioning of services and implementation of population health initiatives

Date: March 2024

Adult social care digital transformation

Background

While there has been significant investment in digital transformation for the NHS, the social care sector has lagged behind, with huge variability in levels of digitisation among providers.

There are structural challenges to greater digitisation, for example the benefits of digitisation are often not realised by the social care organisations making the investment. In more practical terms, some providers are held back by inadequate broadband connectivity and the up front cost of investment.

The adoption of technology has the potential to transform the care people receive. Digital social care records will allow carers to spend less time on administrative tasks and more time delivering care, care tech such as acoustic monitoring solutions will help to reduce falls in care homes and avoid hospital admissions, and enabling integration with NHS systems will ensure that care staff and clinicians have the information they need about a person, when they need it.

NHSX will work with the social care sector to support digitisation at scale. We will address the connectivity, skills and cyber security challenges the sector faces and accelerate the adoption of technologies that make the most difference to the care people receive.

Delivery approach

NHSX will work with NHS Digital to improve the infrastructure for care homes which have slow or no internet connectivity (under 45Mbps), improving the internet connectivity for over 1,000 sites over the next 3 years. Support will also be provided for the digital switchover of analogue lines that will occur in some parts of the country as early as December 2022 by raising awareness and enabling more informed investment decisions for replacements and upgrades to be made.

We will work in partnership with the sector and partners to develop and realise a digital skills strategy for the social care workforce that will result in development of the necessary skills and confidence to support rapid digitisation.

Starting with digital social care records and acoustic monitoring solutions we will support the adoption of care tech by:

Removing the barriers to adoption, through:

  • developing evidence of which types of care tech have the biggest impact on care and articulating these benefits in a way that is meaningful for care providers
  • producing an assured list of supplier solutions, providing ongoing market management and stimulating the market where we know there are gaps
  • defining a roadmap for standards adoption and establishing a process for the ongoing assurance of supplier solutions
  • defining minimum data requirements so that data can be collected and shared where there is consent to do so
  • providing funding to support implementation, helping to mitigate the up front investment costs

Helping care providers to help themselves, through:

  • developing best practices guidance, case studies, tools and templates to support care providers to buy and implement the care tech that is right for them
  • establishing masterclasses to support care providers in areas ranging from contract management to change management to value creation and benefits

Helping care providers to help each other, through:

  • recruiting change champions and developing peer support networks so that care providers can share their experiences and the lessons that they have learned

Helping care providers who need the most support, through:

  • providing additional capacity, within local teams, to provide hands-on support to those care providers that need the most support - including support to meet the necessary data protection and cyber security requirements for data to be shared with the NHS (subject to consent)

The support we provide will be locally aligned to make sure that the voice of the care sector is heard at a national, regional and local level.

Commitment Milestones

Publication of a roadmap of interoperability, data and governance standards that all assured digital social care records will comply with including, from March 2022, admissions and discharge data standards and, from September 2022, interoperability with shared care records and digital person centred care and support planning standards.

Date: October 2021 (compete)


100% of assured digital social care record systems can provide access to care plans to the individual in receipt of care.

Date: March 2022 (complete)


100% of assured digital social care record systems have the capability to display appropriate NHS data.

Date: June 2022


Publication of an agreed standardised minimum dataset for social care providers that brings together existing work on the common information standard, quality matters and regulatory reporting.

Date: July 2022


100% of assured digital social care record systems capture all of the data in the minimum dataset for social care providers.

Date: September 2022


By March 2024, 80% of social care providers have an assured digital social care record.

Dates:

45% by March 2022

60% by March 2023

80% by March 2024


All care homes in England have an available internet connection of at least 30mbps, so they can fully utilise digital technology for care and support residents to stay connected to friends and family.

Date: March 2024

Better connectivity for health and care

Background

As health and social care organisations continue to adopt, deploy and rely on more sophisticated digital services to support the delivery of care, it will be critical to make sure the right underlying network infrastructure and connectivity services are available to support them.

Data loads travelling over networks will increase significantly with:

  • the adoption of video consultations and other increasingly sophisticated digital services
  • the adoption of cloud-based services
  • increased interoperability and integrated care records.

Organisations will need appropriately sized and reliable network connections to make sure the digitisation of health and care can progress successfully.

NHSX and NHS Digital want all NHS premises and care homes in England to have access to the network connectivity they need to support their digital ambitions. The work to achieve this will seek to make the most of planned UK government and industry investment in Gigabit Capable Connectivity (GCC) infrastructure and is also addressing how needs will be met where these investments will not deliver soon enough.

Delivery approach

NHSX and NHS Digital will work with ICSs and telecoms providers to ensure high-speed network connectivity is available to them when they need it. This will be done by helping local organisations upgrade ADSL and poor quality FTTC connectivity that is already prohibitive as a matter of urgency. We will work collaboratively to jointly develop ‘gigabit pathway’ plans that will:

  • be owned by the ICSystem
  • identify the most effective and efficient route for obtaining gigabit capable network infrastructure in a timely manner
  • maximise benefit from already planned DCMS (Project Gigabit) and infrastructure provider investments in high-speed network infrastructure
  • identify investment required to augment DCMS and commercial infrastructure provider plans in order to achieve full and timely high-speed network infrastructure coverage for all health and care premises

Commitment milestones

Premises in scope for urgent upgrade from ADSL/copper or poor FTTC with ICSs (or equivalent sub-regional collaboratives) and regional NHS England teams confirmed.

Date: August 2021 (complete)


NHS organisations restricted by ADSL/poor FTTC connectivity identified and funded to commence upgrades.

Date: January 2022


All NHS organisations have been provided with a draft baseline gigabit pathway (level 1) plan established through NHS Digital co-operation with DCMS and commercial infrastructure providers.

Date: January 2022


Early adopter NHS organisations (ICSs) have a validated gigabit pathway (level 2) plan detailing how and when gigabit capability will be achieved at all sites as well as investment required to augment planned DCMS and commercial infrastructure provider investments in order to achieve full and timely coverage.

Date: January 2022


NHS organisations identified as restricted by ADSL/poor FTTC connectivity complete upgrades.

Date: December 2022


All NHS organisations (ICSs) have a validated gigabit pathway (level 2) plan detailing how and when gigabit capability will be achieved at all sites as well as investment required to augment planned DCMS and commercial infrastructure provider investments in order to achieve full and timely coverage.

Date: March 2023


All relevant NHS organisations have initiated their gigabit pathway plans.

Date: March 2024

Future wireless strategy (5G, wifi, satellite)

Background

Whilst the ‘better connectivity’ initiative will ensure health and care premises are connected to high-speed network infrastructure, access to high quality wireless connectivity will also be vital to enabling the fast, reliable and ‘always on’ connectivity needed to enable ambulance staff, community nurses, care workers, clinicians and the public to utilise advanced technologies and digital services as effectively remotely and when on the move as they can from a well-connected fixed location.

There are a multitude of wireless solutions such as wifi, mobile, satellite and narrowband, each with their own strengths and weaknesses and use case applicability. Furthermore, each of these options has its own roadmap of variants (such as 2G, 3G, 4G and 5G in mobile for example). As a result, the landscape is complex but there are significant opportunities to radically improve the use of digital services in healthcare by optimising existing technologies and using emerging wireless capabilities.

Delivery approach

The future wireless project will, working with the telecoms sector, the Department for Digital, Culture, Media and Sport and others, to:

  • investigate how a variety of wireless capabilities can be utilised, optimised and orchestrated to support the delivery of healthcare services
  • identify and demonstrate the benefits of various wireless technologies - establishing testbed initiatives to demonstrate the ways in which new wireless technologies can transform healthcare in a variety of health settings
  • consider the challenges and limitations associated with their delivery and adoption and propose ways to overcome them - determining the standards and policies required to support successful adoption and utilisation and developing investment proposals for 5G, wifi 6 and LEO satellite adoption throughout the health and care system
  • consult with industry to understand their future wireless technology roadmaps and capabilities
  • work with DCMS and existing regional and local initiatives already working to make use of emerging wireless technology
  • establish a cohesive strategy for the adoption of wireless technologies in health and care now and into the future

Commitment milestones

First phase of discovery work to investigate how future wireless capabilities could be used to support a better provision of healthcare completed

Date: September 2021 (complete)


Trials initiatives aimed at demonstrating the ways in which future wireless connectivity can transform healthcare started.

Date: October 2021


Strategy including guidance and follow-on recommendations for health and social care future wireless capabilities completed

Date: March 2022

Digital readiness

Background

NHSX has commissioned Health Education England (HEE)’s Digital Readiness programme to continue the work of the Building a Digital Ready Workforce (BDRW) programme. It will address requirements made in the Topol Review (2019), which explored how to prepare the healthcare workforce to deliver the digital future.

This programme is about making sure the health and care workforce has the right skills to support new ways of working. We will know we have succeeded when:

  • every leader in health and social care is confident to drive digitally-enabled change
  • systems and organisations have the right executive digital leadership
  • there are established professions for both clinical and non-clinical digital professionals
  • every new doctor, nurse and allied health professional is confident and digitally-literate in their delivery of clinical, care and operational practice

To date the programme has delivered a range of product and service offerings, including the renowned and successful NHS Digital Academy digital learning service. It has kicked off digital board development with NHS providers and has overseen the establishment of the Faculty of Clinical Informatics and the Federation for Informatics Professionals. It has also launched the Topol Digital Fellowships in Healthcare and introduced future workforce supply routes such as the DDaT Graduates/ Graduates into Health Programme, which place graduates into hard to recruit to digital roles in the NHS.

Delivery approach  

Delivery from the 2021 to 2022 financial year is focused around four areas, including:

  • supporting the right culture and environment, notably including board and senior leader digital development and awareness
  • professionalising our digital workforce, including defining roles, standards, attractive career pathways and establishing digital communities and networks as well as professional member bodies
  • establishing digital learning and development, including the NHS Digital Academy model as well as tools for addressing digital literacy for the whole workforce
  • building our future digital workforce, including workforce analysis and modelling and putting in place sustainable models to recruit and reskill

The route to market for adoption relies upon existing infrastructure, such as regional Skills Development Networks and the Federation for Informatics Professionals. The delivery approach for the social care workforce is defined jointly with DHSC and NHSX adult social care teams. We will also align with and learn from wider industry (for example mentoring support opportunities).

Commitment milestones

Established a support model for our digital communities/networks. This will include establishing Informatics Skills Development Networks (ISDNs) in all regions (by April 2022), providing knowledge, support and development opportunities.

Dates:

5 regions by September 2021 (complete)

All regions by April 2022


A sustainable digital workforce strategy will be established for the NHS (by October 2022), benchmarked to industry and providing a clear understanding of both current stock and future demand (shape, capability, capacity).

Date: October 2022


An extensive range of digital development sessions, with supporting resources, will be delivered to support our senior leaders. This sees delivery initially for 70 Trust boards (by April 2022) and expanding to at least 120 (by April 2023).

Dates:

40 trust boards by September 2021 (complete)

70 trust boards by April 2022

120 trust boards by April 2023


A focused ICS board offering (from January 2022), all leading to a sustainable model (by April 2024).

Date: April 2024


Create a national infrastructure that attracts, grows and rewards talent. Deliver a standardised job role and career framework. Develop a sustainable (by April 2023) federation of professional bodies, which will include the Faculty of Clinical Informatics, alongside standard digital professions/roles adopted widely (by April 2024).

Date: April 2024


Digital learning and development, including the NHS Digital Academy service model (by April 2023), will be fully established with constituent learning programmes, online learning and fellowship offerings impacting all areas of the health and care workforce (by April 2025).

Date: April 2025


Embedded digital learning content into existing undergraduate and professional curricula (by April 2025).

Date: April 2025


Established sustainable supply models to address the gaps highlighted by digital workforce planning, including apprenticeship and graduate recruitment, and reskilling opportunities (by April 2025).

Date: April 2025


The whole workforce will be able to access, as the norm, generic and specific tools, learning and information that will help them become ‘digitally literate’ (by April 2025). This includes a digital knowledge self-assessment and signposting tool, which will be in use widely across health and care (by April 2023).

Date: April 2025

NHS digital and technology approvals

Background

NHSX applies Cabinet Office national digital and technology spend controls and standards to all national products, services and programmes developed by DHSC and its agencies and public bodies. This involves upfront approval of plans of plans to spend, and quality assessments of services against core standards - the Tech Code of Practice and the government Service Standard. This framework of standards, spend approvals and quality checks has helped us build and buy excellent national services and technology for citizens, patients and professionals.

We will adapt the best of this framework to support local needs and support the NHS to invest well in digital and technology. We said that we would do this in the NHS Long Term Plan and the ‘Future of Healthcare’.

NHSX completed a first phase of work in the 2019 to 2020 financial year before the pandemic. The project re-started in spring 2021, working with a range of frontline NHS organisations to design and test different models.

Delivery approach

New upfront NHSX digital and technology approvals will start in April 2022. These will apply to NHS organisations which are buying or building lower value digital and technology products and services.

From April, NHSX will work collaboratively with CIOs and CDOs to check that products and services will meet core quality standards, before giving NHS organisations the green light to spend.

Pilots and wider engagement with the NHS during winter 2021 will set the detail of spending approval thresholds and finalise the types of project and organisation in scope.

October to December 2021

We will work with a small number of commissioner and provider organisations to pilot new NHSX-only approval processes for their digital and technology projects and plans. We will test how the NHS can best share information and receive rapid approval, and test the tools and questions we will use to support approval. We will also design a support offer for the NHS, including:

  • a new team of NHSX experts to be partnered with regions/ICSs
  • access to specialist support on areas such as cybersecurity, accessibility, interoperability and user-centred design
  • advice and guidance on central components and platforms that might help save time and money.

January to March 2022

We will recruit the new team and publish full details of the new approvals process for digital and technology spending, and engage the NHS on implementation.

Commitment milestones

Alpha research and design work completed.

Date: July 2021 (complete)


Pilot new processes, questions and tools with a range of organisations.

Date: December 2021


Publish reports on the pilots and communicate full details of the new processes.

Date: March 2022


A proportionate and supportive process has been put in place covering local NHS organisations to help teams expediently buy and build digital services or technology and provide value for money by assuring any spend is compliant with national standards.

Date: April 2022

Connect - overview

We will connect health and care providers across the country.

We will develop data assets that can be safely used for direct care, population health management, research and innovation. By linking and combining data, we will save unnecessary referrals, alleviate workforce pressures, reduce medication errors, eradicate paper, find opportunities to intervene early, and prove the effectiveness of new standards of care. We will establish a federated ecosystem of trusted research environments on linked NHS data that will enable research and innovation while maintaining public trust.

We will put in place platforms, architecture and standards - data standards and APIs, core platforms that support local services (demographics, electronic booking and referral systems). We will remove duplication and burden from the frontline through a more intelligent approach to data flows.

The programmes in this section provide more detail on how we will help NHS services to connect.

Electronic triage, referrals and bookings

Background

Patient referrals, bookings and appointments are a fundamental part of a fully functioning health and care system, and NHSX and NHS Digital are working on the optimisation of the existing electronic-Referral Service (e-RS) and its transformation to offer a comprehensive approach to managing referrals, bookings and appointments for all sectors within the NHS.

The e-RS optimisation and transformation programme is the national programme to digitise pathways through digital platforms and processes to create an any-to-any referral and booking environment; facilitating advice and guidance; ensuring referral to most appropriate clinical or social care professional; and to refer, book and manage appointments efficiently and effectively. The overall programme comprises three complementary strands: e-RS optimisation (digital referrals and consultations), e-RS transformation and the development of a bookings and referrals standard.

Work between the 2021 to 2022 financial year and the 2023 to 2024 financial year will have three main strands:

Optimisation of e-RS

Improving existing functionality and delivering new and enhanced functionality and features to the current live service.

e-RS transformation

Develop the vision and approach for the next steps in the evolution of the advice and guidance, referral, booking, and appointment process.

Bookings and referrals standards

Development of the booking and referral standards to enable ‘any-to-any’ bookings and referrals. The first use-case will be to replace the current EDDI solution with a long-term capability for NHS 111 (telephone and on-line) to book and refer directly into emergency departments (ED). Subsequent use-cases are being prioritised and will follow.

Commitment milestones

e-RS optimisation (digital referrals and consultations): Capability developed for new professional users to access e-RS via the internet.

Date: June 2021 (complete)


eRS transformation (booking and referral standard): Complete Technical evaluation of proposed referral standard - Deliver a technical view of the emerging referral standard to ensure technical feasibility and any understand complexity to overcome in delivery of the standard.

Date: August 2021 (complete)


e-RS optimisation (digital referrals and consultations): e-RS and other systems (3rd party software suppliers) enabled to ‘talk’ to each other via a suite of APIs, to allow clinicians to spend more time on patient care and less time switching between IT systems, and driving adoption of advice and guidance and referral assessment services.

Date: September 2021 (complete)


e-RS transformation: Publishing a clear vision for the development and of future e-RS capabilities, in conjunction with industry suppliers.

Date: November 2021


e-RS optimisation (digital referrals and consultations): User interface for e-RS upgraded to speed up booking and referral process for referring clinicians, reducing the number of clicks and manual input required, making the referrer process more efficient and saving clinical time.

Date: January 2022


e-RS optimisation (digital referrals and consultations): e-RS is accessible on the Internet (without the need for a HSCN connection), so it can be used by a greater range of clinicians, suppliers and settings to help patients access care.

Date: March 2022


e-RS optimisation (digital referrals and consultations): e-RS data to be available on a secure online data platform, enabling users to interrogate, develop new insights and form performance improvement trajectories to improve the uptake (an efficiency of eRS enabled services), reducing rework and demand on services.

Date: March 2022


e-RS transformation (booking and referral standard): A range of policy levers and incentives exist, are in place, enabling software suppliers in the 111 to ED pathway to transition to the new standard, and for providers (NHS ED departments) to adopt the latest standard into their workflows by March 2023 (a 1 year transition process).

Date: March 2022


e-RS transformation (booking and referral standard): Standard v2 published to include referral standard and updated booking standard - Patient care improves as the appropriate referral information is standardised between settings and made available to the correct people to support individual health needs.

Date: March 2022


e-RS optimisation (digital referrals and consultations): Increased file size capacity for eRS referrals enabled, to support referrals with requiring multiple or high resolution images to be attached and shared, encouraging care settings that are reliant upon image based referrals to adopt e-RS standards, thereby improving the efficiency of image transfer and the associated workflows.

Date: December 2022


e-RS Transformation: Microservices developed that will form the new architecture and functionality of e-RS to enable the vision of an any-to-any sector triage, referral and booking ecosystem for health and care.

Date: March 2024

Direct care APIs

Background

Direct Care Application Programming Interfaces (APIs) are a series of APIs which allow GP practices and authorised clinical staff to quickly and efficiently share and view GP practice clinical information and data between IT systems. They make sure that patient medical information is available to clinicians when and where they need it and therefore improves patient care.

Direct Care APIs are an enabler for the Interoperability Standards defined on the Digital Care Services Framework. Direct Care APIs products are also actively supporting the ongoing NHS response to COVID-19.

Direct Care APIs currently offer four products, including:

  • access to records, allowing clinicians to view a read-only version of the patient’s detailed GP practice record
  • appointment management allowing organisations to share and manage their appointments to support joined up patient care
  • structured records that allow organisations to ingest the GP practice record and save the information as part of their own clinical record, supporting holistic patient records where data from multiple sources can be displayed together
  • send document functionality, allowing a consultation summary to be sent from one clinical setting to another, in PDF format, supporting joined up patient care

Delivery approach

Work will continue to develop the GP Connect services under the banner of Direct Care APIs. It will include smaller changes related to the continual improvement of the products and larger changes to support the emerging needs of the health and care community.

Commitment milestones

GP patient record: Specification published that supports GP practices to receive documents into their system, patient matched and added to workflow.

Date: September 2021 (complete)


Health care professionals can book and manage GP appointments across primary care settings and systems.

Date: September 2021 (complete)


Health care professionals can view, access and import a patient’s full GP clinical record irrespective of their care Setting or organisation.

Date: September 2022


A patient’s record can be transferred from one GP practice to another as part of a new patient registration (replacing legacy GP2GP messaging)

Date: September 2022


General practice can receive updates to a patient’s record from other health care professionals and online consultation systems

Date: December 2022


Health care professionals can book untimed appointments across primary care settings and systems, supporting appropriate triaging of patients by GP practice staff

Date: December 2022

These milestones are awaiting formal sign-off from the programme board and are therefore subject to change.

Digital medicines

Background

The NHSX vision for digital medicine is the seamless flow of medication and prescription information between health and care settings. The intention is to:

  • support safer, joined up care
  • improve medicines related patient safety
  • reduce the burden on frontline clinicians
  • improve patient experience

This will be achieved through the establishment and use of interoperable medicines standards that will facilitate the flow of medicines and prescriptions between the systems used across health and social care. In addition comprehensive sets of patient level medicines data collections will be established for secure secondary use by the NHS and research community.

Analyses of the data will inform improvements and safer care and ultimately result in improved health outcomes. The programme intends to use information standards and explore other non-spend levers to facilitate and underpin the work.

Delivery approach

In the 2021 to 2022 financial year NHSX and NHS Digital are leading work to:

Define national interoperable medicines standards and increase uptake of the dictionary of medicines and devices standard in secondary care, by addressing barriers to its adoption and creating an education and awareness campaign.

Update the Electronic Prescription Service (EPS) so that it can be used in all care settings. This will have an increased value for clinicians by allowing efficient remote working and for patients by offering the convenience of being able to track prescriptions. Access for hospitals and homecare providers will be enabled first.

Deliver an initial collection of secondary care prescribing and administration data to support COVID-19 research, leading to the accelerated establishment of a national collection.

Commitment milestones

Interoperable medicines standards: Completed clinical and technical assurance of Fast Healthcare Interoperability Resource (FHIR) UK core medicines and allergy / intolerance resources. HL7 FHIR UK Core V1.0.0 STU 1 released.

Date: September 2021 (complete)


Medicines data for secondary uses: Further engagement work is underway, the draft specification to underpin an information standards notice has been shared with system suppliers.

Date: September 2021 (complete)


Interoperable medicines standards: Education materials to support the adoption and uptake of the dictionary of medicines and devices have been released.

Date: September 2021 (complete)


The initial technical uplift of the electronic prescription service has been completed to support new and existing suppliers. Onboarding with suppliers is underway.

Date: October 2021 (complete)


Interoperable medicines standards: An information standards notice to support the use of the FHIR Interoperable Medicines Standards has been published with a compliance date of March 2023 for all care settings.

Date: October 2021 (complete)


Electronic Prescription Service (EPS) – Next Generation: The technical uplift of the Electronic Prescription Service (EPS) has concluded to support new and existing suppliers. The first Electronic Prescribing and Medicines Administration (ePMA) suppliers have been onboarded and adoption of EPS in secondary care has commenced. Following user research, the first set of enhancements are available to suppliers.

Date: March 2022


Interoperable Medicines Standards: A core set of fully interoperable medicines standards have been defined and tested by early adopters and are available to system suppliers. An education and awareness campaign about the Dictionary of Medicines and Devices (dm+d) is underway in secondary care.

Date: March 2022


Medicines data for secondary uses: An information standards notice has been published (October 2021) and, in line with the compliance date of June 2022, trusts are required to flow Electronic Prescribing and Medicines Administration (ePMA) data which is available via the NHS Digital Data Access Request Service (DARS).

Date: June 2022


Medicines data for secondary uses: A mechanism and IG / legal framework has been established for the collection of medicines data from the Electronic Prescription Service (EPS) (outside of general practice) and the first data is available via the NHS Digital Data Access Request Service (DARS).

Date: September 2022


Medicines data for secondary uses: Transition to business as usual has completed to include ongoing management and further onboarding of the Electronic Prescribing and Medicines Administration (ePMA) and Electronic Prescription Service (EPS) data collections.

Date: March 2023


Electronic Prescription Service (EPS) – Next Generation: The majority of Electronic Prescribing and Medicines Administration (ePMA) system suppliers are in development along with additional new and existing suppliers. Following user research, further enhancements including patient facing, are available to suppliers.

Date: March 2023


Interoperable medicines standards: An information standards notice is supporting wider adoption of interoperable medicine standards which have been incorporated into national programmes. A comprehensive feedback loop is supporting increased adoption of the Dictionary of Medicines and Devices (dm+d) across secondary care.

Date: March 2023


Electronic Prescription Service (EPS) – Next Generation: There is increasing evidence of adoption of the Electronic Prescription Service (EPS) across secondary care. Following user research, further enhancements are available to suppliers. Existing suppliers have been onboarded to enable the deprecation of the legacy service to commence.

Date: March 2024


Interoperable Medicines Standards: National adoption of interoperable medicine standards to underpin the transfer of medicines information for hospital admission and discharge is underway. Early adopters are demonstrating the capability of a consolidated patient medication record.

Date: March 2024

Digital nursing

Background

The nursing workforce is a critical component in digital healthcare. The benefits of increased capabilities are vast in a workforce who are engaged with technological changes related to functionality, workflows, digital literacy and the impact of technology on patients and staff. The workforce needs to be supported to become engaged and knowledgeable and to deliver the full potential of digital transformation.

The Chief Nursing Information Officer (CNIO) has eight principles for delivering digitally enabled nursing and midwifery, including:

  1. the use of technology to support nurses and midwives’ vital role in joining up care
  2. improving safety and reduce avoidable harm
  3. strengthening the evidence base for nursing and midwifery using big data to target care and support decision making about nursing and midwifery interventions
  4. reducing the documentation burden on nurses and midwives
  5. releasing time to care - tech for task, extend humanity
  6. empowering people to actively participate and contribute to their care
  7. empowering the frontline through the adoption of the principles in the Chief Nursing Officer’s collective leadership programme
  8. the professionalisation of nursing and midwifery informatics

These principles will form the basis of a shared NHSEI nursing directorate and NHSX digitally enabled nursing and midwifery strategy to be developed over the 2021 to 2022 financial year. This strategy will be co-designed with the professions to make sure the resources and culture shift required for digital transformation can be delivered.

Delivery approach

NHSX will be leading work to address five themes, including:

  • education
  • practice
  • research
  • leadership
  • strategy, initially focused on what good looks like for nursing

An initial digital maturity baseline assessment identified variation across England, and from this core themes for action and big questions that require further exploration to ensure nurses have the knowledge and skills to practice and lead in a digitally enabled health and social care system, now and in the future with nursing practice fully supported by the use of digital technology and data science.

Development of national standards for nursing will support care delivery by making sure that core nursing documentation, such as functional needs assessments can be shared between organisations interoperability. Additionally, work to explore the potential to create a minimum data set that can be used to support nursing audit and research into nursing care will commence.

Work is already underway to develop a better understanding of the current challenges to engage with existing digital nursing communities. Key posts have been appointed at a national level in both NHSX and NHS digital to increase the nursing voice in digital transformation and digital workforce development. These roles will work together to speak with one voice.

Underpinning this co-designed approach will be a robust communication strategy co-owned by NHSX and the NHSEI nursing directorate. That will include chief nursing officers, chief nursing information officers at national, regional and organisational level as well as nursing and digital networks. We will look to work with stakeholders for delivering the expansion of digitally enabled nursing and midwifery learning communities beyond those national networks that already exist.

Future plans will include an education programme for CNIOs and aspiring digital leaders, further research to identify improved nursing outcomes by allowing comprehensive comparable and timely data for functional needs assessed and care delivery.

In summary, we will be working with nurses and midwives across the system to support commissioners to make sure both the interoperable standards and the wider strategy are underpinned by the CNIO eight principles. We will also support them to make sure the standards are developed, embedded and delivered to meet local needs.

Commitment milestones

The future of nursing in a digital world - digital maturity assessment findings published.

Date: June 2021 (complete)


Research advisory panel established.

Date: June 2021 (complete)


The publication of a digitally enabled What Good Looks Like (WGLL) self assessment framework for executive level nurses.

Date: March 2022


There is a single national digital nursing standardised documentation framework available to the NHS and relevant care settings to support safe nursing practice contributing to the reduced risks of patient safety.

Date: June 2022


What Good Looks Like (WGLL) in current digital nursing practice is defined and a support package and tools is available and adopted by executive nurse leaders to monitor and assess their digital maturity, improving patient care.

Date: March 2023


The adoption of a minimum data set to support evidence based nursing practice and inform improvements to care and its delivery.

Date: March 2023


Established recognised formalised roles and responsibilities that enable the delivery of digital nursing leadership to all nurses working in England.

Date: June 2023


Nurses are given access to the knowledge, skills and education required for safe, effective digitally enabled practice in whatever role they hold (working with the digital readiness programme).

Date: March 2024

Digital clinical safety

Background

We need to make the NHS the safest digital health system in the world.

The Digital Patient Safety strategy (launching September 2021), will set out how digital clinical safety will be delivered in partnership with a range of stakeholders, and what improvement can be generated for patients, staff and the larger NHS system. The aim of this strategy is:

  • to improve the safety of digital technologies in health and care, now and in the future
  • to identify, and promote the use of digital technologies as solutions to patient safety challenges

The outputs of this collaborative strategy, over the next three years years, will include:

  • collecting data about digital clinical safety as part of the Learn from patient safety events (LFPSE) service and share insights for system-wide learning
  • developing new digital clinical safety training materials and expanding access to training across the health and care workforce.
  • creating a centralised source of digital clinical safety information, including optimised standards, guidelines and best practice blueprints.
  • accelerating the adoption of digital technologies to record and track implanted medical devices through the medical devices safety programme
  • generating evidence for how digital technologies can be best applied to patient safety challenges

Commitment milestones

The publication of a Digital Clinical Safety (DCS) strategy.

Date: September 2021 (complete)


Review of international best practice in digital safety completed.

Date: January 2022


Nationally, digital safety assurance model agreed in the DCS strategy.

Date: March 2023


User needs assessment and early findings/prototypes and alpha testing (wider system) completed.

Date: March 2023


Suppliers, healthcare staff and the public understand how to achieve best-practice for digital clinical safety.

Date: December 2023


Healthcare staff are equipped to use current and future digital health solutions safety.

Date: December 2023


The NHS will be internationally recognised as a leader in digital clinical safety having clearly understood priorities and objectives.

Date: December 2023

Medical devices safety

Background

The Medical Devices Safety Programme (MDSP) brings together DHSC, NHSX, NHS Digital and NHSEI GIRFT to collaboratively respond to recommendations from Baroness Cumberlege’s Independent Medicines and Medical Devices review which were made to drive patient safety.

This will improve patient safety and patient outcomes. It will put the NHS in a world-leading position in respect to the visibility of device procedures and outcomes, and the associated benefits to health research. Patients will have confidence and assurance in their medical implants and devices and would be contacted quickly in the event of any recalls. Providers and researchers across the UK will meanwhile have access to world-leading contextual procedural data with which to make their clinical decisions, contributing to the longer-term avoidance of harm for patients.

Delivery approach

The Medical Devices Safety Programme is a major piece of work involving cross-system collaboration to establish interoperable solutions, changing the behaviour in NHS and Private provider organisations across the UK, and is estimated it will take several years to implement.

For the 2021 to 2022 financial year, the Medical Devices Safety Programme will seek to design, test, and refine a cross-system end-to-end service model including UK-wide NHS and private providers, and specialties prioritised for phase 1. The end-to-end service model will ultimately include multiple elements of the patient journey, including electronic capture of data at the point of care, data being received by the Medical Device Information System (MDIS), and the analysis and interpretation of this data by registries, which will ultimately inform patient and clinician decision making.

To this end, the medical devices safety programme will:

  • accelerate adoption of digital technology to improve the tracking and monitoring of medical devices
  • establish a new information system/infrastructure to collect, link and analyse outcomes by procedure - enabling the tracking of implanted medical devices and the provision of appropriately rich datasets for outcomes analysis
  • support increased analysis of outcomes data to drive improvements in device, patient care and safety, and enable informed, shared decision-making between clinicians and patients

Commitment milestones

Creation of an MDIS by March 2022 for a minimum of two registries, receiving data from up to 10 test sites which captures medical device and patient data, which is developed with key stakeholders and system partners including the DAs, ensuring registry rollout is prioritised according to patient and clinical needs.

Date: March 2022


Creation of a blueprint for how MDIS will interact with current and future registries, including a methodology for prioritising registries.

Date: March 2022


Reduction of patient harm due patients being able to make more informed decisions about the treatment they receive and being contacted quicker in the event of recall/review after the creation of MDIS.

Date: from March 2023


Increased availability of high quality data to researchers and registries after the creation of MDIS.

Date: December 2024

Cloud and internet first

Background

To comply with the DHSC’s Technology Code of Practice and the government’s cloud first policy, public sector organisations digital services should move to the public cloud unless there is a clear reason not to do so that is approved by System Design Authority (SDA). All digital services should adopt internet standards and protocols, and services must be available over the public internet by default.

There are signs of progress in moving to Cloud hosting, but progress is slow and fragmented. As a result, both infrastructure running costs and the NHS carbon footprint remain excessively high. Whilst there are pockets of good practice, there is a lack of standardised tools, patterns and knowledge sharing for cloud environments, which is causing inefficiencies and operational pain at scale. There is also a lack of deep cloud expertise to optimise cloud opportunities and prevent incidents that negatively impact service provision.

NHSX and NHS Digital plan to mobilise a sustainable hybrid cloud and infrastructure strategy that will cover the objectives outlined below.

Improve security and resilience

Helping reduce the number of legacy systems more vulnerable to cyber-attack and service incidents, supporting the adoption of appropriately designed and architected cloud services and helping the NHS to be responsible data custodians.

Improve value for money and reduce costs

Establishing and providing access to reusable, best-practice assets, diverting more capacity to value added activities and reducing waste by optimising cloud consumption.

Simplify and standardise service deployment patterns, increase agility and improve responsiveness

Enabling quicker system development, increasing release times ten-fold, moving from an average of weeks between releases to days, enabling systems to scale quickly to deal with fluctuations in demand and meet the needs of future healthcare technologies.

Help the NHS adopt Sustainable Hybrid Cloud and Infrastructure successfully

Simplifying and accelerating the adoption of Cloud services, optimising hybrid Cloud/on-premise hosting arrangements and enabling the NHS to become a responsible Cloud operator.

Deliver a positive sustainability impact

Reducing the Carbon footprint and improving the Power Utilisation Efficiency associated with infrastructure operations throughout the NHS.

Delivery approach

NHSX is developing the infrastructure roadmap for modernising and optimising hybrid cloud and infrastructure environments for the benefit of national systems and services.

Local organisations will be supported through the establishment of a central cloud orchestration capability and coherent hybrid and multi-cloud strategies. These will enable flexible, rapid and secure digital transformation and delivery. Cloud engineering capabilities will be boosted to support the introduction of standards, patterns and governance to improve delivery of new cloud environments and migration away from private data centres.

In addition to the publication of a cloud adoption strategy for health and care organisations, we are developing an assessment model to understand the current uptake across the service which will serve as a baseline for the work. As we support organisations in working towards the strategy we will use this assessment model to monitor progress.

NHS Digital has been commissioned to establish a centre of excellence for the coordination of hybrid infrastructure arrangements for their national services and selected local organisations. This centre of excellence will also support work to ensure that nationally provided services are internet facing and not held on private networks.

Health and care organisations will be invited to join a set of exemplar sites to demonstrate the best use of cloud technologies and contribute to the centre of excellence. This centre of excellence will be in place by December 2021. For organisations already using cloud technologies, there will be support to identify how they might make extra efficiencies by better use of the technology.

To further support organisations with their cloud adoption, we will develop guidance to help organisations understand the current offerings on the market and provide a framework to support their procurement.

Commitment milestones

Cloud centre of excellence and foundational service offerings/ catalogue for 2 exemplar sites (1xICS and NHS Digital) established.

Date: September 2021 (complete)


An assessment model is developed and launched to establish the current uptake of cloud technologies across health.

Date: October 2021


Analysis of assessment for health and care of use of cloud technologies published.

Date: December 2021


Cloud community of practice established to bring organisations using cloud technologies into the community.

Date: December 2021


Internet facing services policy published

Date: December 2021


Community Cloud accelerated adoption concept piloted with Tommy’s charity and Royal College of Obstetricians and Gynaecologists (RCOG).

Date: December 2021


Cloud strategy for NHS published.

Date: January 2022


Cloud procurement framework published.

Date: March 2022


Initial cloud blueprints and case studies from exemplar sites and Cloud COE pilots published to the Cloud Community of Practice and the collaboration platform.

Date: March 2022


A standardised approach to Cloud and Internet adoption across the NHS is established and tested through the creation of a Cloud CoE.

Date: March 2022

Burden reduction

Background

To reduce the data burden on providers we have a long term vision for ‘zero burden’ which is to use routinely collected patient data for all national reporting and ensuring that collecting this data centrally imposes zero burden on providers. The aim of the burden reduction programme in the 2021 to 2022 financial year is to pilot the implementation principles of zero burden with a view to fully roll out in future years.

Data provides a rich resource for the NHS to support policy and treatments, enable effective oversight, and identify efficiencies. However, it is recognised that across the health and care system data is not always acquired in the most efficient or effective way. The current annual burden of national data collections across the health and care system has been estimated at around £600 million, along with a great deal of staff frustration and time lost that could have been spent on caring for patients.

The current commissioning datasets (CDSs) were developed in the early 1980s. Since that time there has been a rapid and sustained increase in volume, scope, and complexity of patient care in hospitals, but CDSs have not been developed to keep up with these changes.

The reducing burden programme aligned with the long-term vision for zero burden described above will help address some of these inefficiencies and unlock the potential for data to be used more effectively by enabling more frequent data flows and safer linkage of data from multiple sources.

Delivery approach

The programme will demonstrate the feasibility of the proposed approach during the 2021 to 2022 financial year.. During this year the programme will be delivering a number of workstreams to assess the feasibility of the proposed approach, and working towards a programme business case.

Once the feasibility of the automatic extraction of data, rapid feedback and level of existing duplication is established, the programme team will then move in the 2022 to 2023 financial year towards expanding the offering to a greater number of providers, and also towards automating data extraction of additional high burden datasets. At the same time the programme team will develop the capability to manage data acquisition at scale, identifying efficient deduplication processes for data items and collections.

Commitment milestones

Discovery stage user research and co-design work is completed with a provider (Oxford)

Date: September 2021 (complete)


Identification or development of tool to automate and match data items needed to produce aggregate collections

Date: September 2021 (complete)


A dashboard showing urgent and emergency care metrics will be available within 24 hours of data submission

Date: February 2022


A simplified approach to collecting urgent and emergency care data will be developed

Date: March 2022

General practice data for planning and research

Background

Data saves lives. GP data has been used for many years to improve healthcare services through planning and medical research in England, helping us better understand and develop treatment for serious illnesses, such as heart disease, diabetes, and cancer.

There is no clearer demonstration of this than our response to the pandemic, which has been underpinned by data. It has allowed us to bring down the number of deaths and hospitalisations from COVID-19.

As we ease out of the pandemic, we must build on these examples to drive forward our commitment to the GP Data for Planning and Research system and the huge potential it has to improve how we use and collect data, for the benefit of the health and care system and patient outcomes.

GP Data for Planning and Research will replace the old system which is now out of date. This new system will deliver better health and care outcomes for our population. We are determined it should be done in a way that maintains the highest possible standards of privacy and security.

The new GP Data for Planning and Research service, will collect data from GP practices in England and will analyse, publish statistical data and provide safe, secure, lawful and appropriate access to GP data for health and social care purposes. Once fully established, this new collection will help to reduce the number of patient data flows currently managed by each GP practice.

Delivery approach

NHS Digital has engaged with the British Medical Association (BMA), Royal College of General Practitioners (RCGP) and the National Data Guardian (NDG) to ensure relevant safeguards are in place for patients and GP practices.

Ministers have committed that data extraction will only commence once a number of conditions are in place, including:

  • an ability to delete data if patients choose to opt-out of sharing their GP data with NHS Digital, even if this is after their data has been uploaded
  • the backlog of opt-outs has been fully cleared
  • a trusted research environment has been developed and implemented in NHS Digital
  • patients have been made more aware of the scheme through a campaign of engagement and communication

Once collection begins, progress will be tracked using the spending objectives and associated benefits identified in the business case. Further success factors for metric evaluations will be completed using the number of GPES extracts able to migrate each month and subsequent cost savings associated with each collection close.

Commitment milestones

This programme is in strategic review. Confirmed commitments will be available in Q3

Pathology standards

Background

Pathology results need to be standardised to enable flow patient data to safely flow between health and care systems and the current and legacy technologies (PBCL and EDIFACT) are no longer updated nor are they fit for purpose.

Delivery approach

NHSX and NHS Digital will continue work to develop a consistent set of standards to enable the effective sharing of pathology results across all healthcare settings and across organisational boundaries. Once approved, these standards will be included in the NHS standard contract and be mandated for new system procurements.

Standards will be developed in a number of areas, including:

  • unified test list (UTL) - a national standardised list of pathology test request and result names, aligned with the international clinical terminology standard (SNOMED CT)
  • units of measure (UoM) - a national set of standardised units of measure for test results, to be aligned with the international standard (UCUM)
  • message specifications - to electronically exchange all required information relating to pathology test requests and results (including the above UTL and UoM), based on HL7 Fast Healthcare Interoperability Resources (FHIR)

Commitment milestones

Pathology specifications successfully tested through proof of concept case studies, enabling further adoption.

Date: May 2021 (complete)


Blood sciences and pathology bounded code list based ‘unified test list and message’ specifications approved as information standards by data alliance partnership board.

Date: June 2021 (complete)


Pathology Test and Results published as Information Standards by data alliance partnership board for use in the NHS.

Date: December 2021


Pathology test and results standard included in all contracts and investment justifications from the 2022 to 2023 financial year.

Date: March 2022


Implementation and compliance with pathology test and results standards by health and care organisations across England.

Date: April 2024

Standards and interoperability

Background

Interoperability means information can flow between digital systems in different NHS and social care organisations so that they can work together to deliver care.

The benefits of successfully delivering an interoperable health and care system are huge. The benefits are:

  • improved patient safety through reduced errors
  • more integrated care by making the right information available at the right time and at the right place
  • a thriving and innovative health tech sector with usable apps and products
  • people able to access their own information and supporting the use of data for population health, policy making and research

Information standards specify how information should be structured and processed in the health and social care sector to enable interoperability. However, there are several challenges that have prevented a standards based approach to delivering interoperability from achieving full potential - standards are often developed in silos and without a consistent approach and a clear focus on user needs and benefits, making their purpose unclear. This leads to confusion in care providers and suppliers as to which standards they should adopt, and whether it is cost effective to do so, preventing adoption.

Our goal is to enable and drive fit for purpose standards that are open, maintained, usable, accessible, tested in reality and based on actual behaviours and needs. These will be developed collaboratively with implementers, vendors, providers, clinicians and incentivised and enforced to ensure they are widely adopted to deliver real-world benefits.

Along with driving forward existing standards, this year we have:

  • set up a UK-wide HL7 Fast Healthcare Interoperability Resources (FHIR) board to prioritise, promote and enable a UK-wide approach for developing core technical standards to form the strategic basis of interoperability standards and capability
  • won system-wide input and support for an end-to-end model for standards development
  • published the 2 UK Core FHIR profiles covering medications, immunisations along with patient, practitioner and organisation profiles
  • set out and agreed key digital health interoperability commitments with G7 partners to agree a standardised minimum health dataset for patients’ health information, using the International Patient Summary (IPS) standard, and promote use of open standards and develop shared principles around patient access to data
  • published the Pathology Test and Results Standard
  • submitted the transfer of care In-Patient discharge standard to the data alliance partnership partner for approval, so it can be announced as a standard under section 250 of the Health and Social Care Act 2012 and published via an Information Standards Notice (ISN)

Delivery approach

By providing strategic direction, a robust model for standards development and implementation as well as clarity on what exists, what is required and which suppliers and systems are conformant, we will streamline standards development and compliance. NHSX will lead the work to establish fit-for-purpose interoperability standards, working closely with NHS Digital, wider NHS, the social care sector, standards bodies and the vendor community.

We will do this by both continuing to support and drive standards development work, working with providers, suppliers, national and international standards bodies and NHS Digital to ensure standards are fit for purpose, tested in reality and collaborated on. This means engaging widely with the users and beneficiaries of interoperability standards as well as building on what’s worked well previously and incorporating learnings across the ecosystem.

Our current focus is on building an enabling environment for standards development and adoption by publishing a strategy, roadmap of standards under development to help align programmes of work, implementing a consistent end-to-end model for developing standards, aligning levers and incentives to make adoption of standards easy and quick, but backed by monitoring and enforcement if needed and delivering a portal to provide a single source of truth on what standards exist, what’s mandated, dependencies, versions and which standards are relevant to which use cases for suppliers, providers and commissioners.

Commitment milestones

Set up a UK-wide HL7 Fast Healthcare Interoperability Resources (FHIR) Board to prioritise, promote and enable a UK-wide approach for developing core technical standards to form the strategic basis of interoperability standards and capability.

Date: May 2021 (complete)


Set out and agreed key digital health interoperability commitments with G7 partners to agree a standardised minimum health dataset for patients’ health information, using the International Patient Summary (IPS) standard; promote use of open standards and develop shared principles around patient access to data.

Date: June 2021 (complete)


Published the first draft release of 12 UK Core FHIR profiles covering medications, immunisations along with patient, practitioner and organisation profiles.

Date: September 2021 (complete)


Draft Open Source Policy published through Github.

Date: November 2021


Publish for consultation the core parts of the standards and interoperability strategy including the vision and the roadmap.

Date: December 2021


Publish a core of UK-wide Fast Healthcare Interoperability Resources (FHIR) to be a stable foundation for new standards.

Date: December 2021


Publish for consultation the end-to-end process for standards creation through to approval and implementation.

Date: December 2021


Publish the standards and interoperability strategy setting out the next 3 years to enable organisations to future-proof and plan their interoperability roadmaps to support better information sharing, which we will then regularly update.

Date: March 2022


Publish a digital playbook on how to open source your code for health and care organisations. Guidance on where to put the code, how to license and maintain it and best practice for working with suppliers will be published in addition to case studies of teams who have done this.

Date: April 2022


Publish and maintain a publicly available roadmap of standards proposed and those in development.

Date: April 2022


Deliver a new service to allow users (in particular supplier and providers) to browse and search for interoperability standards and identify the standards relevant to their needs.

Date: April 2022


Publish final Open Source Policy through Github.

Date: May 2022


Publish a report into the blockers to the adoption of standards and develop a strategy for aligning regulatory levers, procurement and incentives.

Date: June 2022

API management

Background

Data plays a huge part in the transformation of the NHS but it is currently very hard to access. Our Chief Technology Officer’s (CTO) vision is to access data and services through Application Programming Interfaces (APIs) which would be enabled through the use of a central API gateway. There is a gateway in place, but currently very few services are offered through it. A culture shift is needed in the development of national capabilities so that they are built with APIs which can be used by a much greater range of systems across the wider health service and health technology industry.

NHSX and NHS Digital will establish a single API platform for health and social care including the single digital access mechanism (‘a single front door’) to enable suppliers to access data with the complexity that lies behind it abstracted away. All commissioned services will be curated and managed data through this gateway. This will extend to support APIs created by third parties to open up innovation and potential commercial models for partners.

Delivery approach

NHSX will establish a policy to define the use of the API gateway as part of the national target architecture.

This will include:

  • a digital first process for onboarding new APIs and for gaining access to APIs
  • technical tools to enable suppliers and developers to integrate with APIs, including sandbox environments with test APIs
  • sample anonymised patient datasets that can support development

The API platform will be enhanced with technical improvements to make wider aspects of integration technically easier. This includes improved integration with NHS identity and access management systems for user and system authentication and verification. Security and stability will be improved through advanced rate-limiting policies to manage demand and proactive monitoring of use.

The set of national APIs will be presented and published through the gateway service with a priority given to those which enable patients to access their data, along with a roadmap of APIs and feature enhancements, and a set of KPIs will measure the performance and improvement.

Commitment milestones

Commitments that show the steps to delivering the ambition set out above will be available in quarter 3 of the 2021 to 2022 financial year.

Transforming demographics data services

Background

The global pandemic has highlighted shortcomings in the Spine Personal Demographics Service, illustrated by a range of data quality issues that have impacted on the ability of the NHS to communicate effectively and economically with the English population. There is a need to transform the way in which personal demographic data is handled and maintained so that data held is of higher quality and breadth

Delivery approach

NHSX and NHS Digital will change the tools and management surrounding the national demographic service with the aim of making it easier for both people and health and care professionals to identify and update personal demographic data.

This will be done by:

  • enabling people to view and update their personal information and preferences online using the NHS App, NHS Account and via online GP registration tools
  • enabling health and care professionals to access and update personal demographic data held within the national demographic service through existing local systems
  • enabling patients to register with a GP using digital channels
  • identifying and flag potentially poor quality data providing tools to notify both people and health care professionals which will be used in combination with the above tools for correction
  • improving access to demographic APIs to underpin above initiatives
  • validating data on entry to improve quality and standardise the format of data such as postal addresses
  • providing notifications to subscribers of changes to a person’s demographic data, enabling local demographic sources to remain consistent with centrally held data

These services will be delivered in conjunction with initiatives such as NHS Account to ensure a consistent patient experience.

Commitment milestones

Milestones and confirmed commitments will be available in quarter 3 of the 2021 to 2022 financial year.

Identity and workforce management

Background

Identity of staff affects all areas of work and all information technology and security initiatives. Key NHS programmes and in general the NHSX Digital Transformation initiatives depend on the establishment of a joint approach to Identity and Workforce Management issues.

Identity data, the user records which are consumed by security and business systems to authenticate and authorise individuals, are a business asset and, as such, must be owned, governed and managed by the data controllers across organisations with criteria of data quality, availability and integrity.

The areas of identity and access management are closely related to workforce management in two directions, one being the Joiners-Movers-Leavers processes and systems access, and the other being the delivery of the “digital staff passport” capability to support staff movements.

The combination of identity and access management with workforce management capabilities will help the NHS achieve the objectives of reducing the “logon burden”, accelerating workforce mobility and in general the digitalisation of health and care services.

Delivery approach

NHSX will investigate how identity capabilities can be used, optimised and organised to support the delivery of healthcare services. As well as identifying appropriate technologies the work will also understand the challenges and limitations associated with their adoption.

Work will include:

  • developing a standardised and consistent identity for patients and citizens across all of health and social care
  • developing strong authentication and access control methods to ensure access to local, regional and national services and data
  • supporting the development of a digital staff passport for across health and social care to provide a record of all professional qualification, training and capabilities

The digital staff passport capability is about the use of standards for the exchange of digitally signed credentials between staff and service providers. The staff movement programme within NHSEI is working to enable staff and employers to use this capability to support the completion of employment checks in a secure and efficient manner and to improve systems access.

NHSX will consult with existing local initiatives already working to make use of emerging identity technology and will also establish a community of practice to share initiatives and to support alphas to identify the best regional or local vehicle for delivery.

Commitment milestones

Identity architecture principles and guidelines established.

Date: November 2021


Establish identity and access management architecture governance and review national projects for strategic alignment.

Date: January 2022


Care identity management has started a public beta (trial).

Date: February 2022


Self service registration public beta (trial) starts

Date: February 2022


Identity and Access Management (IAM) policy and standards have been changed along with the supporting authentication technology to allow NHS staff to work flexibility across locations.

Date: April 2022


Staff without routine access to a registration authority are able to self-register for a strongly verified identity

Date: April 2023


Care Identity Service (CIS) authentication service decommissioned

Date: September 2023

Shared care records

Background

The move towards integrated models of care depends on timely access to a complete view of patients’ records from all of the health and care services they use.

The former Local Health and Care Record Exemplars (LHCRE) programme began work in this area, which has evolved into this programme. The aim of the Shared Care Records programme is to give health and care professionals near real-time access to the information they need so they can make the best decisions about the care they give, regardless of where the information was captured.

Subject to stringent privacy protections, this will also provide the opportunity to analyse that data at scale to support a shift to population health and guide long-term planning decisions.

NHSX’s immediate objective is to make sure that there is good progress towards national coverage of shared care record solutions by 30 September 2021 and that this complies with a baseline standard of functionality, the minimum viable solution 1.0 (MVS1.0). This will ensure that NHS trusts and general practice within an integrated care system are able to share data in line with the standards set out in the core information standard. The MVS requirement also requires the use of direct in-context links to shared care records to avoid busy professionals having to log-in to a separate portal to see the shared care record.

It is essential that shared care records not only enable the sharing of information within integrated care systems, but also between them. Once the basic systems are in place, we will support interconnection of local systems, so as to address the needs of people whose care spans ICS boundaries as well as service providers operating across those boundaries.

The longer-term plan is to incorporate additional partners, data and functionality over the next 3 years. In particular Shared Care Records will need to include the social care sector, and care plans - the “look forwards” - as well as records of past interactions - the “look back”.

Delivery approach

Accountability for achieving the required standard, capability and functionality resides with the ICSs. Some ICSs are working independently; others have chosen to work in collaboration with their neighbours because of common patient flows. The Shared Care Records programme will be providing regional leads to assist ICSs. The mechanism for funding application is through NHSX’s Unified Tech Fund, although ICS’s will initially be able to use the existing ShCR funding process to apply for funds.

Commitment milestones

National coverage of a basic shared care record between GP’s and hospitals in place in digitally mature integrated care systems.

Date: September 2021 (complete)


Develop a Shared Care Records delivery strategy for the remainder of the NHS Long Term Plan.

Date: December 2021


National coverage of full shared care records in place (subject to review and confirmation later in 2021).

Date: March 2024

Digital child health and maternity

Background

The digital vision for child health and maternity is to use the potential of digital technology to increase patient safety and empower pregnant people, children, young people and their families to participate in decisions about their care. We also want to provide commissioners with the information they need to make better decisions about child health and maternity services without increasing the burden on staff.

NHSX is supporting the implementation of recommendations in Better Births for maternity digital care records to support sharing of data and information between women, medical professionals and organisations. This will enable women and their families to make informed choices about their maternity journey. The work to share data will also support improved patient safety. In addition we are also evaluating how to support the need to reduce burden for clinicians and improve that patient experience.

We are working with the Children and Young People programme and with the early-years review to shape the business case and work required to deliver the Start for Life proposition. This will help us establish whether the scope supplements or replaces the current Digital Child Health portion of this programme.

We will continue to replace the paper red book with a digitised alternative that will better help families make choices for their child's health regardless of where they live in England. This will also improve the data held on children and young people helping clinicians to recognise issues at an early stage to reduce any risks to the child.

Delivery approach

During the 2021 to 2022 financial year NHSX is leading work to:

  • understand the child health and maternity records, and to develop a national technical architecture model to support system wide interoperability with all stakeholders involved.
  • define commercial mechanisms and funding models for the procurement of compliant child health and maternity technical solutions with assurance against the defined standards, regional procurement activity, service level assurance, and supplier and market relationships.
  • drive adoption of the latest data sharing standards between local and regional organisations to make sure core data sets are available for all user groups for child health and maternity, and support local and regional systems to implement them.

Commitment milestones

Commitments that show the steps to delivering the ambition set out above will be available in quarter 1 of the 2022 to 2023 financial year following the completion of scoping and the programme discovery phase

Transform - overview

We will use digital technology to transform NHS services.

We will help the health and social care system to fundamentally change how people use services.

Through digital tools and services we will enable transformation of pathways to support the redesign of care pathways for a truly person centred care experience, keeping patients well, at home, optimising efficiency and eradicating friction.

The widespread adoption of data driven solutions, such as AI, will help the health and care system use data innovatively, increasing productivity and maximising the positive impact of research and innovation for the benefit of the NHS.

This section provides detail on our transformational programmes.

Digital in urgent and emergency care

Background

The top priority for the digital teams in urgent and emergency care (UEC) is to support the UEC system in managing demand more effectively through 111 and 999. As commissioners of live services including NHS Pathways, the UEC Directory of Services, and 111 Online, and through our digital transformation programme, NHSX is an active and responsive contributor to recovery, continuous improvement, and service transformation initiatives led by NHSEI. We keep our delivery priorities and milestones under regular review to ensure these initiatives are fully supported by digital.

The vision of NHSX’s digital UEC programme is to support the transformation of UEC with digital services that enable patients and the public to be directed to, or connected with, the right service to meet their individual needs.

For patients, digital will contribute to greater certainty, fewer delays, better health outcomes, safer care, and improved experiences. Care systems and providers should see a reduction in ambulance conveyances, reduction in hospital and other acute admissions, reduction in time on scene for community and ambulance staff, and efficiencies in call management.

​​Digital transformation in UEC will enable fuller, faster feedback loops through which all the actors in a healthcare system - including patients, carers, clinicians, administrators, managers, and commissioners - can learn together what works, and implement sustainable solutions for putting that learning into action.

Delivery approach

Working in partnership NHSX and NHS Digital will deliver improvements in the following areas:

Understanding patient flow

We will develop insights into UEC patient journeys through the use of linked data sets. This will increase the evidence base for clinical and operational decision-making and support the evaluation of new and existing digital programmes using Triage Internal Metrics (TIM) and Triage External Metrics (TEM).

Profile updater

The profile updater tool will be updated to cover a wider range of care settings. The data on the directory of service that it uses will become more accurate as service provider staff will have a user-friendly intuitive digital method of reviewing and updating their service profile.

999 to 111 transfers

We will provide an interoperability standard for ambulance 999 operators to transfer active patient cases electronically to a 111 or an integrated urgent care service, in a consistent format. When implemented this will remove manual processes, providing digital access to the previous consultation and enabling clinical input for patients that may not require an ambulance dispatch.

Post event messaging (PEM)

We will provide a standard for post event messaging across urgent and emergency care using modern coding standards. This will create interoperability that enables continuity of care between settings. Transcripts of patient encounters within NHS 111 will be understandable by their GP, giving GPs visibility of patient encounters..

Patient encounter history

The repeat caller service will be updated nationally and made available across urgent and emergency care services. This will allow 111 advisors to see where a patient has sought advice multiple times in quick succession. This will mean that worsening illness can be identified sooner and prevent escalation. Providers will have access to a patient contact history.

Mobile referrals

The service finder will be updated to enable NHS staff to make referrals on the move, by providing access to both service information and referral pathways. This will reduce time spent on scene by ambulance crews and community teams and reduce delays for patients by providing seamless access to referral pathways.

Commitment milestones

Triage Internal Metrics (TIM): Deliver the initial stage (beta) for end to end patient journey analytics bringing in more data sources for linkage to achieve a fuller coverage of patient journey, improved frequency, processing and timeliness of the updates.

Date: March 2022


Triage External Metrics (TEM): Deliver the alpha and private beta phases of the interactive dashboards for commissioners and providers, that will provide them a resource to understand trends and patterns in the UEC patient journey.

Date: March 2022


Profile updater: The next version of a profile updater tool (that can be used across all care settings) introduced to cover initial care settings (dentistry/pharmacy). To establish an operating model and prioritisation list for onboarding remaining further cohorts from April 2022.

Date: March 2022


UEC standards: Define and implement the operating model for the renovation and future development of the standards of UEC Interoperability, including having a clear backlog of prioritised UEC interoperability standards for production.

Date: April 2022


999 to 111 transfers: In live (private beta) demonstration of the capability of a published interoperability standard to transfer care between 999 and 111 and to establish a path to live for nationwide adoption plan.

Date: April 2022


Post event messaging: Make encounters with 111 more understandable by the GP. Building the info model required for a new strategic interoperability standard fully published and adopted between 111 and Primary Care providers.

Date: December 2022


Mobile referrals: A service made available to ambulance and community staff at the point of providing urgent/emergency care to identify referral pathways, enabling them to refer in a single transaction on any device.

Date: March 2023


Patient encounter history: A service available nationally across urgent and emergency care services (aligned with existing RCS service) allowing 111 advisors and clinicians across the system to see where a patient has sought advice multiple times in quick succession, reducing clinical risk from the existing system.

Date: December 2023

Customer experience

Background

A focus on customer experience (CX) puts the person at the centre, with services built around them, rather than reflecting the complexity of the organisation around them. It provides a lens through which we can look at our journeys for people to understand how well they work, how well they dovetail into other related journeys or services and how easy it is for people to interact with us across the entire lifecycle of their relationship with the NHS.

Looking at things this way will mean we are able to identify and fix the flaws in individual digital service journeys and ensure that they stack up to a much greater whole; that enables us to provide a much more comprehensive, supportive, preventative digital NHS for people, meeting them where they need to be met and supporting them in ways that make the most sense for them.

Supporting this ambition:

National digital channels

The vision for the national digital channels (the NHS App and the NHS website) is to provide a consistent, cohesive experience of NHS digital services that is simple to use, easy to access and able to support people to stay well as well as when they are unwell. A single NHS login will be the key that gives people access to their own information, links them to the services that are available to them and allows them to engage directly with the NHS, putting them in control of their own health and care.

The strategy for the national digital channels is to become a ‘companion’ for people’s health and care. We will provide access to all NHS services a person is eligible for, give them access to their information and make it easy to self-serve and provide choice in the ways they interact with us through provision of a multi channel experience. Should they choose to, people will be able to take advantage of a ‘logged in’ experience and create an ‘account’ via the NHS App or the NHS website that will deliver a more personalised service, with services, content and messages delivered directly to the app on your phone.

Whether accessing digital urgent, primary, secondary or tertiary care, services designed to keep you well, your information or correspondence sent to you by the NHS, the vision is that you will be able to access these all from one place; the national digital channels.

NHS account

The NHS account will be the ‘engine’ that enables us to connect people with the services available to them and provide a personalised experience. While not mandatory to interact with the NHS, it will offer people the opportunity to access the NHS digitally from one place - either via the NHS App or the NHS website.

It will contain a profile which holds a person’s core information (NHS number, GP, contact details and contact preference etc) with ability to update those details where relevant. The Account holds a memory of transactions, allows people to control who can access their data (including nomination of proxies, trusted individuals to access health and care information on their behalf), enables people to contribute to their records and enables proactive tailored care and a personal experience, based on the information people choose to share (for example lifestyle habits). It will be user authenticated by NHS login.

NHS wellness and prevention

In the 2021 to 2022 financial year NHSX is commissioning the development of a digital wellness and prevention hub to give people the tools and information to keep themselves healthy. This will be a person-facing digital wellness offer with a set of web-based and app-based tools that will be accessed through our current suite of patient facing services, including the NHS website and the NHS App.

The ambition for the wellness and prevention programme is to improve the health outcomes of the nation by providing a personalised experience that:

  • brings together health and wellness services
  • understands a person’s unique situation
  • offers actions to them based on what we know about them

A key part of this ambition will be to deliver services and tools that help to nudge people to take positive action and remain engaged. By helping people to look after themselves in this way, the aim is to improve the overall health and wellness of the nation resulting in better health outcomes, cost savings and a reduced burden on the front line.

Commitment milestones

National digital channels: Easier NHS login registration for TPP patient online users - using GP record info to verify identity in place.

Date: April 2021 (complete)


National digital channels: Update my contact details available for relevant users upon login to the NHS App.

Date: April 2021 (complete)


National digital channels: Every mind matters site relaunched with interactive content to help users more easily manage their mental health.

Date: April 2021 (complete)


National digital channels: Check my COVID-19 vaccination record is available via NHS App.

Date: April 2021 (complete)


National digital channels: Patients know best personal health record is integrated with the NHS App and is available in 4 ICSs.

Date: May 2021 (complete)


National digital channels: Discovery for integration of primary care messages into the NHS App complete.

Date: August 2021 (complete)


NHS App messaging: An extension of messaging and notification functionality to incorporate primary care communication needs and national use cases.

Date: March 2022


Wellness and prevention alpha: Creation of a person-facing digital wellness offer linking lifestyle and wellbeing services alongside medical data accessible.

Date: March 2022


NHS profile alpha: Delivery of a ‘profile’ alpha as the access point to the NHS account which holds a person’s core information (NHS number, GP, contact details, etc) with ability to update those details where relevant.

Date: September 2022


NHS App and NHS website: Consistent multi-channel experience of core services, giving people choice of whether to engage through the NHS App or the NHS website.

Date: December 2022


Wellness and prevention beta: Provide people with a presentation of lifetime risks to promote informed lifestyle choices and create a ‘lifetime journey’ with the NHS through the NHS App and the NHS website.

Date: March 2023


Personalised service: Content and services tailored to a person’s needs and choices across NHS App and the NHS website, underpinned by NHS account. A dynamic and proactive offer, based on a person's shared information where they can be prompted for actions.

Date: March 2024

Digital transformation of screening

Background

Screening is a way of identifying apparently healthy people who may have a higher risk of developing a particular condition, so that they can be offered early treatment or given information to help them make informed choices

The digital transformation if screening programme seeks to transform the way in which digital solutions, data and technology are used in the delivery of NHS screening services, with the intention of:

  • improving health outcomes
  • increasing the quality, efficiency, and personalization of screening services for participants
  • addressing health inequalities

The first deliverable of the programme is the delivery of an interim IT cervical screening system. The legacy NHS cervical screening service is supported by IT hosted on the National Health Application Infrastructure Services (NHAIS) platform, however, this technology infrastructure is ageing and needs to be decommissioned. The interim solution will have ‘like-for-like’ functionality, will be easier for staff to use, and be a web hosted system.

Delivery approach

An interim solution for cervical screening is in its build phase of its development however the first area to be addressed with the strategic digital solution for screening is breast screening, as recommended by the Independent Review into Adult Screening Programmes.

Many of the screening programmes experience similar issues with their IT infrastructure. We plan to introduce national capabilities in a gradual deployment, starting with Breast, that will:

  • solve the significant issues posed by the breast system initially
  • de-risk the delivery of new technology
  • provide the opportunity to realise benefits and value sooner
  • re-use this functionality across different screening services

The replacement of IT systems is just one part of the potential for the wider transformation of screening services in England. For example, there is an opportunity for improvements in IT systems to enable the wider transformation through:

  • more personalised services that improve the targeting of eligible populations and help to drive greater consistency in coverage and increased uptake of screening services
  • greater transparency and citizen control throughout the screening process to improve user experience and promote higher levels of coverage and uptake
  • increased safety through the elimination of manual processes that entail the risk of error
  • enhanced ability to draw insight from screening data, reducing the cost and time needed to generate new evidence on the effectiveness of interventions
  • improved operational and cost efficiencies through the greater automation of processes, and a reduction in the cost of ongoing support and maintenance

Commitment milestones

Target technical architecture designs have been drawn up for breast screening.

Date: June 2022


National digital service technical architecture has been set out across all in scope screening services, including:

  • adult screening services - abdominal aortic aneurysm, bowel, cervical, diabetic eye
  • antenatal and newborn screening services - bloodborne pathogens, foetal anomaly, sickle cell and thalassemia, newborn and infant physical exam, newborn blood spot, newborn hearing
  • targeted screening services - lung cancer, lynch syndrome

Date: November 2022


Cervical Screening Management Service replacement “like for like” system deployed.

Date: TBC

Delivery of these milestones will be contingent on securing approval of business cases and therefore may be subject to change.

Supporting people at home

Background

We have an incredible opportunity to support many more people through tech-enabled care at home. We want to reach 1 million people with care at home in the 2021 to 2022 financial year. To achieve this acceleration in digital home care we have three cohesive programmes of work.

Regional scale plans for remote care

Thanks to great work led by local care systems via the seven NHSEI regional teams, we have supported scaling of remote monitoring to over 125,000 people in ten months. We have been able to develop a successful partnership approach with regions and local care systems that provides an infrastructure to scale remote monitoring as a model of care to support pathway transformation and our plan is to increase the scale of this work during the 2021 to 2022 financial year.

In the 2021 to 2022 financial year, we intend to enable digitally supported care at home or closer to home, to 300,000 people in a number of priority areas, including:

  • long term condition management including virtual wards
  • the care sector
  • annual physical health check and remote electrocardiogram (ECG) for patients with severe mental illness

Through this work, we will also:

  • support the delivery of the technology enabled care by the provision of expertise and products to enhance and enable faster spread and adoption
  • Provide support to the community of adopters to continue to share learning and practical resources
  • Continue to develop and foster a learning system that will provide wider benefit to other technology enabled projects through developing capability across the system, such as the benefits work this year

This will provide infrastructure and building blocks for wider pathway transformation at scale in future years. It also enables the testing of patient activation at scale in terms of self management.

Digital pathways

During the pandemic NHSX helped the NHS transform clinical pathways using digital technology to support the continued delivery of care. Building on this will be a key element of the restoration and sustainability of services.

This work will build on the 2020 to 2021 financial year delivery achievement in areas of particular risk to the NHS such as shielded patients in cardiology. We will Increase the uptake of advice and guidance following the improvements in electronic referral guidance infrastructure to make sure that 200,000 further patients get rapid access to advice and guidance and deploy 200,000 additional monitoring devices for hypertension, targeted at patients most at risk of developing serious conditions. There will be a focus on areas where there has been a marked increase in the volumes of patients and length of waiting times such as ophthalmology and dermatology.

The ambitions for the next 3 years, include:

  • all high volume specialties will have agreed an established digital pathway offering choice for patients and making sure that clinicians are able to concentrate time in those patients with more complex conditions.
  • support for patients to monitor their long term condition at home, with access to guidance to support self-care.
  • the most complex long term conditions will be monitored more closely with digital platforms
  • there are effective flows of data between clinical systems, supported by technical standards, to make sure that clinical teams have the data to make decisions along the clinical pathway

Digital health partnerships

There are two programmes of work which support the NHS to identify and implement digitally enabled care that works supported by national standards and best practice:

  • Digital health technology.
  • Digital Health Partnerships Award.

Digital health technology will deliver three projects:

  • Digital Health Technology Assessment Criteria (DTAC)
  • An impact and evidence framework
  • Patient facing tools and services

The DTAC gives staff, patients and citizens confidence that the digital health tools they use meet our clinical safety, data protection, technical security, interoperability and usability and accessibility standards. The DTAC brings together legislation and good practice in these areas. It is designed to be used by healthcare organisations to assess suppliers at the point of procurement or as part of a due diligence process, to make sure new digital technologies meet our minimum baseline standards. For developers, it sets out what is expected for entry into the NHS and social care.

DTAC forms the core baseline assessment, however it intentionally does not consider the efficacy or impact of a product.Working with NICE and the MHRA, the impact and evidence framework will join together DTAC and Evidence of Effectiveness, to make the NICE standards accessible to the system, as DTAC has done for baseline requirements.

This patient facing tools and services project will provide a simple staged delivery of how we can support NHSEI and local policy teams to identify the right digital tools and services for their cohorts or patients. It will support system and patient facing solutions and their adoption throughout the cohorts by leveraging our national and local product suites and through the development of a portal to showcase impactful products to the system.

The Digital Health Partnerships Award has been created to accelerate the adoption and scaling of the most impactful digital health technologies that meet the strategic aims set out in the NHS Long Term Plan.

The award is run across health, social and community care and will identify and support technologies that will improve patient outcomes. Delivered in partnership with industry, bids will need to identify how partnerships with other organisations will deliver the opportunity at pace, with clear sustainable outcomes.

The award will be run across 2 phases in 2021 and 2022. Both phases will support the use of connected home technologies and services so that people with long-term conditions can monitor their health remotely, at home or in the community. The award will support technologies across the spectrum of development, from initial deployment to scaling proven technology and through to supporting local community trusts deliver support in the community. Phase 1 launches in June 2021 with phase 2 planned for later in 2021.

Organisations will need to demonstrate how their bid can support the following four areas of work across an individual area or encompass more than one of these four areas:

  1. Optimisation of care pathways
  2. Patient centred data exchange
  3. Self-management and prevention advice
  4. System efficiencies

All digital health technologies supported through the award will have to demonstrate compliance with the Digital Health Assessment Criteria for Health and Social Care (DTAC) and have the required Medical Device Classification. Support will be available for this during the process.

Delivery approach

The following outlines the approach to delivery of the three programmes.

Regional scale plans for remote care

To drive delivery, the regional scale plans for remote care programme, will:

  • allocate each region a target for a total number of patients to be offered technology supported care at home, based on CCG weighted allocation - the level of associated implementation funding mirrors this approach
  • ask regions to provide a detailed programme plan describing how they will support their allocated number of patients and how this will be split amongst the four areas against which funding will be allocated

Digital pathways

In the 2021 to 2022 financial year the digital pathways work in its aims to reach 500,000 people, will:

  • support ophthalmology image sharing; by producing an API and support regions to implement referral management and image sharing in every region of the NHS in England enabling optometrists to connect to ophthalmology patients for the first time, with more patients offered advice and guidance during the implementation over the next year
  • complete and publish six digital playbooks that advise on the digital innovation at clinical specialty level
  • have deployed a range of image sharing products in each region to test streamlined dermatology pathways
  • lead the technology development of the perioperative pathway working with the Getting It Right First Time (GIRFT) team and improvement directorate with the aim of deploying in two regions reaching potentially 50,000 patients in the first year

Digital health partnerships

The digital health technology programme will secure success of the DTAC project. It will do this by driving the roadmap for the adoption of baseline standards and best practice across the NHS and social care. This will ensure that capability is built to review DTAC evidence across the system, and the required assurance processes within ICSs in place. It will also create capacity for NHSX and NHS England and NHS Improvement to ensure that all digital health technologies supported by programmes meet the same baseline requirements.

The programme will deliver the impact and evidence framework project by developing support tools for suppliers to effectively and consistently:

  • model how a product works, defining the value proposition
  • provide techniques for baselining impact of digital health technologies
  • demonstrate their business readiness to scale
  • support understanding of business and product fidelity
  • provide ‘how to’ build data for evidential studies and full NICE evidence standards framework evaluation

The programme will support the the patient facing tools and services project though:

  • defining a new baseline for digital health technology
  • changing how digital health technologies are assessed
  • developing a clearer pathway to demonstrating impact and effectiveness
  • delivering digital policy blueprints to identify impactful patient facing health apps
  • supporting selection, procurement and prescription of DHT for national and local commissioners

NHSX will work alongside colleagues from across the health and care system to identify, promote and drive adoption of good, impactful digital tools.

In the 2021 to 2022 financial year the digital health partnerships award programme aims to reach over 100,000 people, through:

  • delivering two phases for NHS organisations to submit their bids
  • working with winning bidders to support the delivery of the projects and ensure that learnings can be shared across organisations
  • Identifying opportunities to leverage national or international partnerships based on the national view of collaborative and partnership activity

Commitment milestones

Regional scale plans: National innovation collaborative - knowledge library live.

Date: July 2021 (complete)


Digital pathways: Hypertension - trailblazer wave completed.

Date: July 2021 (complete)


Digital pathways: Access to digital pathway innovations across the country is improved through publication of eight digital playbooks that share examples on digital innovation at clinical specialty level.

Date: October 2021 (complete)


Digital health technology: Criteria for health and social care - first 100 products assessed against DTAC throughout the health and social care system.

Date: October 2021 (complete)


Digital Health Partnerships Award (Phase 1): Partnership awards have been granted.

Date: November 2021 (complete)


Digital pathways: The architecture for sharing referrals and images for eyecare services across the country supporting the reduction of waiting lists for eyecare improving access to diagnosis and treatment is delivered through an API that links referral platforms.

Date: December 2021


Digital pathways: Advice and guidance for hospital services for patients delivers an increase of people receiving advice and guidance by 15% across the country and 25% in dermatology through the funding of new platforms.

Date: March 2022


Digital pathways: Improved monitoring of hypertension delivered through the spread of a digital hypertension home monitoring pathway offer to upto 200,000 patients, leading to better management of unstable hypertension.

Date: March 2022


Regional scale plans: By March 2022, more than 300,000 are people supported by remote monitoring at home.

Dates:

50,000 by June 2021 (complete)

80,000 by September 2021

150,000 by December 2021

300,000 by Mar 2022


Digital Health Partnerships Award - Impact and evidence framework developed.

Date: April 2022

NHS COVID pass

Background

In March 2021, NHSX was commissioned to build a COVID-19 certification solution for residents in England for travel use by 17 May and domestic use by 21 June. Both were delivered successfully and on time.

The NHS COVID Pass enables individuals to share their COVID-19 vaccination and test results in a secure way. There are three options available in England to demonstrate COVID-19 status: via the NHS App, through the NHS website (www.nhs.uk) and via letters from 119.

The COVID Pass Verifier App launched for scanning of COVID Pass 2D barcodes in voluntary certification settings on 19 July, following trials as part of the DCMS Events Research Programme. The NHS COVID Pass has developed in line with evolving government certification policy and to meet the needs of a diverse group of users.

Delivery approach

We are working closely with partners including NHS Digital to deliver the programme. We have undertaken extensive user engagement and research to ensure that the solution is fit for purpose and iterated; working closely with technology suppliers such as Google and Apple to ensure optimum use of their capabilities and platforms; and working closely with target groups in field pilots.

Since the integration of the NHS COVID Pass within the NHS App, there have been over 14 million new registered users of the app; 50 million 2D barcodes have been generated and nearly 3 million letters have been requested. We delivered digital solutions for Wales on 25 June and Isle of Man on 25 August and continue to work with the devolved administrations and international countries on interoperability.

During the 2021 to 2022 financial year, the team will continue to develop the NHS COVID Pass, responding to developments in government policy and international standards. This work will include:

  • enabling the authentication of COVID Pass in more countries
  • incorporating any new and booster vaccines
  • provision of a digital wallet so users can store their certification status without needing to sign in each time they want to access it
  • work to continue to scale and strengthen the overall service

User centred service transformation

Background

NHSX is working with and supporting teams across the health and care system to deliver improved outcomes using modern delivery practices that are agile and user centred. Through this work, we know there is a growing demand for adopting modern digital delivery approaches and user centred design.

User centred design is an inclusive and evidenced based approach to solving challenging and systemic problems. It starts by understanding people’s needs, then co-designing solutions, testing them, continuously seeking to improve them and working in the open to help others take the same approach. This is something we do as a community of generalists and professionals, bringing all skills, opportunities and insights together to deliver real meaningful value on the ground in frontline services. A common pitfall of digital delivery is to rush to technology as quickly as possible rather than taking the time to understand what people really need. Good design can improve safety, effectiveness, and staff and patient experience.

NHSX will be supporting national, regional and local teams to use these agile and user centred approaches to digital transformation. We will build capability and confidence to use design and help teams to understand, organise and commission work around user journeys.

As part of service transformation, this approach allows teams to:

  • understand people’s needs and design services to meet them
  • see how their work fits into broader services, experiences and journeys
  • avoid duplication and create a coherent, connected user experience
  • design better future experiences through cross-functional working, co-design and co-production with patients, professionals and staff

Delivery approach

Nationally, NHSX is partnering with teams across NHSEI, working with regions and local care providers to demonstrate the value of a user centred approach to transformation. We are also working closely with the Customer Experience team to make sure our service design work enables the design of journeys into a personalised, consistent and seamless experience.

NHSX provides experienced professionals in user centred design and agile practices to deliver the digital transformation of whole services and to inform high-level commissioning and prioritisation decisions. We evolve how work is approached, structured and governed, with a focus on user centred design, service ownership, agile teams and iterative delivery.

In the 2021 to 2022 financial year, we are focusing on a number of priority areas, including:

  • eye care
  • urgent and emergency care
  • mental health

NHSX and NHSEI are working with regions and local care organisations to transform eye care services and are looking to implement, test and scale new technology-enabled service models.

NHSX has partnered with the NHSEI digital mental health team and teams across the NHSEI mental health programme to develop resources to support the digital transformation of pathways of care. This involves embedding digital specialists with local NHS organisations to understand user needs, then test and validate opportunities. We are then supporting the roll out and scale of new digitally transformed pathways by providing resources and coaching.

To support and scale these new approaches to transformation, NHSX will partner with teams across the system, provide practical tools and resources, develop communities of practice, offer training and build capability building. We demonstrate what is possible through hands-on delivery and equip teams to deliver by themselves.

In the 2021 to 2022 financial year, NHSX will set up and grow a network of regional user centred design teams to help and support local health and care organisations with service design and user research. This function will help to support the growth of user centred design in local organisations.

User centred design is a recognised profession across government and industry and is a growing profession in the NHS. NHSX is helping to establish and grow user centred design as a profession, making the NHS a place where people come to learn and do inclusive design and user research. We are working with Health Education England and with the national and local workforces of user centred designers to develop the structure and support needed to build and sustain the profession.

Digital productivity

Background

The need to improve productivity is more important than ever as we move out of the COVID-19 pandemic. Significant productivity growth will be required for the foreseeable future in order to mitigate the productivity reduction caused by COVID-19 counter-measures.

Research by the University of York shows that organisations with greater levels of improved productivity have reduced:

  • employee sickness rates and absenteeism
  • error rates
  • administrative processing time

An improvement in productivity levels, will give more focus on clinical decision-making and will reduce variations in:

  • clinical practice
  • patient outcomes measures
  • operational and clinical time utilisation
  • financial efficiency

NHSX is supporting HMT’s savings and efficiencies target for healthcare, and NHSEI’s national productivity programme.

With the extensive range of digital solutions available across healthcare, the digital productivity programme aims to help organisations to improve productivity by adopting digital technology. They will be able to:

  • find out where it's being done well
  • read evidence based case studies
  • explore resources they can use now

Sharing the learning promotes sustainability, collaboration and expertise. In turn this speeds up the use of productivity-improving digital technologies, where they can have the biggest beneficial change.

In the 2020 to 2021 financial year a number of health and care wide interventions were delivered. The knowledge gained was shared by NHSX to build a library of evidence and a productivity platform including:

  • Robotic Process Automation (RPA), centre of excellence pilots
  • FutureNHS ‘digital productivity’ web space
  • NHSX web space - the ‘digital productivity hub’
  • universal metrics for measuring digital productivity effectiveness

In the 2021 to 2022 financial year, NHSX is setting out a three year digital strategy and a delivery roadmap with four key pillars:

1. Benefits and research

A library of comprehensive case studies of productivity-improving technology approaches. This will use international literature and academic, evidence-based research on efficacy, costs, technologies, impact, benefits and risks.

2. Sustainability

Blueprints for best practice technology enablement, digital playbooks and open standards for health and care adoption. Delivering a productivity platform for a single view of best practice.

3. Digital enablers

A best practice evidence-based pipeline of productivity-improving technology solutions. Grounded in compelling evidence of clinical efficacy, these will improve efficiency and effectiveness for health and care systems. Capital support allows digitally immature sectors to improve and accelerate productivity-improving digital solutions. Examples include robotic process automation (RPA), radio frequency identification (RFID) and real time location services (RTLS), virtual reality rehab and therapies.

4. Community hub

Hubs are national communities of practice, providing a range of high quality and cost effective productivity-improving tools and guidance. These act as a framework of digital solutions for the health and care community, who are developing new services in response to changing community needs.

To avoid overwhelming health and care with too many priorities and support offers, many of the interventions in this programme will be coordinated at Integrated Care Systems (ICS) and Sustainability Transformation plans (STP) level. This will be through a single delivery vehicle, the Unified Tech Fund.

The tech fund underpins the Tech Plan for Health and Care and sets out a simplified route for health and care providers to access financial support to deliver digital interventions being led by NHSX.

The programme of works being delivered by the digital productivity programme is aligned to the national productivity programme. Regional‌ ‌directors‌ ‌of‌ digital‌ transformation‌ ‌will‌ ‌be‌ ‌key‌ ‌in‌ ‌brokering‌ ‌support‌ ‌offers‌ ‌at‌ ‌a‌ ‌local‌ ‌level,‌ ‌assisting‌ ‌in‌ ‌procurement‌ ‌and‌ ‌implementation‌ ‌of‌ ‌systems,‌ ‌and‌ ‌in‌ ‌monitoring‌ ‌programme‌ ‌and‌ ‌utilisations‌ ‌metrics.‌

Delivery approach

The digital productivity team will help organisations to scale productivity improving digital enablers throughout health and care that make a positive difference to improving the working lives of the workforce.

Organisations will be able to bid for capital funding support to help them buy proven productivity improving digital technologies such as:

  • Robotic Process Automation (RPA)
  • real time location services including radio frequency identification (RFID) virtual and augmented reality technologies
  • intelligent automation
  • value added labour saving digital capabilities across all systems

We will engage with health and care organisations, academic researchers and technology vendors. We will publish guidance, signposting, communities of practice and best practice approaches.

Commitment milestones

Digital enablers and sustainability: All health systems, clinicians and other health staff can access, procure and use proven digital productivity tools to deliver care and treatments to more patients, improve the quality of care, save time, lower costs, reduce waste, and increase patient and staff satisfaction.

Date: March 2022


Digital enablers: All designated ICSs [test beds] can test automation to improve services for patients and employees.

Date: March 2022


Sustainability: All health systems, clinicians and other health staff can access resources including GDE blueprints and digital playbooks that provide technological opportunities for improved productivity across health and care.

Date: March 2022


Benefits and research, sustainability, community hub: Launched publication of ‘beneficial changes impact’ from the first 2 years of the programme, including methodology for measuring effectiveness.

Date: April 2023


Detailed deliverables for the 2022 to 23 financial year and future years will be dependent on the outcome of the spending review.

NHS AI Lab

Background

The NHS AI Lab was set up to unlock the potential of artificial intelligence (AI) technologies for improving health and social care. It has established a range of projects in partnership with UK health and regulatory bodies.

These partnerships have enabled health and care organisations to work effectively together to accelerate the development and deployment of safe, ethical and effective AI driven technologies.

Delivery approach

The NHS AI Lab has five delivery projects:

AI in Health and Care Award

Supporting the testing, evaluation and adoption of AI technologies most likely to meet the aims set out in the NHS Long Term Plan with seed funding.

National Medical Imaging Platform (NMIP)

Facilitating the safe, secure and ethical collection of medical images on a national scale to support development, validation, and deployment of AI driven technologies. This will include delivering a National COVID-19 Chest Imaging Database (NCCID) to support pandemic response efforts.

AI Skunkworks

Supporting the wider health and care community to trial innovative ideas or proof of concepts in the AI technology space, using a user-centered design approach, and share lessons publicly on what works and what doesn’t.

AI regulation

Enabling a world leading, safe and ethically robust regulatory ecosystem for the development and deployment of AI driven technologies.

AI ethics initiative

Improving ethical and regulatory assurance for the development and deployment of AI driven technologies in health and care through research and the trialling of practical interventions.

Commitment milestones

AI Imaging - National COVID-19 Chest Imaging Database (NCCID) platform in BAU and continuous engagement with sites. To date 55,639 images uploaded with 26 trusts contributing.

Date: April 2021 (complete)

AI Strategy - Draft national health and adult social care AI strategy published in time for the London tech week.

Date: September 2021 (complete)

AI Skunkworks - 5 Proof of Concepts (PoC) completed across data lens, NHS Resolution, long-stayers, CT scan comparison and Bed management.

Date: September 2021 (complete)

AI Awards - 80 AI technologies selected for funding and Round 3 competition complete - call out to identify and select more technologies (200 applicants), shortlisting underway.

Date: October 2021 (complete)

AI Strategy - Develop a national health and adult social care AI strategy (2024-2030) by early 2022 to consolidate the system transformation achieved through the NHS AI Lab and pave the way for equitable, sustainable deployment of AI technologies at scale across the NHS and care system.

Date: March 2022

AI Awards - Over 125 award projects selected for funding to complete the full portfolio of commitments.

Date: October 2022

AI Imaging Platform - Launch of national imaging platform (alpha “pilot” stage) to support the development and benchmarking of AI imaging technology in health and care (beta deployment stage to follow).

Date: December 2022

AI regulation - Launch of multi-agency advice service to streamline regulatory advice for AI technologies in health and care.

Date: March 2023

AI ethics - Research published on the impact of AI on health inequalities.

Date: September 2023

Skunkworks -Twenty proof of concept projects delivered by the AI Skunkworks. Showing how AI technologies can potentially address live problems across the health and care sector.

Date: December 2023

Promising AI technologies for health and care are funded, deployed and evaluated at scale, with investment of £140m.

Date: April 2024

A clear regulatory and deployment process for AI technologies in health and care is defined with live operational services in place.

Date: April 2024

Operational functions - overview

There are a number of activities that support us to digitise, connect and transform. This section describes the activities that underpin our work, ensuring that we operate safely and effectively.

GP IT operating model

Background

The Primary Care (GP) Digital Services Operating Model is the commissioning framework supporting the provision of digital obligations under the GP contract. It is accompanied by a suite of documents including:

● CCG practice agreement - providing clarity and assurance to both parties on the requirements for the provision and use of digital services available to general practices under the operating model

● digital primary care maturity assurance tool - providing assurance of the appropriate investment of GPIT funds aligned with the requirements of the operating model

● GP IT specification commissioning support pack - providing support on processes and considerations when procuring new systems

The updated, 2021 to 2023 version of the operating model will include a GP advanced telephony specification commissioning support pack. This will outline considerations and recommended specifications to help GPs to procure intelligent telephony systems.

The updated operating model will take into account the digital transformation advances made during the COVID-19 pandemic response.

It will build on the good practice and innovations which include:

  • remote working
  • increased use of digital channels such as online and video consultation
  • practice resilience

The 2021 to 2023 update will include the changes to CCGs commissioning obligations, reflect the significant policy and contractual changes associated with the evolution of ICS and align GP IT with the NHS net zero emissions commitment.

Delivery approach

Around £80 million of GP IT capital funding will be made available to NHSEIs regional teams for which CCGs can bid. The regional teams have responsibility for making sure that all core and mandated requirements of the operating model are met using this funding. Any remaining funding available should be used to support digital transformation initiatives.

Around £246.5 million revenue for GP IT support and services will be included in the CCG baseline allocation to fund the core and mandated requirements of the operating model.

Innovation Lab

Background

The NHSX Innovation Lab trials innovative ideas using disruptive technology and allows new talent (universities, entrepreneurs, SMEs) to assist in rapidly creating proof of concepts and testing them in real world settings. This approach establishes whether a particular technology will be fit for purpose in solving a problem, demonstrates the benefits it could bring, and shows what potential barriers there may be to adoption.

The Innovation Lab assesses and demonstrates the benefit of technology ideas by solving real world problems. It identifies those which could be taken forward to extended pilot and wider adoption and provides the foundations to do so. It also identifies new technologies and implementations which could inform the future roadmap of existing national products.

Delivery approach

The Innovation Lab has a front door process to allow health and care workers to submit their issues and ideas, which ensures the work undertaken is truly user-centered.

The Innovation Lab trials its ideas in real world settings. We work with organisations who submitted a challenge through our front door, or seek partners from existing networks of relevant healthcare decision makers. We aim to co-design solutions with users, clinical settings and other key stakeholders.

During the 2020 to 2021 financial year the Innovation lab demonstrated how automatically transferring patient demographic data from a patient’s phone into a patient administration system could:

  • save time - we reduced time at desk from an average of 1m 43s to 34.5 seconds
  • preserve patient privacy - unlike a verbal exchange of information no others were party to the personal information transferred
  • improve the accuracy of data captured when a patient presents at a care setting - removing the need to manually key in data removes the potential to introduce errors into the patient record

We open sourced the code and are working with a number of national programmes to look at how this functionality could be rolled out by enhancing existing national products.

During the 2021 to 2022 financial year, the team are investigating:

  • how to add data generated by patients to their clinical records, and how clinicians could access and use this, using non-prescription medications as the test case, with the aim to improve patient safety and better understand patient health.
  • novel mechanics to allow front line staff to express frustrations and ideas for digital transformation without having to fill out forms, and have these considered at local, regional and national level, to foster a culture of innovation throughout health and care and take a truly user-centered approach to digital transformation
  • a way to increase transparency of workload in primary care settings, to better manage patient expectations and their understanding of when they will hear back from their caregiver, without adding burden to staff

Commercial function

Background

The NHS is tasked with a number of huge missions: to digitise healthcare services, connect the health and social care systems through technology, and transform the way patients’ care is delivered at home, in the community and in hospital. Almost all of the technology and digital solutions that the NHS will be commissioning, building and developing to support these goals will involve third-party vendors and technology providers from the market. Therefore, it is vitally important that we have a robust approach to buying this technology and managing our vendors.

An area where we are supporting NHS trusts and ICS's is our work on defining the best routes-to-market for the technology that they buy. At present, there is a proliferation of procurement frameworks and framework providers. Many of these frameworks have weak provisions for digital services (for example data standards and interoperability). Both buyers and vendors find it difficult to understand which services should be procured through which frameworks. As a result, the contracts we have with vendors often offer poor commercial protections and represent sub-optimal value for the healthcare system. We are working closely with buyers and market vendors to ensure that we can significantly reduce the number of sub-standard procurement frameworks. This will drive better outcomes and better value, and in many cases also lower barriers for small and medium-sized enterprises (SMEs) and innovators to develop and sell their services.

Another area of focus is the market for clinical systems. This is currently characterised by a small number of vendors, often with relatively little incentive to introduce new functionalities. By driving the separation of data and functional layers in particular, we would achieve a level of interoperability that could drive a more dynamic, innovative marketplace of services and capabilities. This would result in better patient outcomes and a more streamlined, joined-up patient experience.

This work is carried out in close collaboration with the NHS commercial team. The NHSX Chief Commercial Officer leads the Digital Council, a sub-grouping of NHSEI’s Procurement Target Operating Model (PTOM) programme, through which we can identify, prioritise and realise opportunities where the NHS can gain better value by combining its digital and technology spend and influencing the market.

Delivery approach

The commercial delivery approach is tailored to each of our programmes. In some cases, we will be procuring fully-fledged services, in others we will be procuring digital and technology capabilities (for example to augment existing agile teams), and most often we will be using a mix of approaches. The market for technology is fluid and comprises many tens of thousands of vendors. In addition, many of the services or capabilities we will be procuring will be relatively standard. Therefore, in almost all cases we will be procuring these services through pre-existing procurement frameworks, either pan-government frameworks such as G-Cloud (for standard cloud-based offerings) or healthcare-specific frameworks such as those issued by Commission Support Units (CSUs) and other healthcare organisations for clinical communications.

There are exceptions to this, particularly where we are trying to drive innovation for products or functionality which is still immature in the market. For example, the Digitising Social Care programme aims to establish a new dynamic purchasing system so that trusts can access this functionality as it is developed rather than having to wait years for the next framework refresh. In these and other cases we will be following the guidelines for procurement and sourcing as issued by the Cabinet Office (for example Commercial Playbook and the draft DDaT Commercial Playbook).

Data policy

Background

NHSX leads on data policy for the Department of Health and Social Care, the legal framework for the use of health and care data and sets the strategic direction for health and social care data across the system as a whole.

Delivery approach

We will make sure that:

  • policy and legislation enables the use of data to drive improvements in patient outcomes through high quality planning and enable cutting edge research
  • data is accessible and shared for the benefit of the system as a whole, while preserving public trust and confidence
  • the burden on the frontline is reduced, freeing up time for clinicians to concentrate on delivering care
  • the interests of the health and social care system are protected in future trade agreements

We will publish a final version of the Data Strategy for Health and Care in early 2022, following engagement on the draft version and extensive feedback.

We will incorporate in the Data Strategy the response to the Goldacre Review on the use of health data for research and analysis.

We will continue to support the passage of the legislative provisions on data in the Health and Care Bill through Parliament.

We will introduce secondary legislation on the use of health data, as set out in the data strategy, when parliamentary time allows.

Technology policy

Background

NHSX leads on technology policy for the Department of Health and Social Care. The policy team makes sure that ministerial, NHSEI, and NHSX priority commitments and strategic policy intent are implemented. The team also makes sure that key technology priorities are reflected through policies that can be successfully implemented across the organisation and by delivery partners.

Delivery approach

To drive implementation of key tech priorities, an implementation unit is being established in NHSX to solve problems, track and challenge progress, and build capability. A regulatory policy function for digital technologies is also being established to provide expert advice and provide the links into the health and care regulators. Behavioural science expertise is being built in NHSX to provide scientific insight in how to more fully understand people’s real world behaviour and how to change it.

The tech policy team works to ensure digital and technology is supporting the delivery of priority DHSC and NHSEI policies. This has included:

  • supporting the G7 Health Ministers commitments on digital health
  • working with the DHSC obesity team to consider a digital access point as part of the expansion of adult weight management services
  • working with the DHSC mental health team to understand where digital services could improve the admissions process for acute patients

Information governance policy

Background

Historically information governance (IG) has been feared and is perceived as a barrier to transformation. Some headway to address this has been made as part of the response to the pandemic in 2020 and 2021. NHSX and its partners will continue this work in the 2021 to 2022 financial year, making sure that guidance is simplified with the aim of building confidence across frontline staff in the use of health and care patient information.

Delivery approach

NHSX working collaboratively with the Health and Care IG Panel and other partners will support all health and care organisations to use information appropriately. The NHSX IG policy team will also help make sure that NHSX programmes and initiatives have IG built in from the start so they deliver at pace whilst using information safely and securely.

We will build on the work that has started to simplify IG, which included the launch of the IG portal.

This will include:

  • publishing new guidance and frameworks including the IG framework for health and care
  • aligning existing national IG guidance so that it is consistent
  • reviewing existing IG training and developing a strategy to address training for frontline staff

Strategy unit

Background

The Strategy Unit in NHSX has been established to drive strategy development, provide trusted advice and support organisational alignment. Much of our work is internal facing to either NHSX or our parent organisations and other ALBs and many of the outputs or impacts are through the work of others.

Delivery approach

The strategy unit is leading on two specific cross-cutting areas:

Digital inclusion

The strategy unit is coordinating work contributing to the reduction of health inequalities and making sure there is alignment with approaches in NHSEI and DHSC as well as working with other government departments. The outcome is for clear and agreed understanding about the role of NHSX (and teams within NHSX), NHSEI and the role of local systems plus the requirements of other government departments are articulated and understood.

Net zero

The strategy unit acts as the focal point for net zero within NHSX, providing a gateway between teams across NHSX and the Greener NHS team in NHS England and NHS Improvement, and coordinating work so delivery is largely built into existing work programmes across NHSX. The ambition behind this is a quantified carbon reduction through digital transformation and relevant levers.

Analytics unit

Background

In partnership with NHSEI’s newly appointed Chief Data And Analytics Officer, the NHSX Analytics Unit aims to modernise and strengthen the use of data and analytics across health and social care and to support digital transformation.

The unit supports both the internal analytical needs of NHSX and its programmes, as well as the wider use of data and analytics across the system.

Delivery approach

We will support teams and programmes in NHSX, to make sure that the right information is available to the right decision makers, at the right time, and in the right context. We will do this by providing a range of analytical tools throughout the policy lifecycle and associated business intelligence.

Jointly with NHSEI’s Chief Data and Analytics Officer we will:

  • support the development and sharing of new impactful techniques, be a technical lead for collaboration and procurement of data science work and lead by working in an interoperable and transparent way
  • develop analytics as a profession by strengthening the role of data analysis within the healthcare system agenda
  • provide strategy and leadership for analysts who are working in health and care and we will help to build a stronger analytical workforce, for example through the PhD internship scheme for innovation and analytics in health

We will work with key stakeholders including:

  • the data and analyst community in NHSEI
  • HEE
  • DHSC
  • internal stakeholders in NHSX such as the CTO architecture team, data policy team and the AI lab

We will work with established networks across regional and local systems, including:

  • the Association of Professional Healthcare Analysts (AphA)
  • the NHS-R community
  • the NHS Python community for healthcare
  • a range of key contacts representing the local and regional workforce

The Centre for Improving Data Collaboration

Background

The Centre for Improving Data Collaboration (CIDC) fosters more widespread data-driven innovation and better partnerships with researchers and industry, harnessing more value for the health and care system and the people it serves.

The CIDC will provide health and care bodies with guidance and tailored support to help them navigate data partnerships. This will help them to make decisions that are properly informed by legal advice and commercial best practice, and help to ensure data partnerships align with DHSC’s 5 principles

This includes support to:

  • raise awareness of the potential benefits to patients, service users and the NHS and wider society of using data to drive research and innovation, together with the assurance that partnerships can be done well
  • clarify what is expected as a minimum standard, and where there is room for local flexibility
  • provide common approaches to establishing the most appropriate partnership model, as well as consistent financial valuation models, treatment of intellectual property (IP), accounting methods, and legal and contractual drafting
  • ease access to the UK’s healthcare data assets, to stimulate a new wave of digital and data-driven innovation to benefit patients and the wider system

The CIDC (in tandem with the Who Pays For What? programme) will also shape the financial and oversight environment to ensure it better supports digital investments in the NHS by

  • developing a proposed reimbursement approach for digital health technology
  • creating tools for the NHS to model and track benefits from digital investment
  • identifying ways in which the operational planning guidance policies can better support digital investment

Delivery approach

We will achieve our objectives through delivering the following four workstreams:

1. Guiding decision-making

Practical advice, capability-building tools and how-to guidance.

2. Shaping the ecosystem

Research, engagement, profile building, policy development and market regulation.

3. Driving smarter digital investment

Policies and guidance to incentivise NHS digital transformation.

4. Accelerating data-driven research and development

Investing in data infrastructure and support services to enable more research and innovation.

The key CIDC deliverables are also set out in the Data Strategy for Health and Social Care.