Health leaders call for national redundancy pot to fund NHS job cuts

By Integrated Care Journal

NHS leaders are urging the Chancellor to rapidly create a national staff redundancy fund to smooth the pathway to the major budget cuts they are being required to make this year by the government.

Integrated care boards (ICBs) have been charged with cutting their running costs by 50 per cent from October 2025, with individual plans to be submitted for government approval by the end of May 2025. Alongside this, NHS trusts have been told to reduce their “corporate cost growth” by half the amount from the year before the pandemic.

But without a national fund that NHS trusts and ICBs can access, NHS leaders say the redundancy programme will take much longer to deliver and will reduce the level of savings from job cuts that can be delivered this year.

This would mean that the NHS would then start the following financial year, the point at which the government’s Ten-Year Plan for Health would begin its implementation, in a state of financial deficit. Health leaders fear that doing this would put the reform agenda, including the commitment to reduce waiting times to 18 weeks by the end of Parliament and to shift more care into the community, at risk.

While recent media reports have suggested up to 30,000 roles across the NHS could be removed, including through the planned abolition of NHS England, and that the total bill could reach £1bn, the NHS Confederation has heard varying figures from leaders on the extent of their expected cuts.

Some leaders of NHS trusts have said they are each looking to cut between 200 and 500 roles, while some ICB leaders have said they are likely to remove anywhere between 300 and 400.

Several trust leaders said that they were budgeting for around £12m worth of redundancy payouts and associated costs.

When looking at the proportion of the workforce that could be removed across NHS trusts, individual estimates from leaders have varied from 3 per cent to more than 11 per cent.

Health service leaders have warned that without access to a dedicated redundancy fund, as was confirmed for NHS England staff in its abolition in the Spring Statement, the process of scaling down will take much longer than the government has asked.

If they are forced to provide the necessary payouts from their own budgets, they say the process will be markedly slowed down and risks stalling the efficiency savings they can make. Recent analysis has already revealed that the gap between trusts’ regular income and expenditure is £6bn, and that this underlying deficit could derail the government’s reform plans.

One NHS trust CEO said: “Essentially, without clear guidance on underwriting redundancy options, whether these are voluntary, mutual, or compulsory, we are dependent on natural turnover and … [other] processes, which are slow and cumbersome.

“Accelerating savings would be possible if the underwriting of impacts could be funded within the year.”

Another said: “We are not planning a redundancy programme as it will be unaffordable, our plan is to reduce headcount through natural turnover although this puts a level of risk on delivery.”

Matthew Taylor, Chief Executive of the NHS Confederation, called on the government to commit to urgently establishing a redundancy fund for NHS trusts and ICBs. He said: “Health leaders understand the troubling financial situation facing the country and the need to improve efficiency where they can, as they have already demonstrated by significantly reducing their planned deficit for the year ahead.

“However, the scale and pace of what has been asked of them to downsize is staggering and leaves them fearful of being able to find the right balance between improving performance and implementing the reforms needed to put the NHS on a sustainable footing.

“They have told us that unless the Treasury urgently creates a national redundancy fund to cover these job losses, any savings the government hopes to make risks being eroded, at best and completely wiped out, at worst. If the Ten-Year Plan for Health is to be realised, it requires the NHS to be in a position of financial stability.”

The call from NHS leaders to create a national redundancy fund comes as the government finalises its Ten-Year Plan for Health as well as the three-year funding settlement that will be announced as part of the Spending Review in June.

NHS leaders anticipate the settlement will be much less than the long term historical average increase of around 4 per cent per year with the government’s latest Spring Statement already revealing that the funding increase for 2026/27 will drop to 1.8 per cent in real terms.

BSI to deliver quality assessment across the Age UK Network through new partnership

By Integrated Care Journal

A new partnership designed to assess quality across the Age UK network, in order to ensure the safety and well-being of older people, has been agreed by BSI and Age UK.

Business standards and improvement company BSI will support Age UK, a leading charity for older people, with the delivery of quality assessment services as part of a new partnership agreed between the two organisations. The partnership will see BSI provide an external quality assessment programme for organisations that use the name ‘Age UK’ against the Age UK Network Charity Quality Standard (CQS). Previously, this had been conducted by a different assessment company.

With a rapidly ageing society in the UK, the services and support the Age UK network provides to older people are increasingly important to managing demand on health and care services. This also comes at a time when a reported nine in 10 charities face increased demand, meaning it has never been more crucial to ensure that a consistent level of quality is offered across the country.

The Age UK network includes 118 Local Age UK Partners, as well as four National Partners – Age UK, Age Scotland, Age Cymru and Age Northern Ireland. While all organisations that are part of the Age UK network are independent charities with their own funding, governance and management arrangements in place, they are all required to meet an agreed set of quality expectations which are outlined in the Age UK Network Quality Assurance Framework.

The CQS is one of several quality standards within the Quality Assurance Framework, which is designed to help charities operate more effectively and efficiently. The standard covers 13 quality areas including governance, managing people, managing money and safeguarding. It also focuses on ensuring that each member of the Age UK Network is legally compliant and practices effective risk management to ensure quality and consistency, alignment with strategy, and the effective use of resources in the provision of services to ensure the well-being and safety of older people.

BSI has designed the assessment programme to ensure that all members of the Age UK Network meet the requirements of the CQS. The initial programme will commence from April 2025 for three years with BSI.

Simon Healey, UK&I Operations and System Certification Director at BSI, said: “BSI is delighted to be partnering with Age UK, a fellow purpose driven organization, on this important initiative, which aims to help make a positive impact on society. As an organization committed to driving quality and ensuring positive outcomes, we are proud to be running an assessment program that will support Age UK in its mission to improve the lives of older people across the country. We look forward to working closely with the team to help them achieve their goals and continue their vital work in the community.”

Victoria MacGregor, Chief Network Officer at Age UK, said: “We are thrilled to be working with BSI to deliver our Charity Quality Standard assessment programme. We consulted with our Partners to select the new assessment provider and were all impressed by BSI’s partnership approach in which they work with their clients to have a positive impact and offer solutions that enhance continual improvement and meet best practice.

“We are also pleased that the BSI ‘mark’ will provide external recognition and demonstrate that we take quality seriously through our standard now being assessed by these external experts.”

Psychology integrated into trust-wide EPR at LHCH NHS FT

By Integrated Care Journal

The innovation at Liverpool Heart and Chest Hospital NHS Foundation Trust sees a single digital system delivering a unified patient record, supporting patients’ psychological needs as they undergo treatment.

The Clinical Health Psychology team (“Psychology”) at Liverpool Heart and Chest Hospital NHS Foundation Trust (LHCH NHS FT) has extended, digitised and integrated its service into its established trust-wide EPR. This digital change is enabling a patient’s psychological care to be documented alongside medical care for a fuller record.

The innovation is releasing considerable and far-ranging benefits, such as streamlined processes, time savings, improved communication and care co-ordination, and enhanced patient safety.

Discussing the difference the system is making, Dr Alexandra Boughey, Principal Clinical Psychologist – Cystic Fibrosis Service and Operational Lead at LHCH NHS FT, said: “With our patient’s psychological notes now managed on the EPR and integrated with the patient’s full medical record, we can set up a team of specific users that have access to view the psychological notes. We’re saving so much time from being able to input our notes directly into the system and automatically sharing with the multi-disciplinary team (MDT).

Psychology set out to deliver the service using a single digital system which could manage a unified patient record, to better support the team and patient care. To be effective, they needed a flexible solution that was capable of making notes available or confidential to other members of the MDT. This was crucial functionality given the confidential nature of psychology case notes and being able to maintain a patient’s privacy wishes, if required.

The Trust decided to utilise its existing Sunrise™ EPR system provided by Altera Digital Health. In a matter of months, Psychology, Altera and the trust’s digital team worked together to configure the system to meet the unique needs of the psychology service. Today, the service is using the system to manage patient questionnaires, appointments, referrals, discharges and communicate with the MDT.

Sunrise™ is also facilitating the collection of meaningful data to monitor and report on specific psychology key performance indicators (KPIs), which differ hugely to medical KPIs.

With all patient data together in one place, in real-time, it’s providing staff with a fuller picture of a patient, supporting all members of the MDT to make more informed care decisions at the point of care.

Paula Dyce, Advanced Nurse Practitioner – CF Diabetes at LHCH NHS FT, commented: “Since being able to have Psychology on our EPR system it has helped us improve patient care and communication across professionals. It has streamlined the link between physical health and mental health appointments.”

LHCH manages a lot of critically unwell patients and nearly 130,000 patient visits every year. This makes the service that the Psychology team provides to the Intensive Therapy Unit (ITU) vital. The increased risks to patients cared for in the ITU makes an integrated system even more important, supporting the team to manage escalations and monitor patients more effectively with accessible notes and alerts for patients that require mental health support. The risk of losing paper notes and electronic files has also decreased which is contributing to enhanced patient safety.

Dr Alexandra Boughey added: “It’s been game changing, when you consider how time consuming the process was before. Previously, we would have to make notes on paper, transcribe them into word documents, file the document, and email/visit the wards to update the MDT with our recommendations.”

Prior to the Psychology digitisation, the EPR was already enabling the Trust to be 99.9 per cent paperless and complete all clinical documentation, order communications and prescribing. The integrated EPR has supported the LHCH’s digital transformation, enabling it to receive an ‘Outstanding’ CQC rating twice and achieve HIMSS EMRAM Stage 7 in its latest digital maturity assessment.

Rachael Fox, Executive Vice President, UK & EMEA at Altera Digital Health, said: “This latest digital transformation is a fantastic addition to Liverpool Heart and Chest Hospital NHS Foundation Trust’s exemplary digital journey so far. They are leading the way as digital-first trust and showcasing how it can support outstanding service delivery.”

MSE FT deploys AI-powered MyStaff App to boost compliance and efficiency

By Integrated Care Journal

With mounting pressure on nursing staff and increasing emphasis on patient safety protocols, the MyStaff App ensures that every healthcare professional has instant access to the most current clinical guidelines, reducing the risk of outdated information impacting patient care.

An AI-driven document management solution is demonstrating efficiency across NHS frontline services, reducing average document retrieval times from 10 minutes to just 30 seconds and unlocking 140,000 additional hours for patient care at Mid and South Essex NHS Foundation Trust (MSE FT).

The MyStaff App, developed in partnership with Diligram, is a cutting-edge digital governance tool designed to simplify access to over 1,500 policies, procedures, and patient care guidelines. By integrating AI-powered search, real-time updates, and mobile-first design, the app is dramatically improving workflow efficiency, reducing risk, and setting a new benchmark for digital transformation in the NHS.

With 90 per cent of the Trust’s 15,000-strong workforce actively using MyStaff App, MSE FT has demonstrated how digital innovation can drive faster, safer, and more streamlined operations across healthcare settings.

Historically, NHS staff have had to navigate outdated, fragmented systems to locate essential documents –leading to wasted time, inconsistent guideline adherence, and increased clinical risk. Before MyStaff App’s implementation, healthcare professionals at MSE FT spent an average of 10 minutes searching for a single document, adding unnecessary delays to decision-making and patient care.

Matthew Hopkins, CEO of MSE FT, explained why the Trust prioritised digital transformation: “One of the biggest inefficiencies in the NHS is time spent navigating multiple systems just to find key policies and clinical guidelines. By using AI to streamline access to critical information, we’re not only saving time but also improving compliance, patient safety, and governance across the Trust.”

Since rolling out MyStaff App in January 2024, staff adoption has risen by 78 per cent, with more than 864 documents accessed every day. These figures highlight a demand for smarter, AI-powered solutions to improve efficiency across NHS frontline services.

MyStaff App’s most significant advantage lies in its advanced AI search functionality, which allows users to retrieve the latest policies and procedures in under 30 seconds. This represents a 95 per cent reduction in search time, drastically minimising interruptions to patient care. The app’s intelligent indexing and natural language processing (NLP) capabilities mean that healthcare professionals can search for information using everyday language, removing the need for complex keyword-based queries.

Describing the impact of instant access to patient information leaflets, Dr Alex Hieatt, Consultant in Emergency Medicine at MSE FT, said: “Having immediate digital access to policies and patient information has transformed the way we work. It reduces delays, ensures patients receive guidance faster, and improves overall safety and efficiency.”

This is particularly valuable in high-pressure environments such as emergency departments, critical care and maternity services, where staff need to make rapid, evidence-based decisions without being slowed down by administrative barriers.

Beyond efficiency, MyStaff App is also enhancing governance and compliance. Before the app’s introduction, guideline compliance at MSE FT stood at 76 per cent. Since adoption, compliance rates have surged to 98 per cent and have remained consistently high for over six months.

Harriet Dobbs, Matron in Antenatal and Postnatal Services, highlighted how digital transformation is reducing clinical variation and improving consistency in patient care: “Having a single source of truth for policies means that when a guideline is updated, every nurse and doctor is working from the most current version. That kind of real-time synchronisation is critical for patient safety and regulatory compliance.”

With real-time audit tracking, MyStaff App allows healthcare leaders to monitor which documents are being accessed, when, and by whom – providing unprecedented visibility into workforce engagement and compliance levels.

As part of the NHS’s £2 billion digital transformation strategy, AI-powered solutions like MyStaff App are playing a crucial role in modernising outdated processes, improving workforce efficiency, and ensuring greater transparency in hospital operations.

Leslie Golding, CEO of Diligram, believes AI-driven automation is the future of NHS digital governance. She commented: “The NHS generates vast amounts of data every day, yet outdated systems mean much of that information is difficult to access or underutilised. MyStaff App is designed to bridge this gap, providing AI-powered automation that makes policy retrieval faster, compliance tracking smarter, and healthcare workflows more efficient.”

Unlike traditional document management systems, MyStaff App is fully optimised for mobile use, ensuring frontline staff can access guidelines from anywhere, at any time—whether on ward rounds, in theatres, or during patient consultations.

The success of MyStaff App at MSE FT has already led to wider adoption, with University Hospitals Bristol and Weston NHS Foundation Trust (UHBW) rolling out the system.

As NHS organisations continue to seek scalable, high-impact digital solutions, MyStaff App’s proven efficiency gains and compliance improvements make it an attractive model for national implementation.

Matthew Hopkins sees MyStaff App as a blueprint for NHS-wide transformation. He said: “One of the biggest inefficiencies in the NHS is time spent navigating multiple systems just to find key policies and clinical guidelines. By using AI to streamline access to critical information, we’re not only saving time but also improving compliance, patient safety, and governance across the Trust.”

With NHS leaders pushing for greater automation, better data management, and AI-enhanced decision-making, MyStaff App is part of a broader shift towards intelligent, integrated digital ecosystems in healthcare.

Key priorities for the next phase of NHS digital transformation include:

Further AI-driven automation to streamline document approval workflows
Integration with wider NHS systems for seamless interoperability
Enhanced analytics to provide Trust leaders with deeper insights into staff engagement and compliance trends

As demand for smarter, AI-powered solutions grows, MyStaff App is proving that real-world digital innovation is possible and already making a measurable impact on NHS frontline efficiency.

Innovative financing: Unlocking the potential of digital health and technology

By Stephen McMillan, Solutions Leader, Europe and UK & Ireland at Philips

With traditional medical equipment financing models becoming unsustainable, flexible financing options are increasingly helping healthcare providers improve their financial efficiency and supporting long-term digital health transformation.

The UK healthcare industry is undergoing a major digital transformation, with innovation already improving care in many areas from reducing waiting times and enabling earlier diagnoses, to delivering better access to care and outcomes for patients. Embracing new technology can help to unlock productivity, giving staff more time to focus on patient care, while also having a positive impact on the planet.

But for many healthcare providers, the high cost of traditional commercial models makes adopting cutting-edge technology a challenge. In fact, according to the Philips UK Future Health Index, a staggering 92 per cent of healthcare leaders say financial pressures are impacting their ability to deliver timely, high-quality care. Even more concerning, 77 per cent report that these financial strains have forced them to delay, scale back, or even cancel investments in medical equipment and technology – worsening existing bottlenecks and slowing down patient care.

Innovative financing approaches, such as pay-per-use (PPU) and “as-a-service” models, integrated into managed service agreements, give healthcare providers flexible, cost-effective access to technology, without large upfront investments. These models also de-risk investment and can help to enhance productivity, improve financial efficiency, and support long-term digital health sustainability.

Flexibility that adapts to demand

As demand for diagnostic and treatment procedures grows, healthcare providers face squeezed budgets and rising costs. IFRS16 (the International Financial Reporting Standard on Leases) now requires leasing costs to be counted as ‘capital’ on balance sheets, and CDEL (Capital Departmental Expenditure Limit) limits capital spend, even when cash is available. Traditional equipment financing, like leasing, is becoming less sustainable.

This is where flexible financing options such as PPU and “as-a-service” models are transforming how hospitals access and use technology. These models enable hospitals to only pay for what they use, reducing financial risk while ensuring access to the latest innovations. This flexibility helps them scale technology adoption based on patient demand and operational needs, keeping systems up to date and healthcare more adaptable.

Boosting productivity with managed services

Managing complex healthcare technology in-house can be time-consuming and resource intensive. The Future Health Index reports that 80 per cent of healthcare leaders have seen increased incidence of burnout, stress and mental health issues among their staff, with knock-on effects for patient care. A renewed focus on supporting staff is needed.

Managed services offer an alternative approach, where healthcare providers partner with experts to oversee equipment, IT infrastructure, and digital health solutions. This ensures technology runs at peak efficiency, reducing downtime and administrative burdens, freeing up staff to focus on patient care instead of maintenance. At the same time predictable cost structures improve financial planning. Ultimately, managed services can improve productivity, reliability, and performance in healthcare.

Smarter spending through outsourcing

Beyond operational benefits, outsourcing healthcare services can also provide significant tax advantages. Managed services can help hospitals identify and recover VAT from eligible equipment purchases, leading to greater tax efficiencies and improved cash flow.

This financial flexibility means hospitals can maximise use of their budgets, ensure compliance and redirect savings toward critical patient services.

Sustaining technology for the future

Sustainability is becoming a key priority for healthcare providers, and innovative financing can support long-term technology longevity. Lifecycle management solutions will extend the useful life of medical devices and IT systems through proactive upgrades, maintenance, and refurbishments.

This approach not only reduces electronic waste – such as outdated or discarded medical devices and IT equipment – and environmental impact, but also ensures that hospitals are always working with the latest, most efficient technology. By adopting sustainable financing and lifecycle strategies, healthcare organisations can reduce costs, improve operational resilience, and align with NHS net zero goals.

A new approach to healthcare technology

Innovative financing is reshaping how hospitals access and manage technology. Flexible models such as pay-per-use and “as a service”, combined with tax benefits and lifecycle management in managed services, help providers to stay ahead in the digital health revolution – without the financial strain of traditional procurement. At the same time, sustainable technology management ensures long-term value and cost-effectiveness.

By embracing these innovative financing strategies, organisations can boost efficiency, improve patient care, and achieve financial sustainability, ultimately unlocking the full potential of digital health and technology.

This article was kindly supported by Philips

News, Thought Leadership April 2, 2025

Service design, not just structure: The key to meaningful NHS reform

By Dr Erere Ikogho

Dr Erere Ikogho, former NHS doctor and researcher at Nexer Digital, explains why NHS England’s reorganisation needs more than just structural change – it needs a service design mindset.

As NHS England is set to be absorbed into the Department of Health and Social Care (DHSC), healthcare organisations face a moment of reflection. Structural reforms like this are often framed as pathways to “efficiency” but there is a risk of disrupting frontline services if they’re not grounded in how people actually give and receive care.

The opportunity here isn’t just about reducing bureaucracy. It’s about reframing reform as a service design challenge, focusing on how services work, not just who manages them. This means listening to the people who use, deliver, and support NHS services, and designing around their real needs.

What is service design, and why does it matter?

Service design is a human-centred approach that focuses on understanding the experiences of all stakeholders, including patients, healthcare professionals, and service partners, to create services that are both effective and user-friendly. In the NHS, this means ensuring that services are designed around the real needs of those using and delivering them. By integrating digital solutions and streamlining processes, service design can help create a more accessible and efficient healthcare system.

Too often, NHS reorganisations focus on changing structures rather than improving how services work in practice. The 2012 reforms that created NHS England as an independent body were meant to reduce political interference and improve efficiency, yet they added complexity without always delivering the anticipated benefits. Without a clear understanding of the real challenges and a focus on user needs, the current reorganisation risks repeating these mistakes.

Why traditional reorganisations fail

Many past NHS restructures have assumed that moving responsibilities around will automatically improve efficiency. However, this approach can often lead to disruption rather than real progress. Organisational changes tend to focus on internal hierarchies rather than patient and staff experiences, making it difficult to achieve meaningful improvements. Restructures frequently lack clear, measurable success criteria and instead rely on broad objectives like efficiency savings, which are difficult to translate into real benefits for healthcare staff and patients.

One major risk is failing to anticipate unintended consequences. Restructuring can introduce new administrative burdens, slow down decision-making, or disrupt key services. Without a test-and-learn approach that allows for adjustments, these inefficiencies can persist long after the changes have been implemented. If the government wants this latest reorganisation to deliver results, it must avoid the mistakes of the past by ensuring that reforms are designed around service users rather than internal management structures.

Service design isn’t just for digital teams – it matters in healthcare reform too

To ensure that this restructuring leads to real improvements, NHS England should adopt a service design approach that focuses on solving the actual challenges within the healthcare system rather than simply redistributing responsibilities. Any changes should begin with a clear understanding of the problems that need to be addressed. If the goal is to remove bureaucracy, it is essential to identify where bottlenecks exist and how they impact patient care. If decision-making needs to be faster, the focus should be on improving specific processes rather than altering reporting structures.

Success should be defined in terms of measurable improvements in patient outcomes, staff experience, and operational efficiency, not just the completion of a restructure. This requires engaging with healthcare professionals and patients to understand their needs and ensure that any changes improve care delivery, reduce administrative burdens, and create a more supportive working environment for NHS staff. Without this engagement, the reorganisation risks being disruptive rather than beneficial.

The potential unintended consequences of centralising NHS England’s responsibilities within DHSC must also be considered. While this move may lead to greater political oversight, it could also slow decision-making and stifle innovation. NHS England has been a leader in digital transformation, driving initiatives such as the NHS App, AI healthcare innovations and accessible and inclusive services. Without a dedicated body leading these efforts, progress in digital healthcare may stall. Similarly, procurement processes may become more complex, creating barriers for small and medium-sized enterprises looking to work with the NHS. Identifying these risks in advance will allow for better planning to mitigate them.

The impact on ICBs

Integrated care boards (ICBs) were introduced to drive more joined-up, place-based care. But as NHS England is folded into DHSC, and with ICB budgets being slashed across the country, the pressure on these systems is growing fast.

Leaders are already facing difficult choices, cutting services, managing deficits, and responding to increasing demand. There is also a possibility of some smaller systems merging with one another to consolidate their services and drive further efficiencies. However, without the flexibility to design services around local needs, and without the resources to implement change, there’s a danger that ICBs become implementation arms rather than engines of transformation.

The impact on procurement and SMEs

For SMEs working with the NHS, the reorganisation could present both opportunities and challenges. A more centralised procurement system could create new opportunities, particularly if the government simplifies procurement routes and creates clearer pathways for suppliers. However, there is also a risk that decision-making could slow down during the transition, leading to delays in contracts and uncertainty for businesses that rely on NHS partnerships.

Ensuring that procurement remains transparent and accessible is crucial. SMEs have played a significant role in driving innovation within the NHS, and it is essential that they continue to have opportunities to contribute. If procurement processes become overly complex or inaccessible, smaller providers could struggle to compete with larger organisations, reducing the diversity of suppliers and limiting the NHS’s ability to adopt innovative solutions.

Defining success through outcomes

A successful reorganisation must be measured not by how quickly structures are changed, but by tangible improvements in healthcare delivery. The key indicators of success should include demonstrable improvements in patient outcomes, such as shorter waiting times and higher satisfaction rates. The impact on NHS staff should also be considered, with reduced administrative burdens and more efficient workflows being key measures of success. Operational efficiency should be assessed not just in terms of cost savings but also in how effectively resources are allocated to improve healthcare services.

Without these benchmarks, the NHS risks repeating the mistakes of past reorganisations by focusing on structural changes without ensuring that they translate into real benefits for patients and staff.

A reorganisation that works for everyone

The scrapping of NHS England does not have to be just another bureaucratic reshuffle. If approached correctly, it could create a more efficient, patient-focused, and innovative healthcare system. However, achieving this requires a shift in thinking, moving away from treating reform as an internal organisational exercise and instead viewing it as a service design challenge.

A service design approach ensures that every aspect of the system, from people and processes to supporting infrastructure, is aligned to achieve real improvements. Rather than simply asking how NHS England should be restructured, decision-makers should focus on how NHS staff and patients will experience the change, where potential barriers might emerge, and what measurable improvements should be achieved beyond cost savings.

By embedding service design principles into this reorganisation, the NHS can avoid another cycle of structural change that fails to deliver meaningful results. Instead, it can build a healthcare system that works better for the people who use it and the professionals who keep it running.

Dr Erere Ikogho is a Researcher at Nexer Digital

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Digital care homes model could save ICBs £14 million annually, report shows

By Integrated Care Journal

New report sets out a blueprint for transforming health and care in the community, with real-world evidence suggesting that scaling the model across an ICB could reduce the cost of healthcare by £14.2 million annually, and over £360 million nationally.

A validated, integrated model of care delivery is transforming health management in care homes, with the potential to reduce the cost of healthcare for the NHS by millions annually, according to a report published today.

Led by Kent County Council, the model provides the care sector with tools and skills to enable early detection of deterioration and management of health risks – such as infections, chronic cardiac and respiratory issues, and other common causes of falls and exacerbations – reducing unnecessary conveyances and hospital admissions. The approach could deliver £14.2 million in annual savings for local health systems if scaled across all care homes in the Kent and Medway ICB alone, with savings from national adoption exceeding £360 million.

Transforming care through digital innovation and proactive change management

The report, co-authored by Care City – a Barking-based centre for healthy ageing and regeneration – and healthcare consultancy Candesic, in collaboration with Kent County Council and Feebris, proposes a blueprint for integrating data and technology to improve care delivery in the community. The model is built around three key pillars:

Proactive health in care homes: Equipping care staff with advanced training and digital tools to detect health issues early, preventing avoidable deterioration and exacerbations
Integrated multi-disciplinary collaboration: Improving coordination between care homes, GPs and community health teams through a connected digital infrastructure, allowing for the delivery of joined-up, person-centred care for residents with complex needs
Hospital-level care in care homes: Ensuring residents receive the care they need in the most suitable setting, cutting down avoidable hospital admissions and supporting care homes to manage acute health needs where appropriate

Real-world impact: Improving outcomes while reducing avoidable utilisation of emergency services

Focusing on the first pillar, the report includes an evaluation of a 12-month initiative running in Kent and Medway. Through this project, the Feebris virtual care platform was deployed across 24 care homes to deliver early risk assessment and proactive monitoring for 1,000 residents.

The evaluation demonstrates the impact of the integrated digital model of care delivery proposed, with key findings including:

75 per cent of care homes adopted proactive health workflows, enabling earlier detection of deterioration
8x fewer care homes experienced high volatility in care needs, improving resource allocation
Over 50 per cent fewer care homes reported above-average ambulance callouts, with 70 per cent fewer reporting high hospital conveyance rates
Hospital admissions dropped by 20 per cent, reducing strain on the NHS and improving resident outcomes

For care home residents, this means receiving personalised care that allows them to remain healthier for longer in a familiar environment. By detecting deterioration early, the appropriate healthcare service can intervene sooner and reduce any potential distress and disruption caused by emergency admissions while also mitigating risk of deconditioning.

£530,000 in NHS savings for every 1,000 care home residents annually

Over the 12-month period, the reductions in hospital admissions and ambulance callouts resulted in an estimated £530,000 in NHS savings, with 860 bed days freed up for every 1,000 care home residents, leading to a 5.2X Return on Investment.

Helen Gillivan, Head of Innovation and Partnerships at Kent County Council, said: “We’re proud to have led this successful initiative at Kent County Council, which is making a real difference to care homes, care staff and some of our most frail residents across Kent and Medway. Care teams tell us this system has become part of everyday practice, helping them to deliver more responsive, person-centred care that benefits both staff and residents.

“Social care is critical to the sustainability of our entire health and care system. As this research shows, investing in the sector doesn’t just benefit care providers – it strengthens the wider system, improving outcomes for our staff and for residents while easing pressure on health services.”

Removing barriers to scale: What can we change today to drive long-term transformation?

While the findings highlight the impact of digital innovation in social care, the report also puts the spotlight on key structural barriers preventing widespread adoption. It highlights a number of recommendations, including:

Restructuring financial incentives to enable social care providers to resource delivery of preventative interventions, given the impact demonstrated with the model adopted by Kent and Medway.
Strengthening the care workforce through greater investment in training and development, helping to attract and retain talent and recognising the vital role played in supporting ageing populations and reducing growing system pressures.

Matt Skinner, CEO of Care City, said: “This report is proof that social care can and must play a bigger role in the future of our health system. By empowering care staff with the right tools, training and trust, we can improve outcomes, reduce emergency demand and deliver more joined-up, preventative care. It’s been a privilege to support this work and co-author a blueprint for transformation that we hope will inspire action across the country.”

Dr Michelle Tempest, Senior Partner at Candesic, said: “This report represents a huge effort in gathering real-world data from across health, community and social care to showcase real impact and set out a proven model of transformation that meets the needs of our ageing populations. At a time when ICBs are under immense pressure and need support, this work provides an actionable roadmap to driving sustainability and impact.”

Tracy Stocker, Director of Operations at Medway NHS Foundation Trust, said: “We are pleased to see the results of our colleagues in Kent County Council and excited to say that we are aligned in our approach and looking forward to linking this work up with our Virtual Hospital vision. This is a springboard to building connected virtual ecosystems of care, centred on the patient, meeting them where they are, and coordinating our resources in the most efficient way.”

Dr Elina Naydenova, CEO and Co-Founder of Feebris, said: “It’s long been clear that transformational change is required to meet the growing challenges faced by the system, and as today’s report highlights, our partners at Kent County Council are leading the way with their approach. Given the tremendous financial pressures on health and care globally, now is the time for a grassroots movement of forward-thinking organisations to come together and evolve the care model to meet these challenges head-on.”

A summary and the full white paper can be accessed here.

For more information or to arrange an interview, please contact leo@feebris.com.

A broken process that is digitised is still broken – reflections from Rewired 2025

By David Duffy

Rewired 2025 offered a timely and valuable touchpoint for a healthcare sector still absorbing the shockwaves of seismic reform and uncertainty. Speakers struck a careful balance between optimism about the future and realism about what is possible in a resource-constrained environment.

A growing realisation is taking hold: there will never be enough money to meet every demand, so the key lies in driving system-wide improvements and enabling local innovators to lead the way. With this in mind, Rewired’s vast array of digital experts, NHS leaders and industry stakeholders put forward a cautiously optimistic vision of UK health and care’s future, with some using the platform to inject a dose of realism into the digital healthcare debate.

Abolishing NHS England – opportunity or risk?

Just days after the Prime Minister’s announcement to abolish NHS England, Rewired 2025 provided a platform for the sector to process the news and begin charting a path forward. Senior leaders, including NHS England’s Transformation Director Vin Diwakar acknowledged the gravity of the decision. However, he and many senior figures speaking at Rewired framed it as a necessary step to reduce barriers to digital innovation.

While uncertainty about the future was evident, the conference floor was abuzz with anticipation for the upcoming 10-Year Plan and how this can unlock innovation across health and care.

Diwakar also used his keynote to reassure innovators and tech suppliers that the Government remains committed to digital investment, with a stronger focus on interoperability and unified procurement. There is a sense that NHS England’s merge with DHSC presents an opportunity to free local innovators to drive implementation at pace.

Tech alone won’t solve the productivity crisis

NHS productivity fell by over 20 per cent in 2020/21, and bringing this back to pre-pandemic levels remains a monumental challenge. The government (much like every government in living memory) has claimed the solution lies in a digital future driven by AI.

There is no doubt that digital innovation and AI are part of the solution, but they are not magic bullets for this deeply complex issue. Increased digitisation does not automatically lead to increased productivity. As Pritesh Mistry of The King’s Fund put it:

“If you digitse a broken process, you get a broken digital process.”

The need to be realistic about digital was repeatedly borne out during discussions, with agreement that it is the job of sector leaders to tamper expectations and chart a realistic, iterative path to transformation.

Dr Marc Farr of East Kent NHS Foundation Trust highlighted the importance of reframing digital innovation to ensure staff buy-in. Technology should not only improve efficiency but also enhance staff satisfaction and happiness. All staff understand the need to be more efficient, but tech should also make the NHS a happier place to work. Stephen Powis echoed this in his keynote address, emphasising how effective digital tools can boost staff satisfaction and retention in primary care.

Getting a better deal on tech

Professor Powis also called for the NHS to drive better value from tech procurement, drawing comparisons with the NHS’s ability to negotiate favourable drug prices. A more strategic approach to tech investment could deliver better outcomes and cost efficiencies.

In a time where the NHS is being constantly told to live within its means and drive up productivity before receiving more funding, perhaps it’s time for tech suppliers to be held to account for extracting digital benefits. With such focus on short-term savings, the business cases for digital transformation are increasingly difficult to develop. It was suggested that suppliers who benefit from recurring funding from lucrative NHS contracts should take a more central role in ensuring trusts and systems are able to extract value from their solutions. Enhanced collaboration is surely good for business, good for the NHS, and good for patients.

True benefits of AI will be unlocked at system level

Dr Jess Morley of Yale University provided a refreshing dose of realism on AI in healthcare. In short, we have a long way to go before AI can transform our system.

The current impact of AI on NHS services is tiny, with significant limitations in infrastructure holding back its capability. As Dr Morley argued, “AI is a system level technology that allows us to redefine healthcare for the 21st century for modern populations, not simply address old problems with reskinned, age-old solutions.”

Healthcare is not just medicine, and the most important and impactful interventions (vaccines, testing, screening, etc) are made at the population level. In this context Dr Morley argued that the NHS is still only focusing AI on problems we already know how to solve, such as reading scans, rather than using it to transform systems. To harness AI’s full potential, it should be applied to developing population-level interventions.

Dr Morley went on to assert that our NHS approach to digital innovation is not yet centred on the right problems. The much-lauded potential of a single patient record across the UK, earmarked by many across the sector as the NHS’ key to future survival and sustainability, is “not a solution to modern problems”, and can never be paradigm-shifting as long as transformational thinking is based in silos.

What about social care?

One notable gap in the discussions for which I was present was the lack of progress in digital adoption within social care. There is a risk that, amid the current phase of NHS reform, social care could once again be left behind. Achieving digital parity between the NHS and social care remains a significant challenge and, if James Mackey’s new NHS England transition team is anything to go by, social care is going to be waiting a while before it receives the same attention for service transformation as the NHS.

Rewired 2025 underscored the need for both strategic investment and realistic expectations about what digital can achieve. The sector is moving towards a more mature understanding of tech’s role – not as a cure-all, but as a vital tool for improving both productivity and staff experience.

Lack of support causing ‘dangerous cycle’ of mental health readmittance, says CQC

By Integrated Care Journal

CQC report highlights shortfalls in mental health services, with young people, people from ethnic minority groups, and people from areas of deprivation facing the biggest barriers to accessing care.

Many people with mental health needs are not getting the care they need, the Care Quality Commission (CQC) highlighted in a report published last week.

As part of its monitoring activity in 2023/2024, CQC interviewed more than 4,500 people who were detained under the Mental Health Act or ‘sectioned’, covering 870 wards, and speaking to relatives and people who were previously detained. This year’s Monitoring the Mental Health Act report once again raises that a lack of staff, beds, and training, are leading to harmful gaps in care and treatment.

With demand far outstripping capacity, the report finds that there are not enough beds available, meaning people are placed far from home, their family, and their friends. One person interviewed reported being detained and placed five hours from home, and didn’t receive any visitors during her time in hospital as a result. Another woman had to wait hours in a police staff room, accompanied by two police officers, while a bed was sourced.

Jenny Wilkes, Interim Director of Mental Health at the Care Quality Commission, said: “Without timely access to necessary mental health support, people may find themselves being bounced from service to service without ever receiving the level of care that they need. This is a particular concern for children with mental health needs who risk missing out on school and their social life, and carrying their trauma and feelings of isolation into adulthood.

CQC’s report identifies a lack of sufficient staff numbers to support all patients, which is affecting people’s access to care and leading to people being restricted from going outside as there is nobody to supervise them, or in the most extreme cases, people being inappropriately confined.

While many people describe healthcare workers as “caring” and “wonderful”, the report identifies ongoing concerns with staff numbers and training. In particular, not all staff have undertaken the mandatory training to understand the needs of autistic people and people with a learning disability.

The combination of overwhelming demand and limited resources has led ward managers to feel pressure to discharge the “least unwell” patients. One woman reported being discharged before she was ready and without support to find her way home; she subsequently overdosed. Another person said, “I was only discharged because I was 18, not because I was better.”

Despite a legal entitlement to aftercare, overstretched general practice and community mental health services are not always able to provide a supportive transition back into the community, meaning people do not have the best chance at recovery. In nearly half of cases where a child or young person was detained, they had to be re-admitted within a year.

According to CQC, young people, people from ethnic minority groups, and people from areas of deprivation face the biggest barriers to accessing care and are sectioned at higher rates than the general population. Black people in particular are detained at 3.5 times the rate of white people. Meanwhile people from the most deprived areas are attending A&E services for their mental health at 3.5 times the rate of people from the least deprived areas.

CQC also registers concern that a lack of suitable community resources continues to lead to inappropriate hospitalisation of people with a learning disability and autistic people. However, the report cites CQC’s early work on Independent Care (Education) and Treatment Reviews, which has seen people move out of long-term segregation.

The regulator is calling for national action to tackle system-wide issues in community mental health. Better funding, improved community support, and a specialised and sustainable workforce are needed to ensure that people receive the care they need.

Jenny Wilkes added: “These issues will be all too familiar to people in mental health crisis, and their loved ones. We urgently need more community support and a better understanding of people’s needs to reduce the number of people being detained. And we know the situation is even starker for people from deprived areas, people from ethnic minority groups, autistic people and people with a learning disability. While the Mental Health Bill aims to address inappropriate detentions and improve mental health care, this can’t be addressed by legislation alone as there simply aren’t the resources to fix these issues.

“It is essential that the government addresses these significant gaps now to protect people for the future. With the right funding, a sustainable and well-trained workforce and enough beds to meet demand, we can break this damaging cycle.”

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The role of digital nurses in transforming healthcare

By Integrated Care Journal

Judy Sealey, Clinical Solutions Specialist at Altera Digital and former nurse, health discusses the evolving role of digital nurses in health and care and explores why their roles are so important.

Digital nurses are registered nurses who already have a wealth of clinical experience and have developed expertise in using digital technologies to improve patient care. They bridge the gap between traditional nursing practices and the modern digital healthcare landscape, ensuring technology is effectively integrated into clinical workflows to standardise and streamline processes to improve patient safety and enhance their healthcare journey.

How and why did you make the transition into digital nursing?

Judy Sealey: I have worked in the NHS for over 15 years mostly in emergency department (ED) and critical care (ICU) nursing, I have also dabbled a bit in specialist fields like infection control, tissue viability and cardiology as I searched for my true passion. At one time, nursing education was where I thought my passion lay, however, it was while I was a clinical educator in an ICU that was using an electronic patient record (EPR) that my passion for digital healthcare technology blossomed. I started off by making suggestions for optimisations, becoming more involved in refining some of the workflows and ensuring that staff were adequately trained and comfortable using the system. This led me to a variety of other opportunities and experiences.

For the last thirteen or so years I have taken on several roles within this space. My greatest passion and desire is continuous improvement to healthcare delivery and the huge role digital systems plays in this. I know firsthand the challenges of excessive repetitive documentation, time wasted searching for patient paper records, inefficient and clunky digital tools and workflows. I leverage my nursing expertise and wealth of digital skills to advocate for more user-friendly designs, less complex workflows that will enhance patient care and reduce clinicians’ burden and burnout.

How do digital nurses affect patient care and outcomes?

JS: Nurses are the largest workforce in health and care and are therefore the primary users of digital systems. Digital nurses bring a unique skill set to the table. They leverage their clinical knowledge and expertise to enhance digital tools like EPRs, mobile health apps and telehealth platforms. By doing so, they ensure the system is user-friendly, practical, efficient and safe. For example, at Bolton NHS Foundation Trust, collaboration between digital and clinical teams has significantly improved patient safety through better EPR configuration and optimisations.

It sounds like collaboration is key. Can you talk a bit more about what happens when there’s a disconnect between clinical and digital teams?

JS: Unfortunately, that disconnect can often be traced to a lack of clinical input in the design and development of digital tools. Without clinical input, digital solutions may lack the context needed to be truly effective, which can disrupt workflows and compromise patient safety. That’s why digital nurses are essential – their input at every stage of the project ensures collaboration and bridges this gap, ensuring the creation of a system that enhances patient care and patient safety while improving efficiency.

How can healthcare systems better support digital nurses and foster collaboration?

JS: To truly support digital transformation, we need to invest in the digital nursing profession to ensure nurses have the necessary training, skills and dedicated time to be successful in this very important role. Digital nurses should be involved in all patient-facing digital projects, from planning, testing, training to delivery and optimisation. Nurses, being on the frontline, are uniquely positioned to identify service gaps and act on opportunities to make impactful changes.

NHS England’s National Chief Nursing Information Officer (CNIO) advocates for CNIOs in every NHS organisation. What’s your take on this?

JS: That’s a fantastic initiative. CNIOs are essential for every hospital because they play a vital role in ensuring the nursing perspective is represented in all aspects of digital health and care transformation. It underscores the importance of nursing leadership in driving the digital agenda and aligns with the goal of embedding digital nurses in all areas of care delivery. Crucially, the CNIO bridges that gap between clinical and digital teams, translating nursing needs into technical requirements and ensuring technology truly meets the needs of supporting patient care.

Looking ahead, what role do you see digital nurses playing in the future of health and care?

JS: As health and care continues to evolve, digital nurses will play a central role in driving the change in successfully navigating the future of digital healthcare. They will become more involved in the entire process, from selecting the most suitable digital solutions, to designing, implementing, testing, training and, indeed, optimising them. From EPR rollouts to telehealth projects and beyond, they’ll be key in ensuring that digital transformation truly meets the needs of frontline staff and continuously improves patient outcomes. Their involvement will drive innovation, improve patient safety and create efficiencies across the board.

Do you have any final thoughts for organisations looking to embrace the digital nursing profession?

JS: Yes, invest in your nursing workforce and be sure nursing curriculums include some aspect of digital training. Involve digital nurses in all patient-facing projects and make collaboration between clinical and digital teams a priority.

Without this, organisations risk digital transformations that compromise patient safety, hinder rather than support care and increase nurses’ workloads, which can contribute to burnout. An approach that embraces the involvement of digital nurses will drive effective inter-organisational collaboration that will help unlock the full potential of digital transformation and ensure it delivers real value to patients and staff alike.

Judy Seeley, Clinical Solutions Specialist, Altera Digital Health

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