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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Workforce planning programme underway at Countess of Chester Hospital NHS FT

By Integrated Care Journal

A major workforce optimisation programme has started at the Countess of Chester Hospital NHS Foundation Trust in partnership with workforce planning specialists, SARD.

A new workforce optimisation programme has commenced at the Countess of Chester Hospital NHS Foundation Trust. The programme will seek to engage with the Trust workforce to gain a greater understanding of clinical capacity and demand, and empower teams to make more informed decisions about workforce planning. This work will support optimised service delivery, safe and efficient patient care and adequate resourcing to promote staff wellbeing.

Discussing why the project was initiated and the progress so far, Dr Nigel Scawn, Medical Director at Countess of Chester Hospital NHS Foundation Trust, said: “Like many NHS hospitals, we are seeing a rise in demand for our services – coupled with an ageing population who have more complex health needs – so this project is a key part of our workforce strategy which will help to transform services to meet the future change in needs of local patients.

“We’ve completed the discovery and diagnostic phase, which included working with transformation leads, HR teams and our medical workforce to agree plans, review current policies, share SARD methodologies and understand their requirements.

“It’s been a complex, but critical, exercise because every specialty is unique and runs itself slightly differently. Information has been gathered from 303 job plans across the Trust’s 30 specialties and fed into a diagnostic report.”

Over the next twelve weeks, the Trust will focus on the core part of the programme by working closely with clinical consultants to make enhancements to job plans and processes that are aligned with capacity and demand. The process will also involve benchmarking job planning against other NHS Trusts in England.

Dr Scawn added: “At this stage, it’s about piecing all the information together to create a fuller picture of capacity and demand, which we can use to drive informed decisions and decide what resource we need and where. Ultimately, we’re looking to remove some of the peaks and troughs in our capacity and ensure we’re sufficiently resourced and distributed across our clinical areas. This balanced approach will help us make sure we’re using our resources effectively.”

Insights from the programme will support Countess of Chester Hospital NHS Foundation Trust to plan better for future demand. The proactive approach will enable the Trust to devise clear and strategic recruitment plans, especially in areas where demand is anticipated to increase in the short-to-medium term.

In addition, greater oversight and improved job planning capabilities will support the Trust to reach the advanced levels of attainment for medical job planning set by NHS England. The framework ranges from level 0 to level 4 and published data from NHS England indicates that the national average is currently at 0.6. The Countess of Chester Hospital NHS Foundation Trust is expected to be at level 3 on completion of the project.

The Trust also intends to share the outputs and learnings from the work with NHS England to help build a national picture and inform policy and planning.

Phil Bottle, Managing Director at SARD, said: “The Countess of Chester Hospital NHS Foundation Trust’s commitment to redefine its job planning and transform operations is abundantly clear. The Medical Director, Nigel Scawn, and his team are fully embracing new ways of working to resolve long-standing challenges with workforce planning that many NHS trusts are facing. They are demonstrating that best practice goes beyond just deploying job planning systems.

“During the discovery stage, the engagement from the medical workforce has been fantastic and there is a desire to create positive change across the Trust. SARD’s ethical approach to workforce planning is led by service, staff wellbeing and sustainability so we are perfectly aligned with Countess of Chester Hospital NHS Foundation Trust to deliver an effective long-term job planning solution that supports safe and effective patient care. We’re looking forward to helping the trust optimise its workforce planning in the same way we have supported other NHS Trusts including Oxleas NHS Foundation Trust and Cornwall Partnership NHS Foundation Trust.”

The workforce strategy at the Countess of Chester Hospital NHS Foundation Trust is part of an overall improvement programme across the Trust, focusing on improved care for patients and families and a greater emphasis on staff wellbeing. The Trust has three hospitals – The Countess of Chester Hospital, Ellesmere Port Hospital and Tarporley War Memorial Hospital – and provides services to 420,000 people across West Cheshire.

The project is set to be completed by April 2025.

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AXREM hosts event celebrating women in health and care

By Integrated Care Journal

AXREM, the trade association representing the suppliers of diagnostic medical imaging, radiotherapy, healthcare IT and care equipment in the UK held an event to mark International Women’s Day.

AXREM has championed women in health and care during International Women’s Day for several years, but this year elevated its celebration further by hosting an event at The Florence Nightingale Museum at St Thomas’ Hospital, London.

On the eve of International Women’s Day 2025, in an aptly chosen venue, AXREM hosted more than 60 key industry female opinion leaders and key stakeholders.

There was a full programme of speakers including an actor as Florence Nightingale talking about her work, a video address from Baroness Merron, Parliamentary Under-Secretary of State for Patient Safety, Women’s Health and Mental Health at the Department of Health & Social Care; Preeya Bailie Director of Central Commercial Function, Commercial Directorate at NHS England; Saduf Ali-Drakesmith, Head of Sales at Smart Reporting & Vice Convenor of the Imaging IT SFG; Yasmeen Mahmoud, Business Manager HPM UKI at Philips Healthcare; and Kath Halliday, President of the Royal College of Radiologists.

Florence Nightingale was an English social reformer, statistician and the founder of modern nursing. Nightingale came to prominence while serving as a manager and trainer of nurses during the Crimean War, in which she organised care for wounded soldiers at Constantinople. She significantly reduced death rates by improving hygiene and living standards. Nightingale gave nursing a favourable reputation and became an icon of Victorian culture, especially in the persona of “The Lady with the Lamp” making rounds of wounded soldiers at night.

Sally Edgington, AXREM Chief Executive Officer said in her speech: “we have gathered to celebrate the strength, resilience, and brilliance of women in our industry. I am a female leader and currently lead a fabulous all female team, I am biased… but they really are all inspirational, supportive and hard working women and I feel truly blessed to work alongside each of them.

International Women’s Day is not just a day to acknowledge the progress we’ve made, but a day to remind ourselves of the work that still lies ahead. It’s a day to honour the trailblazers, the changemakers, and the unsung heroes who have shaped history and continue to inspire us all today. There are many of these women within our sector and AXREM membership”.

Sally ended her speech by saying: “When women rise, society rises with them. We all benefit when women are empowered, when they are given the tools, the respect, and the opportunity to lead, create, and flourish.

So, to all the women here tonight, to those who inspire us from afar, and to the generations of women who will come after us:

Keep pushing boundaries.

Keep dreaming big.

Keep shining your light.

The world is better because of all of us”

Reflecting on the event, Sally Edgington said: “It was a fabulous evening where we were able to bring together some thought leaders from our industry, it was also an evening where we could announce an AXREM Women’s network, This will further build on the important work AXREM has done over the last few years to really champion women in our industry and female leaders, so I am excited to launch this initiative and see how we can work with our members and stakeholders to develop this.”

Huw Shurmer, AXREM Chair & Strategic and Government Relationship Manager at Fujifilm Healthcare UK, said: “I was honoured to attend this event represented by so many strong women working in our industry. The speakers provided thought provoking content which gave me a different perspective on how far we have come, and how far there is still to go. I am looking forward to seeing the development of an AXREM Women’s Network to provide an industry forum and platform.”

One in four Brits seeking help from A&E due to GP pressures

By Integrated Care Journal

A new nationally representative survey reveals more than one in four Brits (27 per cent) have visited emergency departments because of delays in accessing GP appointments.

New survey data reveals that more than a quarter (27 per cent) of the public have visited A&E recently because the waiting time to access a GP appointment was too long, despite 2024 seeing a record high (370 million) GP appointments delivered.

Conducted by Savanta and commissioned by digital-first healthcare provider Livi, the findings also revealed that delays are leading to worsening of conditions or prolonged recovery, along with increasing costs to the public system based on the cost of a GP consultation versus an A&E attendance.

Regional data reveals that 45 per cent of Londoners who responded to the survey have visited A&E rather than wait to see their GP, while 41 per cent of under-35s reported visiting A&E as an alternative to waiting for a GP appointment.

GPs and clinicians are also feeling the strain of the challenges facing the healthcare system.

Dr Dan Bunstone, Primary Care Network (PCN) clinical director for Warrington Innovation Network and lead GP said: “As GPs, we see first-hand the strain on the system every day. We’re working in a landscape of chronic underfunding for innovation, severe staff shortages, and an ageing population with increasingly complex health needs. Demand is rising, and the resources to meet it simply aren’t there.”

Last month, the Government outlined its priorities for the NHS in 2025 and 2026 – including an objective to improve access to primary care services, and to invest in data and digital to improve productivity in primary care. On 28 February, the Government and BMA also announced a new contract for general practice

The results of this new survey demonstrate how urgently this action is needed, to tackle patient access, GP workload and workforce shortages to avoid pressures and rising costs reaching into other parts of the public system.

Dr Bunstone explained that GPs are delivering more appointments than ever but need alternative solutions to help them to tackle the pressures of long waiting lists and workforce shortages: “Patients deserve timely care, and GPs are constantly looking for ways that allow us to deliver care more effectively and empower our patients. Against all odds we are still delivering more appointments than ever. By embracing digital tools and integrating digital and physical care settings with services across primary and secondary care, we need continued investment in innovative solutions and system-wide coordination.”

Dr Kalle Conneryd Lundgren, Chief Executive Officer at Livi, who commissioned the research, commented on the findings: “The Government needs to act now. These findings confirm what we have long known: the crisis in A&E, hospital backlogs, and ‘corridor care’ all stem from a fundamental failure to provide timely, accessible care in the community. Patients are being left with nowhere else to turn, forcing them into inappropriate care settings and overwhelming an already stretched system and leading to increased costs.

“This isn’t just about more resources, nor is it about capacity. It’s about smarter solutions to boost efficiency and get more patients seen cost effectively. The Government must act now to invest in digital, empower ICSs to scale primary care, and fund proven solutions. By integrating digital and physical care, we can streamline referrals, optimise patient pathways, lower costs and improve access. Working together, we can build a system that works better for both patients and the workforce.”

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Council of Deans of Health announce 2025 Spring Conference

By Integrated Care Journal

The Council of Deans of Health’s Spring Conference will focus on shaping the future of clinical academia and healthcare education

The Council of Deans of Health – which represents the UK’s university faculties engaged in education and/or research for nursing, midwifery and the allied health professions – has announced the launch of its 2025 Spring Conference, scheduled for April 1, 2025, at the Congress Centre, London. This event will bring together K arin Smyth MP, Minister of State for Health as keynote speaker, and esteemed experts from the ﬁelds of clinical academia and healthcare education to engage in important discussions on the future of these sectors.

This year’s conference will feature an array of distinguished speakers who are shaping the future of clinical academia and healthcare education. One of the key highlights will be Professor Dame Jessica Corner, Executive Chair of Research England at UKRI, who will share crucial insights and recommendations stemming from the clinical academic workforce task and ﬁnish Group. Her presentation will focus on how we can best support clinical academics in the evolving healthcare landscape.

Additionally, Rob Stroud, Director of Assessment Services and Access to Higher Education at the Quality Assurance Agency for Higher Education, will provide an in-depth overview of recent changes to the Nursing and Midwifery Council’s (NMC) education quality assurance process.

Elizabeth Fenton OBE, Director of Nursing and Midwifery at NHS England, will discuss the ﬁndings of the educator survey. This will offer valuable insights into the current state of the healthcare educator workforce, informed by data contributed by the Council’s members.

Additional speakers include:

Professor Anne-Maree Keenan OBE, Pro-Dean for Research and Innovation, University of Leeds; Academic Capacity Development Lead, NIHR Leeds BRC
Beverley Harden MBE, Deputy Chief Allied Health Professions Officer, NHS England
Dr Simon Cassidy, Head of Placement Experience and Improvement, HEIW
Professor Jane Coad, Professor in Children and Family Nursing, The University of Nottingham; Chair, Clinical Academic Roles Implementation Network
Hugh Tregoning, Professional Liaison Consultant, Health and Care Professions Council

Event details:

Date: Tuesday, April 1, 2025
Time: 09:30 – 17:00
Location: Congress Centre, London, WC1B 3LS

The conference will provide ample opportunity for networking and collaborative discussions, ensuring participants can engage with experts and peers in meaningful ways throughout the day.

For more information and to register, visit this link and follow the Council of Deans of Health on social media. We look forward to welcoming you to our 2025 Spring Conference.

New data sheds light on NHS efficiencies challenge

By Integrated Care Journal

Survey of public sector workers in the UK suggests that 93 per cent of NHS organisations are hindered by substantial process inefficiencies, while most are confident that AI and automation will help to ease administrative burdens.

New research has shed light on the potential impact and scale of process inefficiencies across the NHS. The 2025 UK Public Sector Efficiency Survey, conducted by Appian, in partnership with Coforge, polled 1,000 UK public sector workers, including 242 NHS staff. Of those respondents, 95 per cent stated that they face process inefficiencies in delivering services, averaging out at five hours per week in extra work or delays.

Were this data representative of the NHS’s entire 1.5 million-strong workforce, this would equate to 7.5 million hours of extra work per week.

The top reported obstacles were:

Manual and repetitive tasks
Immediate challenges forcing reactive decision-making over proactive solutions
A need to access multiple legacy systems to review or enter the same information
A lack of training and support

NHS workers also reported process change as a common challenge, with 93 per cent stating that their organisation struggles to adapt its processes (specifically while maintaining productivity amid changing service demands and government policies).

These challenges are intensified by mounting pressure to improve productivity. The 2024 Darzi Report revealed that NHS productivity has declined by at least 11.4 per cent since 2019, and there is a significant gap between the NHS and other sectors in digital transformation progress.

Outdated systems obstruct NHS productivity

Legacy technology remains a significant obstacle to NHS efficiency. A 2025 report published by the Department for Science, Innovation and Technology (DSIT) revealed that NHS England experienced 123 critical service outages last year, due to archaic technology.

“With elective care waiting lists at an all-time high, productivity is an urgent priority,” Peter Corpe, Industry Leader, UK Public Sector at Appian. “The research shows that NHS workers are challenged with legacy technology. Asking them to act as the human glue that binds those systems and technologies together only hinders efficiency further.”

AI and automation: the keys to efficiency?

Despite process challenges, the findings suggest that NHS staff are optimistic about the opportunities process automation and AI technologies offer:

Confidence in AI: 64 per cent of NHS workers expressed some or high confidence in AI’s potential to improve organisational efficiency.
Confidence in automation: 69 per cent believe automating repetitive tasks would simplify their jobs and improve outcomes. Among those already using workflow or process automation tools, 95 per cent reported improvements, including enhanced productivity, improved communication, greater consistency and traceability.

The solution to smarter public services

In a recently released AI Opportunities Action Plan, the government committed to building cutting-edge, secure, and sustainable AI infrastructure to support all public sector organisations, including the NHS. “The government is clear on its mission to automate processes in the public sector,” said Corpe. “AI adoption is no longer a question of if but when.” And according to survey respondents, public sector workers are ready for change.

The solution to process inefficiency, Corpe says, is to make technology part of the process. “And no company is better equipped to deploy AI in enterprise processes than Appian. Appian is the leader in process orchestration, automation, and intelligence. By embedding AI in processes with unified, secure enterprise data, Appian is improving service delivery outcomes. And we’ve been at the forefront of better process outcomes in government for over 25 years.”

“Every NHS organisation is built on processes, and when those processes improve, so do the services delivered,” said Corpe. “With millions of hours a week at stake, resolving process inefficiencies and orchestrating pathways such as referrals or discharge management offers the NHS a chance to work more efficiently. This means more time for strategic and value-driven activities that directly improve patient outcomes.”

Coforge, an Appian partner for over 13 years with 350+ Appian practitioners on staff, has seen these outcomes first-hand. “Modern AI and automation technologies are transforming complex government processes into streamlined digital workflows,” said Coforge Chief Customer Success Officer, John Speight. “By partnering with Coforge, organisations are turning this potential into reality – reducing processing times from hours to minutes to achieve significant cost savings, and deliver smarter, faster, community-focused outcomes.”

Download the 2025 UK Public Sector Efficiency Survey for more findings from public servants.