Universal Care Plan breaks usage records with new integrations and sickle cell care plans

By Integrated Care Journal

More than 5,000 people with sickle cell disease now have a plan on the integrated care platform, covering nearly all of those receiving care for the disease in London.

The Universal Care Plan (UCP), OneLondon’s shared care planning solution powered by Better, has in the last year integrated with the NHS National Record Locator (NRL) and the NHS App, while also extending the care plan support for people with sickle cell disease.

These latest developments within the solution, which spans five integrated care boards across the whole of London and has recently marked two years of existence, are helping to further integrate care, improve patient outcomes, and drive up engagement, in some cases at record-breaking levels.

Introduction of sickle cell care plans

Expanding the UCP to support individuals with sickle cell disease is an important step, following the No One’s Listening report, calling for major changes in sickle cell care. Sickle cell disease affects approximately 15,000 people in the UK. Approximately 60 per cent of people diagnosed with the disease have their treatment in London. With symptoms ranging from anaemia to severe pain episodes known as sickle cell crisis, managing this condition effectively requires comprehensive care planning and prompt treatment interventions.

Since the launch of the care plans, 5,000 people with the disease now have a plan on the integrated care platform, meaning the service is close to supporting everyone who is cared for in the capital.

“I think this is a real game changer for people with sickle cell disease,” said Nick Tigere, Head of the UCP Programme. “They are now able to confidently seek the medical attention they need while in crisis, knowing fully that the services they attend, wherever they attend in London, will be aware of consolidated key information on diagnosis, symptom management, and treatment options.

“Supporting healthcare professionals with immediate access to this critical information is facilitating timely interventions and improved care. It really has been transformative for people’s care pathway.”

National Record Locator integration

With the new National Record Locator (NRL) integration in place, London and out-of-London urgent care services are now able to view a UCP en route to responding to a patient in need. This means that a patient’s care plan, particularly their symptom management requirements, can be delivered immediately as the paramedics make contact with the patient, even when they are away from London. Following the go-live, the number of plans accessed by the Ambulance Service has increased by 20 per cent due to the increased access the integration is providing.

The NRL is an NHS service that allows health and care professionals to find and access patient information shared by other health and care organisations across England to support the direct care of a patient.

NHS App integration

Patients can now also access their UCP in the NHS App, which is another step towards putting patients at the heart of their care planning. It means patients can easily share their plans with healthcare professionals as they move around London and across the rest of the country.
In an emergency, patients may not be able to articulate or communicate their wishes and preferences, in which case they can defer to showing clinicians the plan on the app. The increased accessibility is also empowering patients to take a more active role in managing their information and ensuring it is up to date.

In four months, the app has seen 20,000 jump-offs to care plans, and if a plan isn’t in place, it’s helping to initiate conversations with clinicians to create one, which is in turn contributing to an increase in overall care plans created. During July, the service celebrated a record-breaking 4,200 care plans being generated on the platform.

Concluding on the new integrations and sickle cell care plans, Nick Tigere added: “The UCP platform has become a well-established tool for health and care professionals and is helping to ensure people have their care wishes and preferences respected. Our role is to enable all parts of the system to quickly access relevant patient information at the right place and right time. I am proud that we continue to enable this for people and our health services with these latest developments.”

Darren Ransley, Managing Director UK & Ireland at Better, said: “By expanding access to patient data through the NHS National Record Locator and NHS App, we are advancing interoperability and making healthcare data available anywhere, anytime. These integrations mark a significant step forward in delivering person-centred care and ensuring equitable access to healthcare services.

“By leveraging innovative technology and a person-centred approach, the UCP continues to redefine care delivery standards, setting a new benchmark for integrated healthcare solutions.”

At the end of 2024, the UCP will be transformed into a personalised care and support plan with the introduction of new forms and data fields to create a richer picture of the person receiving care. The new information will cover the PRSB ‘About Me’ standard, living arrangements, medical devices, communication and accessibility requirements, and daily activities and support needs.

Social care monitoring tech could free up two million bed days and save over £1.2bn for the NHS, new report finds

By Integrated Care Journal

New report highlights major potential of lifestyle monitoring technology to address immediate system-wide crisis across health and social care, finding that thousands could avoid hospitalisation from earlier detection of illness, avoiding more expensive residential care.

The NHS could save more than £1.2 billion through widespread use of new non-intrusive lifestyle monitoring technology in social care according to a new independent report. More than two million hospital bed days could be saved, and the extra capacity created in social care able to fund the equivalent of 10,000 additional full-time carers in the system by 2035.

These findings are part of new analysis commissioned by health-tech company Lilli to make the case for urgent digitisation across the health and social care sector. The report uses data from multiple local authorities across the UK who are currently using the AI-driven monitoring technology to address the growing care deficit and mounting social care crisis.

Entitled From passive to proactive: How monitoring technology can help to solve the health and social care crisis, the report follows recent social care promises from the new government to accelerate the adoption of technology in health and care and highlights the ‘domino effect’ that proactive monitoring employed in social care can have not just on council resources but also the NHS and patient outcomes.

It identifies hospital discharge as a key area that can see a significant impact from the technology. Earlier discharge would amount to 2.3 million additional bed days and almost £1.2bn in savings for the NHS, due to reduced costs of providing beds for patients over the next ten years – enough to pay the salaries of 2,000 nurses over the period. It would also lead to better health outcomes for the many thousands of people experiencing delayed discharge every day, with extended stays linked to higher risk of infections, adverse drug reactions and readmissions to hospital.

The report also finds that adopting monitoring technology now would save councils £3bn by 2035 by supporting people to live independently at home for longer and preventing thousands of people entering more expensive care settings, such as residential care. The productivity benefits would help to address the workforce crisis in care, by generating additional capacity equivalent to 94 million hours of carer time across the UK, or to having 10,000 extra care workers. These productivity benefits would be worth an estimated £1.8bn to councils, allowing vital resources to be redistributed to where they are most needed.

Lifestyle monitoring technology works by tracking patterns of behaviour and key indicators of health, such as movement, eating and bathroom activity, and alerting carers to any changes. This allows care professionals to quickly make accurate care assessments, and safely monitor people’s health at home remotely, while being on the front foot to proactively spot signs of health decline before conditions require hospital treatment. Urinary tract infections (UTIs) have been identified as a key area where monitoring technology can help prevent hospital admissions, and the report estimates that the NHS could make savings of £1.8m each year through reduced hospital admissions from UTIs, due to earlier intervention, which could pay for half a million hours of nursing time.

Rebecca Andrew, Service Improvement Manager from Nottinghamshire County Council, said: “The rollout of remote monitoring technology across Nottinghamshire allows our social care staff access to real time data, giving insights into a person’s behaviour over a period of time. This helps them to build a clear picture of what is going on in a person’s life and draw their attention to any potential change in their social care needs. This ensures we can put appropriate care and support in place that is personalised to the individual, and respond quickly to prevent crises, meaning fewer ambulance call outs and hospital admissions.”

According to the report, produced by economists at Policy Points, “there is strong evidence that lifestyle monitoring technology can generate essential, big-ticket savings for both the NHS and for social care, creating a digital dividend by protecting scarce hospital resources at the same time as boosting the productivity of carers”.

Kelly Hudson, Chief Executive Officer at Lilli, said: “Right now, the people who need care are not getting the help that they should, and the problem will only get worse as the population ages. The numbers in this report speak for themselves. The savings and productivity figures highlight the profound difference that an investment in technology now would have not just on the system but on the lives of people up and down the country.”

Lifestyle monitoring technology from Lilli is currently being used by multiple councils across the UK, including Islington, Nottingham and Reading, to enable people to live safely and independently at home.

The report goes on to explain how over the next ten years, the older population will ‘grow by millions’, increasing demand for its services, and for the health and care system to be sustainable, a commitment to overhauling the system at pace and scale is urgently needed. The alternative is a broken system that will continue to be reactive and is unable to meet the care needs of those who need it most.

Kelly Hudson adds: “We are supportive of the new Health Secretary’s ambition for a ‘different politics on social care’ and we urge the new government to tackle the current crisis proactively as they have pledged, by addressing the root cause of the issue. We are urgently calling for more support for the sector to adopt a technology led approach to better support the people in need, reduce wasted costs and deliver better outcomes.”

EHR roll-outs need strategies to mitigate clinician overload

By Dr Dominic Pimenta, Jasmine Balloch, Dr Ellie Asgari; TORTUS

Clinicians are increasingly subject to cognitive overload, and recent studies suggest that without mitigation strategies in place, poor implementation of EHR systems can exacerbate the problem.

In April, a narrative review paper was published in the JMIR Medical Informatics titled Impact of Electronic Health Record Use on Cognitive Loads and Burnout Among Clinicians. My fellow authors and I applied cognitive load theory to explore the impact that routine EHR use has on clinicians and to suggest how the risk of negative effects could be minimised.

It’s important to preface the discussion of our conclusions by acknowledging that EHR systems are essential for the delivery of efficient, joined-up patient care: they allow for improved communication between clinicians, remote access to clinical records and to a high volume of clinician data for research and audit purposes. Rightly, years of effort and significant investment have led to widespread EHR implementation across the NHS: 87 per cent of primary, secondary and community care staff surveyed by the Health Foundation reported using EHRs as part of their work, and in the 2024 Spring Budget, the Chancellor pledged that they would be rolled out across all NHS Trusts by 2026.

However, only 57 per cent of respondents in the same Health Foundation survey chose EHRs as the technology saving them the most time, and their rapid review of 72 studies about EHRs and related tools identified that 44 per cent found no time savings delivered. This indicates that the potential of EHRs is not yet being fully realised.

As our new review concludes, taking a considered, evidence-informed approach to the design and implementation of EHRs makes all the difference when it comes to unlocking their full potential, while mitigating significant potential risk. Importantly, by acknowledging and proactively addressing the relationship between EHRs and cognitive burden, organisations can successfully reduce rates of clinician burnout and minimise risks to patient safety.

EHRs and cognitive overload: examining the evidence

Cognitive load theory explains that human capacity to process information is limited to a few elements in working memory at any given time. When this capacity is overwhelmed by an excessive quantity of information, the resulting cognitive overload can impair decision making, interfere with mental performance and elevate stress levels. Clinicians are typically at high risk of cognitive overload, as they must navigate complex patient data, integrate new information rapidly, and make critical decisions under pressure on a daily basis. The transition to digital records has compounded this challenge by significantly increasing the volume and complexity of data clinicians must handle during patient care.

Recent studies indicate that poorly designed EHR systems can exacerbate cognitive load. The factors contributing to this include inefficient user interfaces, excessive documentation requirements, and the need to navigate through cumbersome electronic systems to access relevant patient information. In addition, dealing with overly-frequent pop-up notifications has been shown to cause distraction and alert fatigue, both of which can lead to clinicians missing important information and result in poor patient outcomes.

Experiencing regular cognitive overload is a major risk factor for burnout. In 2023, 55 per cent of surveyed NHS workers had experienced burnout in recent years, a condition characterised by emotional exhaustion, demoralisation, and a reduced sense of personal accomplishment, which not only affects individual health professionals but also the quality of care they provide. Although burnout has multiple root causes, addressing the design and implementation of EHRs to reduce the cognitive load they place on clinicians is a necessary and important step towards tackling the rise in burnout cases.

Practical recommendations:

Improving EHR user interfaces: Simplifying the user interface of EHR systems can reduce unnecessary cognitive effort. This involves designing more intuitive menus, reducing the number of steps to complete tasks, and organising patient data more logically.
Streamlining information presentation: Tailoring the presentation of information to minimise extraneous load is crucial. This could mean displaying critical patient data in a summarised form, with the option to expand details as needed, thus preventing information overload.
Reducing documentation burdens: Automating routine data entry and employing natural language processing can decrease the time clinicians spend on documentation. This not only frees up cognitive resources but also allows clinicians to devote more attention to patient care.
Incorporating decision support tools: Advanced decision support tools can aid clinicians by providing contextually relevant information at the point of care, reducing the need for extensive data retrieval and analysis.
Training and support: Continuous training and real-time support can enhance EHR proficiency among clinicians. Tailored training programs that address the specific needs of users can alleviate stress and improve their interaction with the technology.

Importantly, emerging artificial intelligence and machine learning technologies offer promising avenues to manage cognitive load by automating routine tasks and predicting patient risks through advanced analytics. However, the integration of these technologies must be handled carefully to avoid adding to the cognitive burden – evidencing a need for user-friendly design and time-saving clinical integration.

In summary, clinician burnout is complex and has multiple causes – such as overall workload, inflexibility of rostering and organisational culture – which is why it could never be fully eliminated even by the ‘perfect’ design and implementation of an EHR. However, by scientifically assessing the impact of different EHR technologies and models, it becomes possible to paint a more complete picture of how they alleviate or exacerbate burnout. In turn, this understanding can be used to ensure that clinicians are equipped with the best EHR systems –and the best integrated technologies – that improve their efficiency and improve patient outcomes.

Supporting care companies in the digital switchover

By Kristian Torode

As many industries embrace the changes the Public Switched Telephone Network (PSTN) switch-off will bring, there are others that have cause for concern. Vital care devices such as telecare systems will be impacted by the switch off — so how can care companies ensure a smooth transition for their customers? Here, Kristian Torode, Director and Co-Founder of PSTN switch-off specialist, Crystaline, investigates.

Around 1.8 million UK residents use telecare devices, which enable vulnerable people to live independently by providing assistance in the case of accidents. These wearable devices alert family, carers or emergency services when pressed and can also connect to other safety equipment such as fall detectors, smoke alarms and door sensors.

However, the PSTN switch-off in December 2025 means that the copper wire phonelines that have historically connected these systems will be turned off, threatening their functionality.

In recent months, a number of stories of serious incidents that occurred when telecare devices no longer worked after users were switched from analogue to digital phonelines have hit the headlines. In February 2024, it was reported that Ofcom is investigating Virgin Media over its compliance with rules to protect vulnerable customers during the digital switchover. Consequently, Technology Secretary Michele Donelan met with telecoms providers to determine how best to safeguard vulnerable users during the switchover, which resulted in a commitment not to migrate customers if the functionality of a telecare system is at risk.

However, this poses challenges for vulnerable telecare users, telecoms operators and care providers alike.

Digital divide

Telecare systems are most beneficial to people who have communication, mobility or visual impairments, meaning many users are elderly or disabled.

While vulnerable users are likely to be more heavily impacted by changes to their phone service, it is difficult for them to access information relating to the switchover and how it affects them. According to Good Things Foundation data, non-internet users are twice as likely to have a disability or health condition than extensive users, and six times more likely to be over 65 years of age. As a result, many of those who rely on telecare lack the digital skills to find online information relating to switchover dates and to set up routers for digital phoneline services.

Although telecoms providers have put protections in place for those with disabilities and additional needs, many customers are unaware that they should give these details to providers, meaning existing lists are likely inaccurate.

Tackling telecare issues

So, what can telecare providers do to safeguard elderly and disabled residents? Firstly, telecare companies and local authorities offering these services should share data on who has a device with telecoms providers, allowing them to support vulnerable customers during the switch off.

The next step is to ensure that the right technology is in place before the switch off date. On the care provider’s end, upgrading to a PSTN alternative such as Voice over Internet Protocol (VoIP) now will make sure that there is time to perform checks on existing telecare devices before December 2025. As a result, non-compatible analogue systems can be replaced in advance of the switch off.

Finally, care companies and local authorities must make sure that customers are aware of how the PSTN being turned off will affect their telecare systems. This allows clients to test their personal alarm after their phoneline has been upgraded to ensure it is still fully functional.

As the PSTN switch off draws closer, elderly and disabled telecare customers stand to be one of the groups most heavily impacted but least informed about the effects of the digital switchover. Getting the systems in place in advance and performing thorough testing means telecare companies can guarantee a smooth switchover that safeguards vulnerable people.

To learn more about Crystaline’s PSTN switch off support services for SMEs, including those in the care sector, and to explore digital telephony alternatives, visit the website.

Study developing AI to spot lung cancer risk from patient data

By Integrated Care Journal

Researchers are developing artificial intelligence which they hope will help to identify patients most at risk of lung cancer before symptoms have even appeared.

A team from Nottingham Trent University and Nottingham University Hospitals NHS Trust aims to create an AI-driven model which can autonomously piece together subtle clues and signs in patients’ data to identify those at risk so that they can be investigated further.

There are about 48,500 new cases of lung cancer in the UK alone each year with almost 35,000 people dying from the disease.

The team wants to address the current challenge of European health systems manually identifying people at risk of certain diseases and also help to reduce the financial burden by ensuring services are used by those who need them the most.

It will involve developing a system to recognise factors which might make an individual high risk and then creating ‘synthetic’ data in order to train it to pick up even the weakest signals that there could be an issue.

The aim is to help save lives by identifying people before the disease becomes symptomatic because that can be too late for patients with lung cancer.

The Nottingham team are the UK partners in PHASE-IV-AI, a much larger €7.6m project funded by the European Union’s Horizon Europe research and innovation program.

The project involves 20 partners from ten European countries and aims to unlock the full potential of AI and data analytics in health care in a secure and privacy-compliant way.

As well as lung cancer, the developments of PHASE-IV-AI project will also be validated by other partners in prostate cancer and ischemic stroke. Lung cancer and prostate cancer are among the top three priorities in tackling cancer in Europe, while neurodegenerative diseases are one of the most relevant issues with the EU’s ageing population.

If successful, it is hoped that the Nottingham team’s model could be trained to identify risk for other serious diseases and rolled out to hospitals and organisations across Europe willing to utilise AI-driven diagnostics.

It is thought that AI can enable real innovations in health care, and that AI systems which can process vast amounts of data quickly and in detail can be harnessed as a tool for preventative health care and clinical decision-making.

Despite this, the way in which information is currently stored across European countries and the limited access to health data can form a barrier to innovation, as developing trustworthy and responsible AI systems often requires large datasets for training and validation.

“The hope is that we could develop an AI-driven model for hospitals which they can then utilise and run to help find those most at risk,” said Dr Mufti Mahmud, an Associate Professor of Cognitive Computing in Nottingham Trent University’s School of Science and Technology.

He said: “Countries have huge amounts of clinical practice data, and we want to understand how we might harness this to identify the right people, so they can be invited for more focused diagnostics. We need the system to be able to find people before they start showing symptoms, and ultimately to help save lives.”

“Health care data storing is very sensitive, very private, so by developing synthetic data we can train the model to function responsibly and to provide the reasons why it selected an individual.”

Nottingham University Hospitals NHS Trust lung cancer consultant Professor David Baldwin said: “Identifying the right people for cancer screening is vital to ensure that the most people benefit whilst not harming people who have a low risk of developing lung cancer.

“AI offers the opportunity to improve the way we target screening programmes to make them more clinically and cost effective. AI is also changing practice in many other areas of lung cancer care. AI tools can help reduce the workload of specialists like radiographers and radiologists, as well as treatment costs, and improve outcomes for patients.”

Primary care network to adopt new digital pathway for heart health

By Integrated Care Journal

New approach to heart failure care will enhance provision of digital services to patients across Widnes primary care network.

Widnes PCN, a locality in NHS Cheshire and Merseyside, has launched a new digital health pathway for heart health. It will support healthcare professionals (HCPs) “to feel confident in prescribing trusted and assessed digital health apps for patients living with heart and circulatory diseases” across the locality.

The digital care pathway will provide HCPs across primary, secondary and tertiary care with the most appropriate apps to prescribe to patients as a digital adjunct to treatment, aiming to improve outcomes for patients who have, or will be diagnosed with, heart failure.

Heart failure affects more than 900,000 people in the UK, accounting for 5 per cent of all emergency hospital admissions. 200,000 new cases are diagnosed annually, and it is the leading cause of hospital admissions among over 65s. Care for heart failure patients meanwhile accounts for 2 per cent of the total NHS budget and it is estimated that hospital admissions for heart failure will rise by more than 50 per cent over the next 25 years.

Five-year survival rates for heart failure are worse than breast or prostate cancer and it is a strategic priority in Chesire and Merseyside. In the Halton locality, heart disease accounts for 10 per cent of all deaths, giving it a higher prevalence than the national average.

Widnes PCN has launched the new digital care pathway in partnership with Boehringer Ingelheim and the Organisation for the Review and Care of Health Apps (ORCHA) for the NHS. There are more than 350,000 digital health technologies on the market, including apps that can help prevent, diagnose and monitor heart health, as well as educational apps. However, only 20 per cent of apps currently meet ORCHA’s set quality thresholds.

The apps included in the pathway have been assessed, critiqued and selected after a three-month period of testing conducted by NHS Cheshire and Merseyside, ORCHA and Boehringer Ingelheim. Staff working across heart health services in the locality have received training on how to use the pathway and the apps within it.

Both the digital care pathway and the featured apps are held in NHS Cheshire and Merseyside’s Digital Health Formulary – a single platform where staff can quickly find and recommend approved apps to patients. Once an HCP prescribes a tool, the patient receives a text or email with a link to download the app and access it via a website.

“Heart failure is a prevalent and incurable condition that requires a focus on managing symptoms and slowing its progression,” said Dr Henry Chan, GP and Heart Failure Lead in Widnes. “Unfortunately, it leads to early mortality and often results in emergency hospital admissions, placing a significant long-term demand on healthcare and social services.

“We are delighted to introduce this innovative digital pathway for heart health to recommend the most appropriate digital tools to support patients throughout their care journey.”

Liz Ashall-Payne, CEO of ORCHA, commented: “Increasing the adoption of digital health is the key to creating a more sustainable healthcare system and has vast potential to save lives. All apps available have been assessed and approved against ORCHA’s standards, so they are only directed to quality-assured tools and this ensures the most effective are recommended consistently across the system.”

Country Managing Director and Head of Human Pharma at Boehringer Ingelheim UK & Ireland, Vani Manja, said: “This project was led by a deep understanding from heart failure patients and clinicians themselves about their experiences and we collaboratively generated solutions that underpin this new pathway. I am hopeful that we can improve the experience and outcomes for patients across heart failure pathways, with a view to offering it more widely in other regions.”

Tackling the winter crisis and future-proofing the NHS

By Rob Shaw CBE

By Rob Shaw CBE, Mastek Adviser and former Deputy CEO of NHS Digital.

Digital infrastructure has the potential to transform the NHS’s response to additional winter pressures by delivering seamless routes of discharge, which accelerate patient flow and maximise available capacity.

For too long, digital infrastructure has been viewed by the NHS as discretionary spending rather than a core budget. If we are serious about protecting the NHS ahead of future winter pressures, digital infrastructure must be at the heart of winter planning and a key priority for NHS England and local NHS systems.

Last winter, 60 per cent of patients in NHS hospital beds were medically fit for discharge. Ahead of this winter, the NHS has invested £200 million and expanded its program of “traffic control centers” to provide an initial point of discharge to ease patient flow through the NHS. This additional capacity aims to free up NHS beds, but it fails to solve the problem of where patients go next.

NHS hospitals shouldn’t be used as traffic control centres; they should be equipped to act as digital command centres, empowered to unlock community care in their local area.

We need to look beyond the provision of extra beds as a solution, and move to a data-driven approach of managing patient flow through NHS hospitals and into community settings. Digital infrastructure in the NHS is key to reducing delayed discharge and maximising community capacity. Digital infrastructure has the potential to seamlessly match community care with a patient who needs it and to coordinate staff to deliver any step-down care that is required.

The Digital Command Centre model currently exists in pockets of the NHS, providing a comprehensive data taxonomy of capacity and staffing levels within a local health ecosystem. It allows NHS staff to quickly identify an appropriate point of discharge within their local area, coordinate urgent and elective care against available staffing numbers, and arrange discharge transport and medicine delivery for at-home care.

Digital Command Centre models can be found in the London Care Record, where patient records from across the capital can be accessed across acute and community settings and have been proven to accelerate discharge from the hospital to care homes.

A Digital Command Centre approach can also be found within the Leeds Care Record, which has created interoperable data sharing across acute hospitals, community services, GPs, social care, and hospices in the region. Nurses reported that the Leeds Care Record allowed them to “discharge and refer more quickly as information is more readily available, and we’re aware of what community care is in place.”

Currently, these examples of local best practice exist as islands of interoperability amid a wider NHS landscape where data on local NHS capacity is trapped within inadequate digital systems and is inaccessible to staff who are desperately trying to match a patient with a point of discharge.

The route to NHS Digital Command Centres: a three-step plan

Step 1: First, do no harm. The depth of winter is not the time to introduce a system-wide overhaul of digital interoperability. Digital solutions must empower staff at times of peak capacity and not act as a hindrance to the delivery of patient care. Before anything else, digital solutions must be resilient. At points of peak winter capacity, digital outages can be fatal, and autumn should be used to test digital systems and to rehearse for adverse events. The introduction of updated digital systems should also build upon existing infrastructure and should avoid forcing NHS staff to work with alien digital tools. Digital infrastructure should identify efficiency within existing patterns of work and empower staff to work effectively during peak winter pressures.

Step 2: Start with what you have. No single operating system will magically combine all the existing data sharing systems in the NHS. The NHS data landscape is messy and complex and requires tailored solutions that target fragility in local systems and maximise their strengths. March to September is a crucial window for the adoption of new digital solutions. It allows us to build on the experience of the winter past and provides an opportunity for staff to gain familiarity with new systems. Focus on data security and system resilience. These are the foundation stones of effective delivery during peak winter months. Digital systems should be dependable, accessible, and should promote confidence in data sharing between NHS services.

Step 3: A Call to Action for NHS England. Digital suppliers and local NHS services can’t promote system interoperability alone. There is a key role for NHS England to play in outlining national standards for interoperability which local NHS services can strive towards. National standard setting also puts suppliers on notice and holds them to account for the systems they provide and how they can support the delivery of joined-up care. Without these standards, we risk perpetuating a landscape of islands of interoperability, where mature systems neighbour immature ones, without any direction of travel towards wider dissemination and adoption of best practice.

To truly transform the NHS and prevent winter pressures becoming crises, the NHS must move to a more digital and data-driven approach, where data serves as an enabler for a system under constant pressure. The above three-point plan can serve as a framework for delivering real change, while recognising the challenges in the NHS.

About the author: Rob Shaw CBE is an Adviser to Mastek, having previously worked as Deputy CEO of NHS Digital.

About Mastek: Mastek is an enterprise digital & cloud transformation specialist that engineers excellence for customers across 40 countries, including the UK, Europe, US, Middle East, Asia Pacific and India. We help enterprises navigate the digital landscape and stay competitive by unlocking the power of data, modernising applications, and accelerating digital advantage for our customers.

NHS to begin roll-out of federated data platform in spring 2024

By Integrated Care Journal

The supply contract has been awarded to software company Palantir Technologies UK and will see up to £330 million in investment over the seven-year contract period.

The NHS will introduce a new platform in spring 2024 to enhance patient care, reduce waiting times, and expedite hospital discharge procedures. The Federated Data Platform (FDP) will consolidate existing NHS data, enabling healthcare professionals to access critical information more readily, resulting in improved and timelier patient care.

This new platform will integrate key data currently held in disparate NHS systems, addressing some of the healthcare system’s post-pandemic challenges. By aggregating real-time data, such as hospital bed availability, elective waiting list sizes, staff schedules, medical supply inventories, and social care placements, healthcare professionals can optimise resource allocation, including operating theatre and outpatient clinic utilisation, to ensure patients receive timely care.

Palantir Technologies UK, supported by Accenture, PwC, NECS, and Carnall Farrar, was awarded the software supply contract following an open and competitive tender process. The contract will entail a seven-year investment period as more trusts adopt the platform. The initial contract year is expected to see an investment of at least £25.6 million, with total investment over the seven-year contract period reaching up to £330 million for the FDP and associated services. Following the award of the contract for the FDP this week, there will be a six-month implementation period where products supported by the current platform will be transitioned across.

Data access within the FDP is strictly controlled by the NHS, requiring explicit permission for any company involved in the platform. Data usage within the platform is solely for direct care and planning purposes. It will not be utilised for research purposes, and GP data will not be incorporated into the national version of the software platform.

Pilot projects utilising the new data-sharing approach have demonstrated reduced waiting times for planned care and discharge delays, as well as faster diagnosis and treatment times. Since implementing the system, North Tees and Hartlepool Trust has reduced long-term stays (21 days or more) by 36 per cent despite increased demand, with a 7.7 per cent increase in hospital admissions.

NHS National Director for Transformation, Dr Vin Diwakar, said: “Better use of data is essential for the NHS to tackle waiting times, join up patient care and make the health service sustainable for the future. Patients come to the NHS at some of the most vulnerable points in their lives, and they want to know that our healthcare teams have access to the best possible information when it comes to their treatment and care.

“This new tool provides a safe and secure environment to bring together data, which enables us to develop and deliver more responsive services for patients and will help the health service drive the recovery in elective care.”

Palantir CEO Alex Karp said: “This award is the culmination of 20 years of developing software that enables complex, sensitive data to be integrated in a way that protects security, respects privacy and puts the customer in full control.

“There is no more important institution in the UK than the NHS and we are humbled to have now been chosen to provide that software across England to help bring down waiting lists, improve patient care and reduce health inequalities.

“It builds on our role supporting the delivery of the COVID-19 vaccine and, more recently, helping individual NHS Trusts to schedule more operations.”

Matthew Taylor, Chief Executive of the NHS Confederation, commented: “Health leaders will welcome the introduction of the Federated Data Platform as an important tool to help organisations across the NHS more rapidly connect and access data, free up vital clinical time and deliver more efficient, faster and safe care for patients.

“For the platform to succeed, it will also be crucial that the public continue to be engaged with, and that any concerns they have on the sharing of their data are addressed meaningfully. Likewise, Government and the wider NHS will need to ensure that there are adequate numbers of staff working in digital and patient data roles.

“We hope the new platform will offer much needed capacity for many Integrated Care Systems and for those systems that have already built their own effective platforms, we welcome both the assurance that they will be able to decide if and when to opt into it, and that they will continue to be supported.”

Can allied health professions catch up with NHS digitisation?

By Andy Soluk

As the UK healthcare landscape undergoes a radical digital transformation, can the independent sector adapt or will it be left behind?

This article was kindly supported by FormDr.

Thousands of independent practices and health-adjacent businesses are being left behind as the NHS moves towards digitisation. The extensive report on June 30th 2023 from Parliament’s Health and Social Care Committee recommends a plethora of changes to the NHS and integrated care systems (ICSs), with barely a mention of the tens of thousands of health and wellness professionals who work outside of the NHS.

Yet, private practices and allied health professionals around the country are interacting with tens, if not hundreds, of thousands of people who would equally benefit from digitisation. Many of these practices are still using pen and paper for their basic functions.

This is a mistake, and these health professionals cannot be left behind.

The process of an osteopath

Let us step into the shoes of an osteopath to explore the process that thousands of people face. While the NHS might cover osteopathy in some areas, most people pay for private treatment and are decoupled from NHS systems.

Upon registration, a patient would fill out a litany of paperwork, from medical history forms to informed consent. Perhaps an osteopath can email a copy of these forms to a patient before the first appointment. However, in our increasingly digital age, only 52 per cent of people living in the UK own a printer, so about half the population will need to complete paperwork in the office.

A patient likely arrives 20 minutes early to complete paperwork and review with the front desk staff. If his or her handwriting is illegible, then the process takes longer and creates additional delays.

Once this initial paperwork is sorted, staff must file it and ensure security. Practices have a false assumption that paper is safe, though we have seen fines under GDPR up to £275,000 for not handling paper health data properly. The Information Commissioner’s Office (ICO) is becoming more active and could strike at any time.

Returning patients might need to complete less paperwork, but the inefficiencies in paper still compound and take up valuable time and resources. One of our own surveys found that small practices saved an average of 21 minutes per patient when digitising.

This hypothetical osteopath is only one example, but it is not difficult to imagine how fitness centres, genetics testers, pharmacies, fertility clinics, anyone offering elective surgery, or small health-adjacent businesses are wasting hours each week on paperwork. For these practices, time spent on paperwork directly impacts client and patient care. These health and wellness professionals also need help digitising.

How practices are impeding their future progress

There is another, less obvious problem with paper processes. As the NHS moves towards digitisation and integration, practices and businesses without electronic records exclude themselves from future involvement. The NHS wants to streamline its processes and make data more accessible for GPs, but paper forms do not allow for this.

The foreseeable future of health care in the UK is built around ICSs. The wider NHS is also focusing more on preventative care, which, due to resource constraints, increasingly falls under the purview of the independent sector. The opportunities for growth in these practices and businesses will exponentially increase as they digitise and can more easily link with the NHS.

What can practices and small businesses do?

Fortunately, solutions to streamline paper processes exist and the rapid expansion of telehealth during Covid-19 shows that digitisation is possible and necessary. While the NHS is moving towards its goal, there are three steps that all practices and businesses, regardless of size, can take today to ensure they do not fall behind.

1) Examine your current process of sending and receiving paperwork.

Any good change management strategy starts with an assessment of current workflow. Do you only offer paper forms when a patient or client comes to the office? How many staff members are dedicated to intake? What do you do if someone is concerned about a Covid-19 resurgence and refuses to sit near strangers? Dive into your process.

2) Look for small, yet impactful changes you can make.

Perhaps you can put a copy of your forms on your website so that patients know what to expect. Emailing or text messaging forms can also be an easy step in streamlining your paperwork. Even a simple change such as highlighting required questions on your form could save hours each week.

3) Digitise where you can.

The more you can digitise your process, the easier it will be for everyone. While the goal should be to digitise everything, small steps are an improvement and worth celebrating. Building secure online forms and creating fillable documents might seem like a large hurdle to overcome, but the time and money savings will be astounding. Moving your paperwork online also allows you to keep electronic records and store information such as photographs in one place.

It is clear that the future of the health care sector will have digitisation at the heart. The unfortunate reality is that most of the focus is on the NHS. However, there are steps that small private practices and businesses can take to move towards a paperless existence and prepare for future benefits. Digitisation will soon be ubiquitous across health and care, so why not start saving time and money today?

Andy Soluk is the Director of European Operations for FormDr: a digital platform for health professionals to build, send, and receive custom forms. Get in touch to learn how we can help streamline and digitise your paper processes.

Digital Implementation, Health Inequality, News, Population Health, Thought Leadership November 15, 2023

Inclusive innovation: using community co-innovation to tackle health inequalities and digital exclusion

By Fran Ward and Dr Paulina Ramirez

By Fran Ward, Project Manager, NHS Arden & GEM CSU and Dr Paulina Ramirez, Academic, Birmingham Business School.

Digitalisation of the NHS has the potential to enable more personalised care and improve health outcomes. But it can also widen health inequalities. Some people in communities facing social and economic deprivation, which are also those experiencing the poorest health, find accessing care increasingly difficult as the NHS becomes more digital.

If those most in need of health services become less able to access them, health outcomes for these communities will worsen and the overall cost of healthcare will increase. Integrated care systems (ICSs), therefore, need to maximise the value of their investment in digitalisation by making it work for all their communities, not just the ones they know and understand well.

The ‘Building Inclusive Digital Health Innovation Ecosystems’ research programme, led by University of Birmingham’s Business School and supported by NHS Arden & GEM’s digital transformation team and Walsall Housing Group (whg), explores how community co-innovation could be used to develop digital healthcare that works for diverse communities and reduces the risk of exclusion.

Co-innovation is about understanding and framing problems and taking a bottom-up approach to generating new ideas in response. Specifically, this programme of community co-innovation is socially inclusive by design, creating an opportunity for disadvantaged communities to share their knowledge and lived experience. It gives these communities an equal share of voice alongside commissioners, clinicians and other stakeholders in the development of new digital health technologies or design of new online services.

Peer research

To genuinely hear what more deprived communities need, it is important to rethink how we in the NHS structure engagement to make it easier and more comfortable for those we most want to hear from. Training peer researchers from whg and local voluntary organisations enabled us to build on existing skills, connections and relationships. As trusted members of the community, peer researchers were better able to have relevant conversations within people’s homes, and elicit more honest and open responses on how people access technology and the barriers they face.

The resulting insights challenged some assumptions around barriers to adoption of digital technologies. The main source of inequality was found to be the lack of skills and confidence to engage with online services, with an individual’s type of work or family support structure often having a greater influence on digital proficiency than age, for example. Concerns around data privacy and information sharing were high, causing some not to access potentially valuable support. Despite positive attitudes towards digital in general, many felt digital services such as online GP appointments were not an adequate replacement for face-to-face health services due to a combination of trust, complexity and importance of healthcare in people’s lives.

Simply developing more digital services without addressing these fundamental barriers is inevitably going to limit success.

Changing the nature of engagement

Although good examples of user engagement in digital health services exist, there are constraints too. In particular, technology companies often have little or no engagement with deprived communities so can’t be sure their technology will work for those most likely to have the highest health needs. Alongside peer research, we need to create spaces for co-innovation to happen, bringing together these stakeholders to share information and work together to come up with new ideas.

A locally hosted co-innovation event enabled system partners in the Black Country ICS and health technology companies to hear from and engage with peer researchers and other local community organisations to start putting theory into action. Based on health priorities identified through the peer research, table group discussions addressed challenges such as how to ensure that a mental health app was used by those who most needed it, and how to increase numbers of patients from areas of high deprivation attending diabetes reviews. Peer researchers were able to articulate the day-to-day challenges people in their communities face and why, for example, simplicity and ease of use is often preferable to feature-packed, complex apps.

The event has already resulted in a dedicated task and finish group being set up at NHS Black Country Integrated Care Board to explore how community co-innovation can be applied to issues such as digital GP access. Whg is also keen to continue building a space for co-innovation within its community. More broadly, however, there is a wealth of learning from this approach which can be applied to digital transformation across the country.

Developing best practice

It is clear from this work that input from communities facing social and economic deprivation is essential in finding solutions to some of the nation’s most complex health challenges – and that how we do that is as important as why.

Findings from the ‘Building Inclusive Digital Health Innovation Ecosystems’ research have been used to develop a What good looks like for our communities report to support the NHS Digitalisation Framework. This highlights the need for affordable, simple, safe and inclusive technology that is well integrated with in-person services, guarantees data privacy and is supported with local skills training and support.

We have also developed a playbook to guide ICSs in using community co-innovation to develop digital health services, drawing on the learning from this programme to encourage greater use of this approach across the NHS. After all, there is no point in developing digital services that aren’t going to work for the communities we most need to help.

Photo caption: Peer researchers interviewing community members in their own homes in Walsall.

To find out more about digital inclusion and health inequalities, see: The digital divide: Reducing inequalities for better, prepared by Public Policy Projects.

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