Five takeaways from three innovative ICSs

Last month, the Digital Healthcare Council was joined by Lisa Emery, Chief Transformation Innovation and Digital Officer at NHS Sussex, Stephen Slough, Chief Digital Information Officer at Dorset ICB and Professor Graham Evans, Executive Chief Digital and Information Officer at North East and North Cumbria ICB. These innovative individuals shared with us their current projects, future goals, and how we can create a more productive digital ecosystem. Read our five key takeaways from the discussion below.

1. You can have the best tech in the world, but if the people and infrastructure aren’t there to make it work, it will fail.

ICSs must have strong foundations in place for innovation to be built upon. Getting the basics right includes building the data infrastructure, implementing shared care records and creating consistency across the footprint. Many services struggle even getting a computer to boot up – so bringing in an innovative system which isn’t compatible with existing, dysfunctional technology will be a waste. Once the foundations are in place, more innovative strategies can be bought in.

For example, Dorset ICS plans to upgrade its analytics platforms, building in AI and machine learning capabilities to analyse what’s happening and predict what’s going to happen – allowing services to plan accordingly.

There must also be the organisational capabilities in place to enable tech to transform. Bringing in a whole new system and a whole new way of working requires staff capacity, teamwork and an openness and willingness to change. Graham shared that the people and processes to enable tech is the rate limiting factor rather than the technology itself.

2. Shared care records are the life force of integrated care.

North East and North Cumbria (NENC) is the largest ICS covering 3.2 million people with a footprint the size of Wales. NENC are rolling out the Great North Care record, a shared care record that spans health and social care over the entire ICS. The record allows social care and local authority colleagues to access records for the betterment of patient care. NENC’s next priority is to digitise social care records for fully bidirectional information flow. Sussex’s Our Care Connected programme similarly joins up records across health and care. Sussex also use data from the programme to better understand the population, identify those at greatest risk of poor health, and design and run better services.

3. Develop ways of scaling success, not reinventing the wheel.

ICSs want to exploit innovations that are working well but the NHS tends to reinvent the wheel rather than transfer what’s already working. Dorset ICB employs a systematic approach to scaling innovation – they coordinate pilot projects through a single channel which is their innovation hub. Colleagues in the innovation hub then assess all inbound proposals and direct innovators to the areas where it is needed most within the ICS. The innovation hub also analyses data from pilot projects, and if proven successful, they can be scaled up. This approach addresses a common theme that emerged throughout the discussion which is not to come to ICSs with solutions to problems that have already been solved.

4. Short-term thinking around funding is harming innovation.

Another pertinent discussion point was challenges with funding, particularly how budgets are often funnelled into the workforce rather than investing in new digital systems. We discussed how providers and ICSs need to highlight the links between investment in technology and resolving capacity and capability issues – funding gatekeepers need to be aware of the long-term benefits of implementing technology and be assured that there will be a return on their investment through improved efficiency and staff capacity. Short-term thinking around how money is spent needs to be challenged, as extra funding is not addressing the root cause of the issue. Lisa said that the demand on the NHS is not going to decrease anytime soon, so we need to look to ways to sustainably cope with this.

5. The more of us who are saying the same thing to NHSE, the better. 

The session wrapped up with a discussion around the importance of collaboration between  providers and ICSs. Organisations such as the DHC can foster relationships between multiple providers to create a joined-up solution that is pitched to an ICS. Graham concluded our discussion to say that we need to move away from the siloed mentality that NHS is renowned for, so having frequent conversations between the NHS and industry partners will help us collaborate and move forward together.

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