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Progressing the acute Global Digital Exemplar
In the second of three blogs, NHS England’s National Director: Operations and Information, and the Chief Information Officer (CIO) Health and Care in England look at how the Global Digital Exemplar (GDE) programme works:
Acute GDEs are progressing on two time tracks: two years for the most digitally advanced and three and half years for those slightly less advanced.
Each trust has been allocated £10million each in phased payments – an upfront instalment; subsequent instalments once targets are delivered; and the last instalment if they deliver agreed requirements within the timescales. Funding for these GDEs was approved by the Treasury and allocated in July 2017, which is when we are viewing the clock as having started.
Crucially, the contract for delivery is between NHS England and the GDE – not between NHS England and any commercial organisations. It is for the local organisations to determine how they spend the money. The key point is that the GDEs volunteered to join the programme and commit to it. It is up to them to now make that happen.
In addition to achieving agreed milestones, the GDEs also committed to three other things:
- To match fund the central money. We did not specify this had to be in cash and we are very happy for this commitment to be met in kind, by the release of staff to work on the project – but we are expecting a commitment of at least that scale from every GDE.
- To find and work with international partners. We have encouraged them to find organisations that both use the same IT system and, most importantly, operate within a similar environment addressing similar strategic situations. We don’t need every GDE to have a different international partner so I am encouraged that a number of the GDEs are looking to work together with the same international partner, but we expect everyone to be partnered with a pioneering organisation that has demonstrated leadership and delivered progress through exceptional use of information technology.
- To partner with other hospitals as their “Fast Followers” and develop blueprints that take the insights and deployment experience of the GDEs and core technical “build” of their system, and work with these Fast Follower organisation to implement these blueprints. We want to minimise the costly replication and learning from scratch that seems to happen with every EPR project at present. In addition, we hope that some of the GDEs will develop their IT and CCIO teams to be able to offer implementation services to their Fast Followers. If we can pull this off we can both increase NHS expertise in large-scale system deployments and reduce future implementation costs significantly.
The approach to Acutes was replicated for Mental Health Trusts: find the leading organisations, invest in them to become exemplars for other organisations to follow and at the same time develop a replicable approach with sites and vendors that would integrate with our wider strategy, increase speed and success of deployment and reduce cost.
The Mental Health GDEs will receive funding in the same staged process as the Acutes, with funding now available to flow to these organisations.
The seven mental health GDEs will each receive £5m, to be matched locally, and are expected to deliver their ambitions of providing world class mental health services enabled by digital technology to a three and a half year timetable.
The challenge here is slightly different to the acute sector in that, in other markets around the world, the inpatient and outpatient mental health solutions are frequently offered as extensions to the major acute systems, which hasn’t been the direction taken by most of the NHS mental health trusts.
The national team is currently working on the right approach for ambulance services. The view emerging from the ambulance services is that we should take a slightly different approach, with all the ambulance services engaged from the start but a small number of the more digitally mature ambulance services working in partnerships as development sites for the others.
Discussions are ongoing but we will share more information in due course.
The first group of Acute Fast Followers were announced by the Secretary of State at Expo in September.
Each GDE has been asked to identify a Fast Follower that they will work with to develop a blueprint capturing the best insights from the experiences of both organisations working collaboratively.
Fast Followers will receive £5m each to a payment profile that reflects them becoming significantly more digitally mature through their partnership with the GDE.
A fast follower opportunity will be created for Mental Health Trusts towards the end of this year.
- In the final part of our GDE blog we will talk about the commercial framework we are seeking to put in place to support this strategy and discuss “where next.”
- Read our first blog in this series: We must make IT compelling for clinicians.