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.
Matthew Swindells

Matthew Swindells is NHS England’s National Director: Operations and Information.

He joined NHS England in May 2016 from the Cerner Group and his role as Senior Vice President for Population Health and Global Strategy.

Matthew is responsible for national performance of the NHS against the NHS Constitution Standards, assurance of Clinical Commissioning Groups, achieving a paperless NHS, information and technology programmes and investment in data.

He has over 25 years’ experience in health care services and has worked in the Department of Health as a Chief Information Officer and as a Senior Policy Advisor to the Secretary of State for Health. Prior to this he served as a Principal Adviser in the Prime Minister’s Office of Public Service Reform.

Matthew began his career at Guys and St Thomas’ Hospital in the early 1990s, and went on to become Director of Clinical Services of Heatherwood and Wexham Park Hospital and later Chief Executive of the Royal Surrey County Hospital, in the early 2000s.

He is visiting professor and chair of the advisory committee in the School of Health Management at the University of Surrey and Member of the Editorial Board for the Journal of Population Health Management.

Will Smart

Will Smart is Chief Information Officer (CIO) Health and Care in England.

A joint appointment between NHS England and NHS Improvement, Will is responsible for providing strategic leadership across the whole of the NHS to ensure that the opportunities that digital technologies offer are fully exploited to improve the experience of patients and carers in their interactions with health and social care; the outcomes for patients; and improved efficiencies in how care is delivered.

Prior to taking up this role, Will was Chief Information Officer at the Royal Free London NHS Foundation Trust for six years and. He first worked in the NHS in Wales and Northern Ireland during his placement year from university, before taking up an analytics role at St. Mary’s NHS Trust in London on graduation.

In addition to senior roles in the NHS, Will has worked as a management consultant with major assignments focussing on IT strategy, service transformation, major IT service and contract reviews and outsourcing.

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