Organisational attendees

Understanding Patient Data
Information Commissioner’s Office
Department of Health and Social Care
Royal College of General Practitioners
Healthwatch
Royal College of Surgeons
NHS Confederation
NHS England
Patients Association
Association of Medical Research Charities
British Medical Association
National Voices
Office of the National Data Guardian

Apologies received

UNISON
Nottingham University Hospitals Trust
NHS Frimley Integrated Care Board
Academy of Medical Royal Colleges

Open actions and decisions recorded

Meeting notes

Welcome and introductions 

The Chair welcomed all members to the call and noted any apologies.

Introductions of new members took place as well as noting any conflicts/declarations of interests.

Minutes and actions from previous meeting

The Chair confirmed the December 2024 minutes have now been approved following feedback form the group.

The group approved the January 2025 minutes.

The Chair reflected to the group that although the group are polite and friendly in their approach to supporting and engaging, this can make it tricky to demonstrate in the minutes the level of frustration, concern, or challenge that a member of the group may want to make. The Chair encouraged the group to continue the friendly and polite manner of engaging with this forum but to please flag where members want to outline a particular level of frustration, concern, or challenge so that this is accurately reflected in the minutes.

The Chair took the group through the open actions.

NHS Federated Data Platform Programme update

The FDP Deputy Director of Demand and Delivery provided an update of the programme to the group.

The programme has achieved a number of key milestones including platform enablement, local and national transition, and achieving the 71 trust FDP sign up target. The team is working through the trusts signed up to the FDP to now deliver core products. The programme is currently on track for achieving the target of 240 organisations with access to FDP and its products by June 2027.

Currently, there are 103 trusts, and 40 integrated care boards signed up to the FDP. The programme recognises that this uptake has been achieved by supporting all trusts that have engaged and outlined the need for core products. The next cohort of trusts will potentially have slightly different requirements in terms of the wider products that are in development and wider capabilities of the platform, as opposed to the core products currently available, which may be slightly more challenging. The programme will continue to engage and support trusts to understand their operational needs and offer/develop appropriate solutions. This includes working with trusts who have an EPIC system (an electronic patient record system) in place to ensure they have a rounded product suite and solution for their operational teams.

The Chair thanked the FDP Deputy Director of Demand and Delivery for noting the move into a more challenging phase of adoption and asked if there is any detail on the adoption profile between now and June 2027. The FDP Deputy Director of Demand and Delivery outlined that for acute trusts there is a target for next year, as detailed in the NHS elective recovery plan, for 85% of acute trusts to adopt the FDP which equates to 115 acute trusts. The programme are confident that this target will be achieved. For the integrated care boards, the current uptake figure is 40 with currently 2 outstanding which the team is working on. The programme is also developing FDP offers for community and mental health trusts. The uptake for organisations over the next 2 years will be driven by the programme’s ability to diagnose challenges and effectively provide tools to support organsiations.

The FDP Senior Responsible Officer commented that the FDP community and mental health offer will be linked to work underway within the NHS and neighbourhood teams. The FDP Programme will be scoping the expansion of the care coordination tooling so that organisations can work more collaboratively as part of the neighbourhood teams’ work. There will be a number of specific challenges that the FDP Programme will look to respond to as they continue to work with existing and new trusts. The FDP Senior Responsible Officer highlighted the importance of the FDP product development framework in ensuring solutions are tested thoroughly before being ready for wider consumption and communications.

A member of the group questioned the impact on the use of the independent sector and asked if the FDP captures data for operations that do not take place in secondary care. The FDP Senior Responsible Officer confirmed that the data will be captured through existing data collection methods and will go into the metrics. The FDP Senior Responsible Officer advised that part of this, including highlighting and reporting on this activity, will be within the support to the wider recovery and productivity lens which is currently being looked at.

A member of the group asked when the group would be able to receive feedback from patients and the public in regard to the FDP. The member of the group emphasised the importance of not just trust impact but also how it is benefitting people, particularly when considering gaining further advocacy. The FDP Senior Responsible Officer agreed and reflected that a focused piece of work on this area hasn’t been commissioned yet, but it is something that is being considered as part of the 10 Year Plan development. The FDP Senior Responsible Officer advised that there may be existing FDP case studies where a further analysis could be carried out and agreed to take this away as an action to explore.

The Chair asked the FDP Senior Responsible Officer for an update on any discussions with the National Data Library team in relation to the FDP. The FDP Senior Responsible Officer advised that this is still being worked through but has suggested that a focus should be on improving the value of data sharing through data that we already publish. The National Data Library team are due to share a list of use cases with the FDP Senior Responsible Officer for review and to support further discussion. The other area that the National Data Library team is scoping is data research which also requires further scoping discussions.

The Chair asked the FDP Senior Responsible Officer for an update on the Data and Digital Neighbourhood Group as part of the 10 Year Plan development. The FDP Senior Responsible Officer advised that the group is going well and has been considerate in making the case for overall digitalisation having a common standard which includes the need for digital foundations that need continued investment. The second element is the Single Patient Record in which the scoping of this is underway. Other recommendations from the Data and Digital Neighbourhood Group will include elements on technology investments.

A member of the group asked whether there is any guidance on how to a certain the value of an Artificial Intelligence product. The FDP Senior Responsible Officer advised that ascribing value hasn’t been looked at as part of the 10 Year Plan but the approach to how artificial intelligence models are used with a monitoring framework is in scope.

The FDP Head of Information Governance provided an information governance update to the group. The team has continued to review all products that are released on to the FDP which includes both local and national products. The FDP Data Governance Group continues to meet on a monthly basis in which the group review approximately 6 products at each meeting. For local products, a DPIA, annex, and privacy notice is released as a template, but this is then the responsibility of a local trust to review and complete. The FDP IG team has also been reviewing existing templates and making improvements in line with feedback and collaboration with stakeholders such as the National Data Guardian and the Information Commissioners Officer. The FDP IG team is also working on updates to the IG framework which will go through the same robust review and feedback process as previously completed. Another area of work the FDP IG team is focusing on is the publishing of the DPIAs which has taken longer than expected due to the need to ensure that communication and NHS England IG colleagues were content with the approach to publication, including making the information as accessible as possible.

Action: FDP Programme team to explore opportunities to carry out further analysis in existing case studies where direct patient benefits/impact could be focused on.

FDP product overview and roadmap

The FDP Deputy Director, Product Development and Implementation, provided an FDP product update and roadmap to the group.

Local product overview

The FDP Deputy Director, Product Development and Implementation provided an overview of the FDP Local and System product development.

There are currently 4 core products that have been made available to trusts from day 1 of onboarding onto the NHS FDP:

• Care Coordination Suite (Inpatients): Provides elective waiting list validation tools, data quality review and tasking module, and a theatre scheduling support module.
• Care Coordination Suite (Outpatients): Provides waiting list validation and data quality review tools, and a clinic management tool.
• Care Coordination Suit (Referral to treatment): Supports the validation of patients on RTT pathways, ensuring accurate waiting lists, and helping to address blockers to patients progressing through their pathway.
• OPTICA (Discharge Planning): Tracks admitted patients and the task as relating to their discharge in real-time through their hospital journey.

The programme is gathering a wealth of information on the outputs and benefits of these products, including scoping the impact on workforce.

The programme is seeing a good level of adoption across the country which will support the adoption and implementation of the FDP, as well as help promote innovation.

A member of the group asked if there is any breakdown to understand the number of patients removed from the waitlist due to validation vs care/treatment completion. The member of the group outlined their concern on current media coverage regarding waiting list reductions and queried the proportion of patients removed due to validation and the risk of stagnation. The FDP Deputy Director, Product Development and Implementation advised that the current analysis hasn’t gone to this level of detail, but advised the need for validation will continue and there are areas where a change in process is identified. The member of the group advised that this will be a source of benefits in identifying where there has been a in process.

The FDP Senior Responsible Officer advised that a focus is on how to maintain validated data to create a live feed of patients. There are elements that are looking to be captured more clearly, such as patient led validation figures, which is part of the long-term focus in how to capture this data and utilise it in areas such as staying well.

The Chair advised that there are some obvious links to direct patient benefits, such as clarity on what the patient may be waiting for from a healthcare provider. However, the Chair raised concern on the potential for accidental removal from waitlists. The FDP Deputy Director, Demand and Delivery, advised that the validation process includes a review of every patient before a decision is made on removal from the waitlist to ensure inaccurate removal is avoided.

The FDP Deputy Director, Demand and Delivery, advised that the FDP team focus on not only validation methods but how to improve organisational workflow and operational processes.

A member of the group challenged the way in which waitlists are counted and questioned how patients with longer term follow up periods are managed. The FDP Senior Responsible Officer advised the current mechanism for counting waiting lists is agreed with the government. The Chair also added that new guidance has recently been released on how rusts should be recording elective waits.

Outpatients product review

The FDP Deputy Director, Product Development and Implementation provided an update on the FDP Outpatient product review.

Following the launch of the FDP Outpatient product, the FDP team proactively analysed and reviewed areas of benefits and identified where there may be opportunities to further enhance the product to improve delivery of value. The FDP team engaged with 10 trusts and conducted deep dives on what has worked well and where there may be opportunities for further modules to be developed to provide additional value.

6 additional modules were identified through this review and were taken through an impact assessment and benefits review. Following this, a shortlist of 2 modules were identified and are currently in incubation. The 2 modules focus on patient pathway management and optimising clinic room booking.

A member of the group advised that they supportive of this approach in motivation being driven by primary outcome of benefits.

The FDP Deputy Director, Demand and Delivery, advised that the FDP Programme is aware that there is a level of change fatigue in the NHS which brings the importance of ensuring products resonate with operational teams and address their challenges, which is achieved through engagement and collaborative working.

Product roadmap

The FDP Deputy Director, Product Development and Implementation provided an update on the FDP product roadmap.

There are a number of prioritised pilot products which are in development and being scoped. This is a continued cycle of engagement, development, and testing along with a prioritisation process for the development of products.

The current identified prioritised products are in different stages of product development but mainly within an incubation or pilot stage. This includes products such as Patient Led Validation, Cancer 360, and Time Care Hub.

A member of the group asked if there are plans in place for communicating new products being released, and specifically referenced interest in understanding how products utilising artificial intelligence (AI) are being trained and also communicated to patients. The FDP Deputy Director, Product Development and Implementation reflected that there is a large responsibility on ensuring appropriate engagement, development, and testing has taken place before communications are shared with the public. There is a need to ensure the pace is correct and enables taking stakeholders on a journey. In regard to the assisted AI discharge summaries, the FDP Deputy Director, Product Development and Implementation advised that there is a lot of work that needs to be completed before AI is considered. The FDP Senior Responsible Officer added that analytical colleagues are currently scoping approaches to monitoring and reviewing AI models, of which standard model must underpin this.

A member of the group asked whether the System Control Centre product would be available at a regional level and referenced the benefits in being able to access data across multi-disciplinary organisations. The FDP Deputy Director, Product Development and Implementation advised that the longer-term ambition is to be able to roll data up to support organsiations at the right level, this includes ensuring appropriate IG processes and guidelines and followed. The FDP Senior Responsible Officer advised that there has been an example of a region taking a ‘1 region’ approach to this product. Other regions have shown interest in a similar approach which the FDP team is working through.

A member of the group asked whether the Patient led validation tool will also provide opportunity to improve data enrichment and quality, particularly in areas of known gaps in patient information. The FDP Deputy Director, Product Development and Implementation outlined that the FDP product development not only focuses on products but also the platform capabilities which enables the surfacing of other products to address areas such as this of which improving data quality and enriching data is a focus. The FDP Senior Responsible Officer added that this is also part of the 10 Year Plan on collecting more data and includes working closely with the NHS App team on how to take that forward.

The Chair raised a concern on whether the behavioural science lens on patient impact from the Patient validation tool is as previous experiences demonstrates that messaging can have a large impact on a patients’ engagement with their healthcare provider. The Chair asked how this is being monitored. The FDP Deputy Director, Product Development and Implementation advised that a core competency across all product development is ensuring there is a strong user centre design which includes a substantial focus on human interaction points and being cognisant of how the products can provide opportunities not only for collating information but also to provide updates and support education.

Centre of Excellence and Solution Exchange

The FDP Deputy Director, Product Development and Implementation provided an overview on the FDP Centre of Excellence and FDP Solution Exchange. The Solution Exchange is a catalogue of products available to trusts and integrated care boards (on behalf of integrated care systems (ICSs) on the NHS Federated Data Platform (NHS FDP). The FDP Centre of Excellence is available to all users of the NHS FDP. It provides knowledge, expertise, and resources to support all user groups to effectively leverage the capabilities of the NHS FDP, including training and education services to empower users with the skills and proficiency needed to harness the full potential of the platform. 

Artificial intelligence and the FDP

The FDP Deputy Director, Product Development and Implementation provided an overview of the assistant AI discharge summary.

The FDP Programme engaged with four acute trusts across Northwest London and consulted on how large language models (LLM)/AI could best support care within their settings. A number of deep dives took place to distil ideas into use cases. The first use case that has been identified as achievable and demonstrated significant benefit opportunities is AI assisting in discharge summaries. There are 3 key areas of opportunities identified; reduction in time required to generate discharge summaries, enabling discharge summaries to the generated closer to the point when patients are medically optimised, and supporting better adherence to agreed standards.

The journey to date has consisted of 2 phases. Within phase 1, the product is still in development and as a result no drafted AI discharge summary has been sent to a GP to continue a patients care. Phase 1 has focussed on robust testing and the classification of the product as a medical device. The FDP Deputy Director, Product Development and Implementation advised that the learning from phase 1 is now being considered and brought into phase 2 which is starting to take stakeholders on the journey of development. This phase will start with using data to baseline the use and generation of discharge summaries which will be done without AI.

The FDP Deputy Director, Product Development and Implementation emphasised that the ‘human in the loop’ will be the key control to ensure discharge summaries meet required safety and quality standards for all phases.

The FDP Senior Responsible Officer advised that the incubation sites conducted a check with 100 members of the public in which there was majority positive feedback collated.

The FDP Senior Responsible Officer advised that further testing needs to be done on the discharge summary template with primary care clinicians to help enable codification back into GP practices.

A member of the group challenged the ability of explainability of AI, due to its complexity, and queried if there have been any tools or guidance to support frontline staff in being able to potentially answer questions on how discharge summary conclusions have been reached.  The Senior Responsible Officer advised the tools are clear in where the source of information is from and has an explainability log against each of the items, so clinicians can double check where the information is being taken from.

A member of the group highlighted concern in the inconsistency in medical device certification and highlighted caution in the need to ensure a tool such as AI assisted discharge summaries doesn’t impact on residential/junior doctor’s key learning and experience opportunities. The member of the group also advised on the need for close monitoring to ascertain the long-term impact of products that use an automated functionality.

A member of the group asked for GPs to be included in the development of this product, to provide input and to help the shaping of the discharge summary templates.

The FDP Senior Responsible Officer agreed with the need to ensure the balance is achieved between the efficiencies of the product vs the need for learning and training through existing methods. The FDP Senior Responsible Officer also confirmed that they are regularly engaging and working with Medical Devices teams, regulatory bodies, and Google to work towards standardisation where possible.

The FDP Head of IG advised that AI products will require more assessment from an IG point of view. The FDP IG team is working closely with the FDP Product team and will also collaborate with the existing IG groups to make sure all are aware of the product and ensuring it aligns to legal guidance.

A member of the group asked if the programme is using ‘off the shelf’ LLM products, and whether NHS England is looking into agentic AI for opportunities such as coordination of appointments to improve patient experience. The FDP Senior Responsible Officer advised that there are current discussions on agentic AI, including engagement with Google. FDP as a policy is agnostic to the LLM models and there will be different models available based on the use case. It is part of the 10 Year Plan that agentic AI needs to be explored to support the long-term ambition for a more digitally enabled healthcare system.

A member of the group challenged the definition of ‘human in the loop’ as this could be a wide spectrum from an ‘alert’ functionality which requires very little interaction, to a higher level of accountability of thinking, the former of which the programme should try and avoid. The member of the group outlined that the question is what does ‘human in the loop’ mean in the context of AI. The Senior Responsible Officer advised that the 10 Year Plan does include the need to take these elements of consideration forward and focus on how to have more open dialogue on this area. The FDP Senior Responsible Officer acknowledged the question in relation to workflow and the ability to further support endorsement in the FDP.

A member of the group asked if there are any standards or guidelines that the discharge summary template is being aligned to. Whilst there aren’t any standards in place for discharge summary templates, the FDP Deputy Director, Product Development and Implementation, advised that the template does align to a number of other standards and guidance and invited to group to also advise on any wider alignment considerations required.

The Chair acknowledged that the topic of AI is large and not all elements will have been covered in today’s meeting. The Chair committed to bringing AI back as a regular agenda item.

Action: AI to be brought back as a regular agenda item.

Any other business and close

The Chair reflected that the discussions during this meeting, in particularly on AI, may lead to a revisit of the Terms of reference for the group because as the FDP itself moves into delivery mode, we might need to think about seeing the FDP into the wider context of how new tools and technology is applied across the NHS so will be brought back to next meeting.

The next meeting is due to take place on Friday 21 February 2025.

The Chair thanked all for their attendance and closed the meeting.