Organisation objective
- NHS Long Term Plan
Working with people and communities:
What approaches have been used to ensure people and communities have informed this programme of work?
- Recruited Patient and Public Voice (PPV) Partners
- Consultation / engagement
- Qualitative data and insight, for example, national surveys; complaints
- Quantitative data and insight, for example national surveys
- Partnership working with voluntary, community and social enterprise organisations
Executive summary
This report summarises the progress in delivering several of NHS England’s priorities to transform the NHS through digital, data, innovation, improvement and research. Delivery of these objectives have resulted in tangible improvements which benefit people, patients, communities, staff and researchers.
The paper demonstrates the benefits of resolving the fragmented and uneven technology and data capability in the NHS prior to the COVID-19 pandemic. It shows the value of the merger of NHS Digital and NHS England into a single national body which is leading the development of a technology enabled, data driven, integrated health system in which science and innovation truly transform people’s lives.
Action required
The Board is asked to note the information provided in the report.
Current state of the portfolio
1. NHS England is making tangible progress towards delivering the national vision for digital technologies, data, innovation, research and life sciences.
2. The future state architecture for digital and data in the NHS is based on five foundational layers on which digital delivery and transformation can be achieved:
- Digitalised health and care records to capture all care events on a patient’s journey.
- Shared care records to place the relevant information about a person’s care history in the hands of all clinicians and patients when they need it to provide safer consistent care.
- A Federated data platform to transform the way we use data to improve operational processes, providing effective tools for our staff to aid collaboration across health and care teams and improving flow of care pathways for patients.
- Research Secure Data Environments to provide secure access to anonymised data for research and innovation, enabling patients and people to gain faster access for innovative treatments (medicines, med-tech, bio-tech, AI, vaccines and pharmacogenomics).
- The NHS App to provide “mobile first” capability which enables citizens to access, navigate and interact with health and care services, support themselves through digitally enabled prevention and early intervention and to access new and more convenient models of care.
Significant achievements
Digitised health and care records
3. The Frontline Digitisation programme achieved the target for 90% of trusts to have adopted electronic patient record systems on schedule. This is an important move away from paper records, meaning staff have up to date and accurate information at the point of care in a digital format.
4. Evidence from EPR implementations over the last seven years shows that introducing EPRs led to a 3.5 percentage point reduction in average sepsis mortality for surgical inpatients. In previous studies, acute providers in the top decile of digital capability have a 13.4 per cent lower cost for admitted patient spells.
5. NHS England has to date invested over £400 million to support 150 NHS trusts to implement their first EPR, or to optimise, extend or replace their existing EPR. 189 trusts now have these modern record systems, with Hillingdon Hospitals and Sheffield Health and Social Care NHS Trusts the latest to go live.
6. As part of delivering the Urgent and Emergency Care Recovery Plan, we have also installed digital smart system control systems which support integrated care systems to use data to respond to emerging challenges, deploy ambulances during surge pressures, optimise discharge or identify hospitals that need extra support.
Modernising Primary Care
7. The Modernising Primary Care team is working with 885 practices and as of December 2023, 599 (68%) have signed contracts with a supplier, which includes 66 practices that are now live with a cloud based telephony system in support of the move of practices from analogue to digital telephony. This activity forms part of NHS England’s Primary Care Access Recovery Plan.
Federated Data Platform
8. The Federated Data Platform (FDP) and Associated Services contract was awarded in November 2023 to a consortium of providers. The FDP is software that will sit across NHS trusts and integrated care systems (ICSs) allowing them to connect data they already hold in a secure and safe environment where they need to work together to provide patient care.
9. Pilots show that this type of software can help local teams better prioritise waiting lists, manage theatre capacity and identify their staffing needs. It has helped local health and care teams to understand the health of the people in their community and personalise prevention and treatment services to better support them. It makes it easier to see where critical supplies are, how much is available, and where there are shortages. It reduces the reporting burden on frontline staff.
10. A separate contract was awarded for privacy enhancing technologies. Following a highly complex procurement, this service will now enter delivery through Q4 and into the 2024/25 financial year and beyond, delivering significant productivity and other benefits to Trusts, building on those seen in the pilot sites.
NHS App
11. As of December 2023, 33.6 million adults in England have downloaded the NHS App, ahead of the March 2024 target, meaning over 75% of adults in England have the App in their pocket. Between December 2022 and November 2023 monthly logins to the NHS App rose by 53% from 14.8m in December 2022 up to 25.8m logins in November 2023.
12. Significant achievements include:
- NHS App messaging is now available for 97% of GP Practices. Over 52 million messages were sent via the NHS App in 2023. 33 million of these messages were sent between October – December 2023.
- Appointments for COVID-19 and flu vaccines are now available on the NHS App. At the end of November 2023, 24% of appointments had been booked via the NHS App.
- Prospective GP record access has increased from 15 practices in November 2022 up to 5205 practices in January 2024. 24m people with online accounts in England now have prospective record access (where their GP has granted access).
- A total of 3.1 million repeat prescriptions were ordered in December 2023, an increase of 44% since December 2022 (2.2 million).
- A new feature is being added to the app which allows patients to generate a barcode for one-off prescriptions that can then be shown at any pharmacy for collection without the need for a paper prescription.
- 111 Online is now available to 100% of fully verified users on the NHS App.
- 4 million secondary care appointments were viewed and managed via the NHS App in December 2023, approximately three-fold increase since December 2022.
13. There are slides which give additional detail on the delivery of the improved functionality of the NHS App.
NHS IMPACT
14. If we are to fully realise the benefits of technology, data and innovation, the NHS needs to be able to improve and change its clinical and operational processes. In April 2023 we established NHS IMPACT (Improving Patient Care Together) and the National Improvement Board to support organisations, systems and providers, including NHS England, to deliver continuous improvements in quality, safety, staff experience and productivity and to share best practice and learn from one another. The National Improvement Board published the Baseline for Improvement an initial ‘needs assessment’ enabling the systems and providers to identify areas of existing capability. The Baseline for Improvement is complimentary to the NHS IMPACT self-assessment which is a developmental tool for organisations and systems to use to assess their current position against the five components of NHS IMPACT and to frame their improvement development plans.
Data for research and development
15. An overarching ambition within the Life Sciences Vision was to “unleash the potential of the UK’s health data to make the UK the best place in the world to undertake ground-breaking R&D”.
16. Patients are receiving faster more personalised treatment that meets their needs through the NHS Research Secure Data Environment (SDE) Network – for example, through large-scale deployment of predictive AI models validated by approved researchers in the London SDE. The NHS England SDE is providing better access to more researchers and life science companies. Eight organisations are currently onboarded, of which three are commercial. These eight organisations cover 284 users and 55 research projects. AI is one of the biggest opportunities to transform care for the better, which is why we are investing in research and deployment of safe, effective and ethical AI with 17 AI studies already underway in the NHS Research SDE Network.
Artificial intelligence (AI)
17. The joint DHSC and NHS England AI Lab and our national programmes are delivering on our mission through programmes such as:
- AI in Health and Care Awards: This is a grant funding programme which has awarded over £123m to a total of 86 organisations to develop, trial and evaluate AI products most likely to meet the aims set out in the NHS Long Term Plan.
- AI ethics Initiative: The AI Ethics Initiative supports research and practical interventions that could strengthen the ethical adoption of AI-driven technologies in health and care, as well as ensuring that uptake of AI does not exacerbate health inequalities.
- AI Regulations: The AI Lab has funded several regulatory projects aimed at creating and robust and streamlined regulatory system.
- Supporting the roll out of AI across stroke networks: use of AI decision support has risen from 5% of stroke units in 2019 to 90% in August 2023.
- The trialling of AI diagnostic support tools for dermatology.
- Supporting the £21m AI Diagnostic Fund (AIDF).
- Launching and implementing the AI Deployment Platform (AIDP) across two imaging networks.
Health technology adoption and accelerator fund
18. Integrated care systems were awarded bids for a £30m Health Technology Adoption and Accelerator Fund for innovations such as remote monitoring devices and point of care tests to support the care of patients at home.
NHS DigiTrials
19. NHS DigiTrials enabled 1 million people to sign up to a research study which aims to recruit 5 million people with at least 700,000 participants recruited through the NHS App. A focus on recruiting volunteers from ethnic minorities and more deprived communities has opened up research opportunities to the largest ever number of volunteers from more deprived backgrounds and ethnic minority groups of any UK health research programme.
Public deliberation and dialogue
20. We know that public support is crucial to ensuring the UK reaps the benefits of the transformative potential of data. Our #PoweredByNHS data campaign has completed a successful pilot, showcasing the ways that secure use of data transforms research and leads to positive, real-world outcomes. 1 in 10 people in England have viewed at least one of the campaign videos all the way through. There is some evidence to highlight public support for specific uses of data, such as for direct care, but continued dialogue with the public as we take forward specific data programmes and policy changes and programmes is key. Our productive relationship with the National Data Guardian, and the advice and challenge that she and other stakeholders provide, is helpful in ensuring that we are taking the correct approach to public engagement.
21. We have announced up to £2 million of funding to deliver large-scale deliberative public engagement over 2024 and 2025, during which members of the public will be involved in shaping how the NHS uses their health data to improve patient care.
Nationally provided capabilities
22. NHS England is responsible for running the vital national IT systems which support health and social care, and the collection, analysis, publication and dissemination of data generated by health and social care services to improve outcomes for patients.
Digital Registration Service
23. 2,249 GP Practices are using the digital registration service, exceeding the national target of 2,000 GPs by December 2023. Over 640,000 patients have used the service. Practices have reported increased list sizes and data shows increased registrations from patient groups that we traditionally find it difficult to provide services to.
Data capabilities
24. 91% of Trusts are now submitting data to the Faster Data Flows system. This will reduce the administrative burden on providers by improving the way data is submitted to commissioners.
NHS Spine
25. The NHS Spine supports the IT infrastructure for health and social care in England, and is now running fully on the cloud leading to a 50% improvement in performance.
Next steps
26. The formal establishment of ICSs last year provides further opportunity to make the most of the investment into transformed community mental health services and within this to strengthen the role of VCSE organisations as key strategic and delivery partners.
27. CMH transformation has shown VCSE organisations to be crucial partners, able to support ICSs to achieve each of the ‘ten principles for how ICSs work with people and communities’ set out in NHS England’s guidance on establishing ICSs published in September 2011; local CMH transformation is precisely the kind of change programme that ICBs and their new integrated governance will be able to deliver on, supported by Integrated Care Partnerships.
28. There is more to do to ensure all areas are fully realising the opportunity and investing in VCSE organisations. We expect to see significant expansion in access to transformed models of care in the final year of the LTP; however, transformation will need to continue beyond 2023/24 to continue to reduce the historical treatment gap for adults with SMI.
29. NHS England will continue to promote and share good practice in this area, encouraging systems to invest a greater proportion of funding in VCSE as well as to recognise the VCSE’s contribution as strategic partners.
30. The Board’s continued support and championing of this work will be important as we continue to improve services and help ICSs to meet their full potential over the coming years.