Digital Primary Care Congress: The Information Revolution

digital primary care congress event

Digital systems are the foundation upon which we will build a modern, efficient and responsive health service. Enabling information to flow between care providers within and beyond organisational boundaries, and between care providers and patients, is a key means by which we will achieve a safe, convenient and personalised health and care service.

Join us in February 2019 as we delve into the world of Digital Primary Care, our Digital Primary Care: The Information Revolution conference has been developed in partnership with NHS England and NHS Digital and will advise GP Surgery’s and Clinical Commissioning Groups on the current tools in place to help them harness technology and drive efficiency.

Events key tops:

  • Electronic Prescription Service (EPS)
  • GP2GP
  • GP Systems of Choice (GPSOC)
  • NHS Pathways
  • Summary Care Records (SCR)
  • Systems & Service Delivery
  • The GP IT Operating Model
  • Digital Primary Care Maturity Assurance model

How the Digital Primary Care Maturity Assurance Model can benefit General Practice:

  • Demonstrate progress against core GP IT services, as outlined in the GP IT Operating Model providing assurance that CCG’s are meeting the requirements of the GPIT Operating Model in the effective delivery of GP IT services
  • Identify areas for investment in GP IT services and digital innovations that supports delivery of primary care at scale, extended hours/7 days working and changing models of care
  • Baseline service provision enabled through technology against other general practices/localities to maximise efficiencies Support CQC assessment by providing insight into the use of digital technology within the practice, to help meet patient need and improve delivery of clinical services
  • Demonstrate progress against GMS/PMS/APMS digital requirements

How the Digital Primary Care Maturity Assurance Model can benefit CCGs:

  • Support the re-procurement of GP IT service provision via the Lead Provider Framework
  • Demonstrate progress against the digital requirements outlined within the CCG Improvement and Assessment Framework
  • Inform the development of Local Digital Roadmaps (LDRs) and Sustainability and Transformation Plans (STPs), helping identify areas for further investment
  • Enable comparison of digital maturity within Primary Care against secondary care, as highlighted in the Digital Maturity Index (DMI) assessment of secondary care

Places are limited for this event so don’t hesitate on getting your place booked today, we look forward to meeting you on the day.

2nd Healthcare Digital Technology Congress: Health systems for a global market

Doctor With Medical Healthcare Icon Interface

In November 2018 The Convenzis Group have developed a 1-day conference that will take a look at how the National Health Service is currently harnessing and adopting technology. The event will be shine a light on how technology can drive productivity and slash budget spend.

Events key topics:

  • The Global Digital Exemplars
  • Local Digital Roadmaps
  • Digital Maturity Assessments
  • GDPR Compliance
  • The New Clinical Digital Council / Role & Aims
  • 5 Year Forward View / Next Steps
  • Paper Free at the point of care

The Deputy Chair of the new Clinical Digital Council argues that for effective digital health services and systems to succeed across the NHS, we need agreed digital health standards which cover evidence, regulation and clinical safety:

The global market for digital health is expected to reach almost £43billion by 2018 and £408billion by 2025.

Health IT systems represent the largest market both globally and, in the UK, where they contribute 66 per cent of digital health sales. But the most promising market for growth is mobile health with sales of apps and wearables predicted to increase by 35 per cent in the UK by 2018.

Join us at our 2nd Healthcare Digital Technology Congress to gain first hand insight into the plans that have been set in place to ensure the NHS are driving towards being a world leader in harnessing healthcare technology, you will get the chance to listen, learn & engage with some of the most well followed and reputable speakers in the country.

We look forward to meeting you on the day.

Patient Flow: Health and Care Improvement for Urgent and Emergency Care Congress

urgent care event

In July 2018 we will be working in partnership with NHS England, NHS Digital and NHS clinical leaders network to bring you a 1 day conference that will focus on Patient flow and the current methods being implemented to help reduce the demand on urgent care departments across the UK.

Each year the NHS provides around 110 million urgent same-day patient contacts. Around 85 million of these are urgent GP appointments, and the rest are A&E or minor injuries-type visits. Some estimates suggest that between 1.5 and 3 million people who come to A&E each year could have their needs addressed in other parts of the urgent care system. They turn to A&E because it seems like the best or only option. The rising pressures on A&E services also stem from continued growth in levels of emergency admissions and from delayed transfers of care when patients are fit to leave hospital. Working with NHS England we are opening open up valued discussions between peers and demonstrating the great work that is already being done across the UK

What’s been achieved in England over the past three years?

  • Cared for 23 million A&E attendances in 2016/17, 1.2 million more than three years ago.
  • Boosted the capacity and capability of NHS 111, which now takes 15 million calls each year, up from 7.5 million three years ago.
  • Expanded “Hear and Treat” and “See and Treat” ambulance services so that they now cover 3.5 million people, with the provision of telephone advice and treatment of people in their homes saving needless trips to hospital.
  • Developed an integrated urgent care model, offering a single point of entry for urgent care via NHS 111, and rolled it out to 20% of the population.
  • Increased NHS staff uptake of winter flu vaccinations from 49% last year to 63% this year – the highest ever.

Our Urgent and Emergency Care conference for 2018 will be looking into improvements across the UK for access to immediate and urgent care. We are already working with NHS England, NHS Digital, British Medical Association and Health Education to name a few. This is a great opportunity for you and your organisation to hear from both public and private sector on how to adopt change

The event will give delegates the opportunity to listen, learn and engage with some of the UK’s most reputable speakers, it will also provide 4 hours of networking time and 8 CPD points for all attendees.

Healthcare Digital Technology Congress: Sustainable change for a better future

digital health congress 2018 manchester

In 2018 we are working in partnership with NHS England, NHS Digital and Health Education England to bring you a 1 day conference that will delve into the world of innovation and technology for the healthcare sector, the event will take place in ETC Venues, Central Manchester on the 26th of June 2018.

This event will provide delegates with a live opportunity to listen, learn and engage with some of the most reputable and well established thought leaders from across the UK healthcare sector, this years key topics will include: NHS reforms: know your STPs and CCGs, Relationship-building and working with the NHS, Commissioning and contracting, IT Change Programmes and Digital Public Health

This event is designed for anyone working in the NHS, public, private, academic and third sector who would like to gain a greater understanding of how the health and care system currently works and how it is changing. Join us for an informal day of learning and networking and find out the answers to questions you’ve always been afraid to ask.

What will you learn?

You’ll hear from some of the most senior policy shapers in the country on how the government and the NHS plan to build and sustain a fully integrated and digital healthcare system:

  • how the system works: how it is structured and how money flows
  • NHS reforms: know your STPs and CCGs
  • relationship-building and working with the NHS
  • what is happening in general practice
  • commissioning and contracting
  • the future of health and social care

NHS Digital’s 2017-18 Business Plan sets out a strategy to reform pretty much all aspects of healthcare. Areas include: Patient engagement, self-care and prevention, urgent and emergency care, digital transformation in general practice, social and integrated care, digital medicines, elective care, paper free at the point of care and public trust and security.

Our upcoming Healthcare Technology Congress: Sustainable change for a digital future conference will discuss each of the above topics. Working with NHS England the conference will offer delegates a first-hand look at the current plans in place to revolutionise the healthcare sector and also give open opportunity to network with policy driving speakers and innovative solution providers.

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NHS Confederation

The NHS Confederation is the only national body working to bring together the health sector and local leaders of growth.
Here, you can find various presentations, webinars and recordings by the NHS local growth adviser, and others, on this important agenda, as well as publications that can help you establish local relationships.

To discuss this in more detail, please email michael.wood@nhsconfed.org

Case studies

Humber Local Enterprise Partnership: Supporting the local health and social care workforce – an example of how Humber Local Enterprise Partnership is supporting its local STP’s workforce plans.

Webinars

Understanding the economic impact of the NHS in the Black Country – Discover why the Black Country sustainability and transformation partnership (STP) commissioned an economic assessment of the NHS’ contribution to the area and how local health and care leaders intend to use the findings to help the Black Country realise its potential.

Download briefings

Building a Britain for the future: Understanding the Industrial Strategy white paper – This briefing explains the Industrial Strategy’s aims and objectives, why it matters for the NHS and how the health service can play a part locally in, and thus benefit from, realising the strategy.

Local growth and the NHS: Building the foundations of a healthy economy – a useful summary of the policy context and the NHS’ role in this key agenda.

Shaping healthy cities and economies: The role of clinical commissioning – a report on how clinical commissioning can help realise full potential of local economies.

The NHS and local growth: Working to ensure a healthy economy – a briefing for local enterprise partnerships on why invest with the NHS.

The NHS’ role in realising every place’s potential: Helping you influence your local economy – a primer on why, and how, the NHS can influence local plans.

Unlocking the power of local: Reflections on the new place leadership – a collection of essays bringing together a selection of voices on new place leadership.

How to influence local enterprise partnerships – five top tips informed by briefings given to NHS HR Directors across England.

Read the latest commentary

Michael is a regular columnist for the Local Government Chronicle.

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Urgent and emergency care

Each year the NHS provides around 110 million urgent same-day patient contacts. Around 85 million of these are urgent GP appointments, and the rest are A&E or minor injuries-type visits. Some estimates suggest that between 1.5 and 3 million people who come to A&E each year could have their needs addressed in other parts of the urgent care system. They turn to A&E because it seems like the best or only option. The rising pressures on A&E services also stem from continued growth in levels of emergency admissions and from delayed transfers of care when patients are fit to leave hospital.

Frontline staff have pulled out all the stops, but over this past winter there have been real difficulties. In providing nine out of ten patients with A&E care within four hours over the past year, the UK offers our patients the fastest national A&E treatment of any major industrialised country. However, in recent years the proportion of patients looked after within 4 hours has been falling – caused by rising demand in A&E departments, with the fragmented nature of out-of-hospital services unable to offer patients adequate alternatives; the need to adopt good practice in hospitals consistently; and difficulties in discharging inpatients when they are ready to go home. So we need to take action to improve services for patients and reduce pressure on our staff.

What’s been achieved in England over the past three years?

  • Cared for 23 million A&E attendances in 2016/17, 1.2 million more than three years ago.
  • Boosted the capacity and capability of NHS 111, which now takes 15 million calls each year, up from 7.5 million three years ago.
  • Expanded “Hear and Treat” and “See and Treat” ambulance services so that they now cover 3.5 million people, with the provision of telephone advice and treatment of people in their homes saving needless trips to hospital.
  • Developed an integrated urgent care model, offering a single point of entry for urgent care via NHS 111, and rolled it out to 20% of the population.
  • Increased NHS staff uptake of winter flu vaccinations from 49% last year to 63% this year – the highest ever.

Key deliverables for 2017/18 and 2018/19

Trusts and CCGs will be required to meet the Government’s 2017/18 mandate to the NHS that: 1) in or before September 2017 over 90% of emergency patients are treated, admitted or transferred within 4 hours – up from 85% currently; 2) the majority of trusts meet the 95% standard in March 2018; and 3) the NHS overall returns to the 95% standard within the course of 2018. In order to do so:

  • Every hospital must have comprehensive front-door clinical streaming by October 2017, so that A&E departments are free to care for the sickest patients, including older people.
  • By October 2017 every hospital and its local health and social care partners must have adopted good practice to enable appropriate patient flow, including better and more timely hand-offs between their A&E clinicians and acute physicians, ‘discharge to assess’, ‘trusted assessor’ arrangements, streamlined continuing healthcare processes, and seven day discharge capabilities.
  • Hospitals, primary and community care and local councils should also work together to ensure people are not stuck in hospital while waiting for delayed community health and social care. They need to:
    • ensure that the extra £1 billion provided by the Chancellor for investment in adult social care in the March budget is used in part to reduce delayed transfers of care, thereby helping to free up 2000-3000 acute hospital beds – the equivalent of opening 5 new hospitals – and regularly publish the progress being made in this regard (22).
    • ensure that 85% of all assessments for continuing health care funding take place out of hospital in the community setting, by March 2018.
    • Implement the High Impact Change Model (23) for reducing DTOCs, developed by the Local Government Association, the Association of Directors of Adult Social Care Services, NHS Improvement and NHS England.
  • Specialist mental health care in A&Es: 74 24-hour ‘core 24’ mental health teams, covering five times more A&Es by March 2019, than now. The service will be available in more than a quarter of acute hospitals by March 2018 and reach nearly half by March 2019, compared with under one-in-ten today.
  • Enhance NHS 111 by increasing from 22% to 30%+ the proportion of 111 calls receiving clinical assessment by March 2018, so that only patients who genuinely need to attend A&E or use the ambulance service are advised to do this. GP out of hours and 111 services will increasingly be combined. By 2019, NHS 111 will be able to book people into urgent face to face appointments where this is needed.
  • NHS 111 online will start during 2017, allowing people to enter specific symptoms and receive tailored advice on management.
  • Roll out evening and weekend GP appointments, to 50% of the public by March 2018 and 100% by March 2019.
  • Strengthen support to care homes to ensure they have direct access to clinical advice, including appropriate on-site assessment.
  • Roll-out of standardised new ‘Urgent Treatment Centres’ which will open 12 hours a day, seven days a week, integrated with local urgent care services. They offer patients who do not need hospital accident and emergency care, treatment by clinicians with access to diagnostic facilities that will usually include an X-ray machine. We anticipate around 150 designated UTCs, offering appointments that are bookable through 111 as well as GP referral, will be treating patients by Spring 2018.
  • Working closely with the Association of Ambulance Chief Executives and the College of Paramedics, implement the recommendations of the Ambulance Response Programme by October 2017, putting an end to long waits not covered by response targets. Actions taken will be subject to the results of evaluation and approval from Ministers.

How changes will be implemented

  • £100 million in capital funding will be provided to support modifications to A&Es to enable clinical streaming by October 2017.
  • Clearer local performance incentives. Previous standard contract fines have been dropped. From April 2017 the rules governing the performance element of the £1.8 billion Sustainability and Transformation Fund (STF) for acute trusts that relates to A&E will be amended in agreement with Department of Health and HM Treasury (24).
  • Aligned national programme management. To ensure complete alignment between NHS England and NHS Improvement in supporting and overseeing urgent implementation of the above actions, we have appointed a single national leader accountable to both NHS England and NHS Improvement. We will also bring together the work of NHS Improvement’s and NHS England’s national urgent and emergency care teams. From 1stApril 2017 a single, named Regional Director drawn from either NHS Improvement or NHS England will hold to account both CCGs and trusts in each STP area for the delivery of the local urgent care plan. Each RD will therefore act with the delegated authority of both NHS Improvement and NHS England in respect of urgent and emergency care.
  • Broader improvement support. Building on the work of the Emergency Care Improvement Programme and the regional teams of NHS England and NHS Improvement, we will offer a broader range of improvement support to frontline staff to achieve the priorities set out above. This will include extending to emergency care both the Getting it Right First Time Programme and the Model Hospital, together with joint work with the Royal College of Emergency Medicine and other professional bodies on workforce and a more standardised clinical operating model.
  • Detail on the technology changes to support these approaches is included in Chapter Nine.
  • The NHS 111 workforce is being developed to deliver these changes and to provide them with the career structure and support they need to thrive.

Urgent Care

Article source: NHS England

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Harnessing technology and innovation

Harnessing technology and innovation

The major work programmes mapped out in this Plan are underpinned by an agreed, costed and phased NHS technology plan, building on the recommendations of the Wachter review. It will simplify patient access to care, in the most appropriate location, while supporting people in managing their own health. Specifically, during the coming two years we will implement solutions that:

  • Make it easier for patients to access urgent care online.
  • Enable 111 to resolve more problems for patients without telling them to go to A&E or their GP.
  • Simplify and improve the online appointment booking process for hospitals.
  • Make patients’ medical information available to the right clinicians wherever they are.
  • Increase the use of apps to help people manage their own health.

Helping people manage their own health

The way that people use services has changed over the past ten years, often expecting to have the option of accessing services online or by telephone. Over the next two years the NHS will make very significant steps towards increasing how its services can be accessed online, whilst remembering that healthcare is about people and that many patients want and need the reassurance of a real person to talk to face to face.

The NHS has led the world for ten years with its health and care website “NHS Choices” which provides comprehensive and trusted advice on conditions and services. In 2016 there were more than 1.5 million visits per day of NHS Choices; over 550 million through the year. Progress has also been made in enabling patients to access their GP record online:  95% of GPs offer online appointment booking, repeat prescriptions and access to their summary care record.  10.4 million people are now registered for online services with 1.9 million repeat prescriptions ordered online in February 2017, 1.1 million appointments managed online and 1 million views of patient records in the same period.

  • NHS apps. In Spring 2017 we will launch the NHS Digital Apps Library with the initial offer including at least 20 apps with categories for Mental Health and Diabetes. This will comprise three tiers of application – ‘NHS approved’ apps which have a published evidence base, assessed by a process developed with NICE, demonstrating that they can help a person manage and improve their health; ‘NHS connected’ apps which means that they have been tested and approved for connection to NHS systems, allowing you to download information from NHS systems into the app; and ‘Health apps’ which will be directory of other health applications which you may choose to use. From April 2017, developers will have the ability to self-assess themselves against NHS criteria, such as where they store your data and whether they sell or use your data for other purposes. The ‘NHS connected’ category will become vibrant during 2017 and 2018 as we make it easier for app developers to connect to NHS data sources.
  • Support for children’s health. From April 2017 parents in London will have access to their children’s health record through the online “red book”.
  • Personal online access. By September 2017 we will have upgraded NHS Choices to become NHS.UK, which will offer a more personalised and tailored experience. It will then be possible for patients to book appointments and access their personal health record through NHS.UK.
  • Free wifi in GP surgeries. Building on the success of the NHS wifi early adopter stage, which commenced in January 2017 and saw us roll out free wifi for patients and professionals across approximately 1,000 surgeries, the wider rollout to the remainder of GP surgeries over the next year, subject to HM Treasury approval, will help encourage the uptake of online health services.

Digitising hospitals

While the NHS leads the world in the use of IT in primary care, the adoption of information technology in the acute, community and mental health sectors lags behind. In 2015, NHS England conducted a survey of information technology adoption, known as the Digital Maturity Assessment.  From this we are able to see the best, the worst and the large number in the middle. In September 2016 we announced the first 12 Global Digital Exemplar acute trusts and since then we have announced four more.

Global Digital Exemplars. These organisations are the most advanced IT hospitals in the NHS and have committed to work to become world class exemplars for the rest of the NHS to learn from.  Their task is not only to become great, but to work with other acute trusts to develop a blueprint that can be deployed to other hospitals, reducing the time and cost for further adoption. Our intention is that, in the future, hospitals won’t merely choose an IT vendor, they will choose a hospital that they want to partner with and implement the same system, keeping the IT  80% the same and making only the 20% of changes that are absolutely necessary to meet local needs.  Subject to HM Treasury capital approvals, the first Acute GDEs are:

  • Alder Hey Children’s NHS Foundation Trust
  • Cambridge University Hospitals NHS Foundation Trust
  • City Hospitals Sunderland NHS Foundation Trust
  • Imperial College Healthcare NHS Trust with Chelsea and Westminster NHS Foundation Trust
  • Luton and Dunstable University Hospital NHS Foundation Trust
  • Newcastle upon Tyne Hospitals NHS Foundation Trust
  • Oxford University Hospitals NHS Foundation Trust
  • Royal Free London NHS Foundation Trust
  • Royal Liverpool and Broadgreen University Hospitals NHS Trust
  • Salford Royal NHS Foundation Trust
  • Taunton and Somerset NHS Foundation Trust
  • University Hospital Southampton NHS Foundation Trust
  • University Hospitals Birmingham NHS Foundation Trust
  • University Hospitals Bristol NHS Foundation Trust
  • West Suffolk Hospitals NHS Foundation Trust
  • Wirral University Teaching Hospital NHS Foundation Trust

In order to spread the learning and ensure that the blueprints really are suitable for other hospitals, the GDEs will be partnered with “fast followers” who will work with the GDEs during their implementation and begin deploying the blueprints elsewhere in parallel.  The GDEs are currently identifying their “fast follower” sites, and these will be confirmed over the coming quarter.

Over the past few months we have also conducted a search for Mental Health digital exemplars. Subject to HM Treasury capital approvals, successful organisations will be:

  • Berkshire Healthcare NHS Foundation Trust
  • Birmingham and Solihull Mental Health NHS Foundation Trust
  • Mersey Care NHS Foundation Trust
  • Northumberland, Tyne and Wear NHS Foundation Trust
  • Oxford Health NHS Foundation Trust
  • South London and Maudsley NHS Foundation Trust
  • Worcestershire Health and Care NHS Trust

NHS Digital Academy. By September 2017 we will launch a new academy to train a new generation of Chief Information Officers and Chief Clinical Information Officers. By increasing the skills to align information technology with business and clinical needs we will increase the chances of successful adoption of new information technology and its use to drive quality and efficiency.

Technology to support the NHS priorities

Urgent and Emergency Care

  • NHS 111 Online. Throughout 2017 we will be working to design online triage services that enable patients to enter their symptoms and receive tailored advice or a call back from a healthcare professional, according to their needs. We will be testing apps, web tools and interactive avatars in local areas and using detailed evaluation to define the best approach. By December 2017 all areas will have an NHS 111 online digital service available that will connect patients to their Integrated Urgent Care via NHS 111.
  • NHS 111 Telephone: Clinical decision support systems are well used throughout the health system. They have supported our ambulance services and urgent care services for many decades. The developments in technology mean these systems are improving exponentially – becoming more personalised and intelligent and able to process more data in real time. From summer 2017 we will be developing and testing new specialist modules of clinical triage for Paediatrics, Mental Health and Frailty and demonstrating the impact of risk stratification. By March 2019 an enhanced triage will be available across integrated Urgent Care, with the potential to also support Urgent Treatment Centres, Care homes and Ambulance services.
  • To ensure that patients get the right care in the most appropriate location, it is also important that clinicians can access a patient’s clinical record. By December 2017 every A&E, Urgent Treatment Centre and ePrescribing pharmacy will have access to extended patient data either through the Summary Care record or local care record sharing services.  We will also have access to primary care records, mental health crisis and end of life plan information available in 40% of A&Es and UTCs.
  • By December 2018 there will be a clear system in place across all STPs for booking appointments at particular GP practices and accessing records from NHS 111, A&Es and UTCs supported by improved technology APIs and clear standards.
  • During 2017 we will begin the work with vendors to seamlessly route electronic prescriptions from NHS 111 and GP Out of Hours to pharmacies via the Electronic Prescription Service (EPS). This will speed up the supply of medicines, and significantly reduce the time and cost involved.

Elective access and unwarranted variation

Analysis of activity across the NHS shows very large variations in the number of patients being referred to hospital outpatients, being followed up repeatedly in outpatients and receiving elective operations.  These variations cannot be explained by differences in health need and are often present between different GPs in the same area and different doctors in the same hospital. Patient and clinician time is wasted on repeating tasks because the information collected by another clinician is not available, and straightforward tasks that could be undertaken by many patients online are still done by clinical staff.

  • By summer of 2017 GPs will be able electronically to seek advice and guidance from a hospital specialist without the patient needing an outpatient appointment.
  • In the summer 2017 an updated online patient appointment system will be launched, providing patients with the ability to book their first outpatient appointment with access to waiting time information on a smartphone, tablet or computer. Alerts will advise patients which hospitals have longer waits so that that they can avoid these hospitals if they wish.
  • The NHS e-Referral Service is currently used by patients to arrange just over half of all referrals into consultant-led first outpatient appointments. By October 2018 all referrals will be made via this route, improving patients’ experience and offering real financial and efficiency benefits.

Digital contribution to research

The ability to collect, aggregate and analyse the data generated by the NHS is not only critical to delivering the triple aims of healthcare, but also underpins the NHS and wider life sciences research strategies. Interoperability will be key to successfully making use of NHS data to support the life sciences research strategy.

Innovation for future care improvement

The UK has a world-leading life sciences industry which is both a magnet for investment and an engine for economic growth – enhancing productivity, driving healthcare innovation and employing over 220,000 people across the regions of the UK. Many important healthcare technologies – from vaccines to MRI scanners – have been nurtured by our strong science base and universities, innovative culture and leading healthcare system.

Over the past year alone:

  • NHS England agreed to commission nationally 33 ground-breaking new treatments, including auditory brainstem implants for people with profound hearing loss; microprocessor controlled prosthetic knees for people with lower limb loss; and Ivacaftor for young children with cystic fibrosis.
  • A new Innovation and Technology Tariff (ITT) aims from April 2017 to expedite uptake and spread of innovation across the NHS. The first six innovations will mean 160,000 patients eligible to benefit. These products include those that reduce obstetric anal sphincter injuries as a result of episiotomies; reduce incidence of ventilated associated pneumonia which causes between 3,000 and 6,000 deaths every year; and provide effective treatment for clostridium difficile without the use of antibiotics.
  • We have also established a national Clinical Entrepreneurs Programme, and the NHS Innovation Accelerator which has supported adoption of innovations that at least 390 organisations are now using.
  • 13 new NHS Genomic Medicine Centres have been established across the country to collect samples, engage patients and family members in the programme to establish the infrastructure needed to make genomic medicine a routine part of NHS care. These centres have collected over 25,000 cancer and rare disease samples. Over 20,000 whole human genomes have been sequenced. By sequencing the genomes in these samples not only can we better understand these diseases, we can also target specific treatments on the patients who will benefit most from them.
  • PHE has supported ground-breaking research which has led to a new technique for sequencing the genome of the bacteria that causes tuberculosis. This technique will enable faster and more targeted treatment of people with TB. Speedy diagnosis will also help scientists detect and respond to potential outbreaks as they happen. This matters since the UK still has one of the highest rates of infection in Europe.
  • The NHS has invested in the Small Business Research Initiative Programme to support 80 small and medium enterprises.

For 2017/18 and 2018/19 the NHS will take further steps to enhance our global position:

  • Begin the roll out of new treatments funded by NHS England’s specialised commissioning, including mechanical thrombectomy treatment for stroke.
  • NHS England will publish an Implementation Plan setting out its delivery contribution to the UK Strategy for Rare Diseases in 2017/18.
  • Expand the NHS’s genomics capability, collecting 50,000 samples in 2017/18 rising to 90,000 in 2018/19. By the end of the 2018 calendar year, 100,000 whole human genomes will have been sequenced. By the end of 2018/19, we will also have developed a genomic medicine service for England, underpinned by a new consolidated genomic laboratory infrastructure and facilitated by informatics, data and analytical platforms to enable the sequencing data we generate to improve clinical practice.
  • Create a more fertile environment for clinical trials by enhancing the Health Research Authority, harmonising approval and recruitment processes, and streamlining bureaucracy including through the use of digital tools.
  • One of the unique features of the NHS is the central role of general practice and this creates valuable opportunities to study ‘longitudinal’ data. NHS England and MHRA increased the number of GP practices registered on the Clinical Research Practice Data Link system (CPRD) by 25% in 2016/17 and in 2017/18 we will recruit an additional 1800-2000 practices to CPRD.
  • In 2017/18, the NHS Innovation Accelerator will select another round of innovations that address the population challenges prioritised by STPs.
  • Academic Health Science Networks and ‘test beds’ will take collective responsibility for driving national adoption of proven innovations, in line with the Accelerated Access Review.
  • The NHS’s international reputation has already led to major agreements with China, the Middle East and Latin America over the last few years, helping put money back into the NHS and UK economy and strengthening our investment in R&D. Healthcare UK (the export organisation for the UK’s health and care sector) has helped health sector organisations win over £5 billion worth of contracts over the last three years. Healthcare UK aim to grow our exports by around 15% per annum to 2020.

More generally, under the banner of the government’s Industrial Strategy, the life sciences sector deal will bring government and the NHS together with industry and charities to create new jobs and economic growth across the UK as well as aiming to improve care for NHS patients. The NHS is a key contributor and a committed partner to providing an environment where technologies can be developed and tested, and used to transform services to improve outcomes and reduce cost. This opportunity sits alongside further strengthening of the science base and clinical trials capability and the creation of an environment which enables small biotech and medtech companies to thrive and grow, and enhancement of our medicines manufacturing capabilities.

As medicine transforms over the next 20 years, the cutting-edge technology in our Universities combined with the NHS presents unique conditions to create new industries, companies and jobs based in the UK and transform the way innovation is delivered to patients, offering an attractive place to research and test new treatments in partnership with innovators. Potential areas include artificial intelligence, the application of genomics to medicine, the development of a range of new diagnostic tools, and therapies for conditions that will enable more healthy aging.

Article Source: NHS England

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Raising the standard in digital health

The Deputy Chair of the new Clinical Digital Council argues that for effective digital health services and systems to succeed across the NHS improving patient care, we need agreed digital health standards which cover evidence, regulation and clinical safety:

The global market for digital health is expected to reach almost £43billion by 2018 and £408billion by 2025.

Health IT systems represent the largest market both globally and in the UK, where they contribute 66 per cent of digital health sales. But the most promising market for growth is mobile health with sales of apps and wearables predicted to increase by 35 per cent in the UK by 2018.

With the increasing value of these markets comes increased focus on the policy around health IT systems and interoperability. This is key to enabling safe and effective data exchange, but unfortunately we have discovered a lack of interoperability with digital health tools such as devices, wearables and integrated apps which need to be addressed.

What has become clear is that the market has pushed on ahead in creating high cost health IT systems, with little focus on building application programming interfaces (APIs) or allowing smaller digital health players to integrate clinically effective tools into those larger electronic health records and IT systems.

In order to address this nationally, it is clear that a standard of what is ‘good’ needs to be developed and adopted. This would allow developers to create tools and products that not only impact clinical care and improve patient outcomes, but that can also connect to and talk to other clinical systems being used within the NHS.

As part of the NHS Five Year Forward View and Next Steps, a common standard across regulators, NICE, Public Health England and other central NHS bodies to review digital health tools was developed. However, in the fast changing world of digital health, it was clear that a cross stakeholder group was needed to maintain this standard and to ensure it changed accordingly with technology developments and advancements.

A group was also needed to address emerging questions around what amounts to good evidence in the digital health space, impacts of real world data, and how we change the narrative of healthcare delivery in the digital age. And while technology in healthcare does not yet truly make intelligent decisions independently, with the pace of change it is clear we need to address these questions now.

To help address these, under the leadership of the outgoing Chief Clinical Information Officer (CCIO), Professor Keith McNeill, the Clinical Digital Council (CDC) was set up at the end of 2017. Its membership includes senior clinical digital health leaders from across the arm’s length bodies – currently the MHRA, NICE, Care Quality Commission, Public Health England, NHS England, NHS Digital and the Department of Health.

The goal of the CDC is to ensure issues affecting digital health policy are raised in the right environment, and it acts as an advisory body to the governance and delivery groups informing the Digital Delivery Board – the governing body which decides NHS technology spending. It is a clinically-led forum for informed discussions and sharing of standards and policies relating to digital health and clinical implementation.

The CDC meets every other month under the chairmanship of the CCIO for health and care and is managed by me, as deputy chair.

Our focus this year is to:

  • Publish a digital health standard with a focus on evidence, regulation and clinical safety. This will inform the wider Health Standards and NHS Digital Service Standards Manual and procurement frameworks;
  • Create a common understanding of what is good evidence with respect to digital health, and use of real world data and trials to inform effectiveness of a product or tool;
  • Explore the challenges of machine learning and intelligent technology to policy and regulation, with an aim to creating a policy framework.

For more information on the CDC contact me at indra.joshi@nhs.net. You can also see our recently published roadmap for patient-facing digital services at www.nhs.uk/transformation

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Digital Primary Care

Digital systems are the foundation upon which we will build a modern, efficient and responsive health service. Enabling information to flow between care providers within and beyond organisational boundaries, and between care providers and patients, is a key means by which we will achieve a safe, convenient and personalised health and care service.GP IT systems sit at the heart of primary care technology facilitating and recording millions of interactions with patients every week. GP practices have led the way in the move from paper to digital record-keeping and are now well on the way to offering online transactions, such as appointment bookings and repeat prescriptions, across all practices in England. By April 2015, all practices will offer online access for patients to elements of their GP-held records.

In a challenging financial environment, IT services must not only improve the quality of care through enhancing the patients’ experience of services, but also enable the practice to realise efficiency benefits such as a reduced administrative burden. Building on the solid foundations which are already in place in primary care, NHS England will support practices to develop IT functionality which responds to the evolving needs of patients and underpins integration across care pathways.

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Urgent treatment centres

Urgent treatment centres will be GP-led, open at least 12 hours a day, every day, and be equipped to diagnose and deal with many of the most common ailments people attend A&E for.

Urgent treatment centres will ease the pressure on hospitals, leaving other parts of the system free to treat the most serious cases. The urgent treatment centre offer will result in decreased attendance at A&E, or, in co-located services, the opportunity for streaming at the front door. All urgent treatment centre services will be considered Type 3 / 4 A&E and will contribute to the 4 hour access and waiting times target locally.

Why change?

The patient always comes first, and as outlined in ‘Next Steps’ the NHS’ aim over the next two years is to provide patients with the most appropriate care in the right place, at the right time.

The reasons for this are simple. We all know where to go when life is in danger – A&E. But estimates suggest up to 3 million people who come to A&E each year could have their needs addressed elsewhere in the urgent care system, but patients tell us that the range of alternatives available can be confusing – Walk In Centres, Urgent Care Centres, Minor Injury Units and others with local names and all with differing levels of service. So A&E is understandably the default choice for many people unsure where to turn when they need urgent care or advice.

This is bad for the NHS because it puts unnecessary pressure on A&E and other parts of the urgent and emergency care system, and it’s bad for patients because many are treated in the wrong setting.

So we are introducing new urgent treatment centres, which will standardise this confusing range of options and simplify the system so patients know where to go and have clarity of which services are on offer where.

What’s happening?

The NHS will roll out around 150 urgent treatment centres by December this year and by December 2019 all services designated as urgent treatment centres will meet the guidelines we have now issued.

We have now published the guidance local areas need to get started on setting up new urgent treatment centres. The next step is for Commissioners, supported by NHS England regions, to review current provision against guidelines and make a plan for each facility. Where locally appropriate plans will be subject to consultation so the views of patients and the public will be heard.

View some of the frequently asked questions to support implementation.

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