Delivering digital services to support integrated care systems

by Will Smart

Today we stand at a moment of important change and challenge in the NHS. We are facing significant operational challenges with growing demand for services because of the COVID pandemic; a workforce that is exhausted faces the winter’s challenges. At the same time, through the Health and Care Bill, we are putting Integrated Care Systems on a statutory footing while creating their organisational structures and leadership teams.

At the heart of these changes is a focus on integrating care at a local level and delivering services that improve the health of our local populations. The Health and Care Bill introduces a duty to cooperate between NHS organisations, with a mandate to integrate care between health and social care settings, signalled in the recent Building Back Better paper.

Other healthcare systems worldwide are facing the same challenges in meeting the triple aim for care – improving outcomes, improving the experience of care for patients and being more productive. They are similarly grappling with the challenges of integrating their healthcare systems, delivering responsive care in the face of a once in a century pandemic. It is, at least, comforting to know that we are not alone in facing these challenges.

We also hold in common with other systems the need to better implement digital solutions to support the transformation of our health and care systems. Like every other industry, healthcare faces three digital imperatives:

  • ensuring that our core digital infrastructure (the digital plumbing and wiring) is secure and capable of supporting the digital services for our patients;
  • the transformation of our clinical and business systems to be able to support working digitally within and across care settings; and
  • rethinking how we digitally support service delivery by creating person-centred solutions, removing unwarranted variation in care delivery to achieve the triple aim.

Like other health systems, the pandemic has increased focus on digital services to support both staff and patients. The pandemic has demonstrated that we can deliver digitally enabled change at pace, safely, and positively impact the service. Having established our ability to execute, now is the time to define our new digital care models and implement digital architectures to deliver. We must move our thinking beyond the EPR, which is at heart organisation-centred, and Shared Care Records that often provide passive views of patient data, to the creation of a digitally connected, always-on, health ecosystem that reaches beyond NHS institutions and that supports the individual to manage and maintain their own health and take control of their care.


About Will Smart

Will is Dedalus’ Global Director for External Relations.  Within Dedalus, Will is accountable for managing relationships with external analysts and managing Dedalus’ Global Advisory Board.

Prior to Dedalus, Will was Chief Information Officer for Health and Social Care in England.  A joint appointment between the Department for Health and Social Care, NHS England and NHS Improvement.

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