STPs released with big digital price tag

The Birmingham and Solihull area will expand its shared care record to cover 1.8 million people within nine months if it manages to secure central funding through its sustainability and transformation plan.

Two of the 44 STPs that health and care communities have been asked to draw up to take forward the ‘Five Year Forward View’ plan to close a £30 billion funding gap across the NHS by 2020-21 were published on Monday.

Both are asking for serious investment from central government, with North Central London claiming it needs £180m for its digital projects alone.

Each STP will outline how its area plans to transform the delivery of health and social care.

The STPs are also the main vehicle through which local health and social care organisations can gain access to central funding to help met this goal.

NHS England has asked STP areas to hold off publication until the STPs have been reviewed by a range of arms length bodies and received communications advice. But two local councils have gone ahead and published anyway.

In the Birmingham and Solihull STP footprint, digital solutions are one of four key enablers in closing the gap between demand and funding, along with selling and upgrading estates and a reshuffle of governance and leadership.

Specifically, the area wants to expand its shared care record – Your Care Connected – from covering half a million patients at four acute hospitals to all 1.8 million people within the footprint.

Other digital initiatives include:

* A footprint wide data sharing platform, with full consultation, information governance agreement, testing and deployment completed within two years.

* Citywide wi-fi available with “digital signs” installed with two years.

*  A structured data transfer system within 12 months.

* Moving to an integrated universal patient administration system.

These projects all require additional funding to get off the ground, something NHS England has already warned will be in short supply.

The STP document says key challenges to the enabling digital transformation include a lack of funding, both for digital solution and the overall STP, and a lack of clarity about when and how funding will be made available.

With more than 700 IT systems running over the footprint, forging overarching interoperable link while still servicing individual organisation needs was also seen as a potential hurdle.

However, the cost of failing to transform the area, either digitally or more broadly, are stark.

The STP says if nothing changes, the footprint will need 430 hospital beds equating to roughly another new hospital in five years, leading to an overall system funding shortfall of an estimated £721 million.

“We must therefore change the way work together to improve care, quality and reduce the need for large scale funding increases.”

North Central London also published its STP on Monday, laying out its plans for closing a projected £876 million deficit by 2020-21.

The London STP as singled out digital solutions as a key enabler but says this part of STP will cost £159 million, with a further £21 million in 2020-21, alone.

It is assumed this money will come from central funding, specifically pots the STP refers to as the Estates and Technology Transformation Fund and “Digital Transformation Fund”.

“We recognise that further work is needed to develop full business cases for the above, and at present these figures are estimated – particularly in relation to primary care and digital investment.”

The STP wants to provide patients with access to digital transaction services, including a personal health record to allow them to “actively manage their own

health and wellbeing”.

The STP also wants to create a “seamless” shared care records across health and social care, and create new “population health management system”.

“Through this system we will move from a landscape of diversity and variation to one of shared principles, consolidation and joint working for the benefit of the population.”

The STPs had to be submitted to NHS England, NHS Improvement, the Care Quality Commission and other bodies by last Friday.

At a recent health select committee hearing, NHS England chief executive Simon Stevens said some might be published shortly, but others would need “more input” from the centre and might not emerge until next year.