NHS England getting set to launch Local Integrated Care Record Exemplars

NHS England is getting set to issue invitations to apply to become one of five expected new integrated care record exemplars.

The official call for invitations are expected to take place in January and will focus on accelerating integrated care records projects that directly support patient care and care coordination.   

Like the previous hospital and mental health global digital exemplar (GDE) programmes, the focus be on those with existing relatively mature record sharing programmes.

Briefing materials seen by Digital Health News indicate the initiative has been re-named the Local Integrated Care Record Exemplar (LICRE) programme will initially focus on developing integrated care records to provide longitudinal care records and care coordination.  They will then be extended to provide the foundations for population health management and regional research databases.

Up to five LICRE pilots will be selected each serving populations of 3-5 million, providing shared records which directly support patient care. The pilots will be expected to build on existing local integrated care record initiatives and deliver a “comprehensive local longitudinal record”.

Invitations to become LICRE exemplars will be issued to ‘collaborations” of local NHS and care organisations, with the Sustainability and Transformation Plans, Accountable Care Systems, and Academic Health Science Networks expected to play a leading role.

Successful LICRE’s will be expected to “build on successful local initiatives where strong professional and public engagement”, be able to demonstrate trust and “delivery at a local level”, as well as “using standards to operate at a national scale”.

The emphasis is on “achieving individual patient care benefits first, with research building on this later”, and having “transparent implementation of opt-out decisions”.

NHS England briefing materials obtained by Digital Health News state that initial invitations to participate will be issued by January, with responses expected back by February and announcements on exemplars by March 2018.

An NHS England spokesperson said in a statement: “We expect the invitations for Local Health and Care Records to be issued in the coming months,” and confirmed “The Local Health and Care Records will focus on individual care.”

The spokesperson declined to confirm the link between local integrated records and regional research hubs, stating: “There will be further conversations about research as the programme develops.  the focus, however, is on individual care.”

A regional, placed-based shared-records exemplar programme has been expected for over a year, with an initial target-based architecture for regional record sharing published by NHS England in November 2016.

NHS England says the LICRE pilots will “co-create key standards and blueprints” for the “wider spread of local integrated care records to deliver a carpet of interconnected local integrated care record solutions covering the country”.

The guidance says the five new integrated care record exemplars, with local information governance and consent mechanisms, will subsequently be used to support population health management and research.

Three of the five will be selected for further investment to become research-focused Digital Innovation Hubs (DIHs), drawing on LICRE sites and national data sets.  The shared record exemplars “will facilitate making data available to the Digital Innovation Hubs while respecting opt-out decisions”.

Crucially, the proposals state: “the Digital Innovation Hubs will have the ability to access data from across the country from these local integrated care records and also national datasets…”

NHS England briefing materials seen by Digital Health News say the focus of the joint programmes will be first on “individual care benefits first” with research to follow afterwards.

Subject to business case approval it is planned to announce the three DIH sites in summer 2018.

The first Digital Innovation Hub, building on Local Integrated Care Record Exemplar, is planned to be live by April 2019.

Digital Health News understands that the Secretary of State Jeremy Hunt gave the initial go ahead to the LICRE and DIH plans last Monday, following presentations from NHS England CIO Will Smart.

The concept of Digital Innovation Hubs was first set out by Hunt in September at the NHS Innovation Expo in Manchester.

There is a high degree of sensitivity about the DIHs potentially being seen to be successors to the ill-fated national Care.data research database initiative, ended in 2015.

NHS England’s guidance states the DIH programme “seeks to work with well-developed programmes to go further and faster. It’s not ‘just another source of funding’.”

It adds: “Localities with strong research and life sciences eco-systems will clearly be strong candidates for DIHs.”

Updated at 16.50 on 18.12.17 to include statement from NHS England.