Harnessing digital to deliver system ambitions

NHS Providers and NHS Confederation has launched a new support programme to help digitisation within Integrated Care Systems. In a piece for Digital Health, the organisation’s interim chief executive, Saffron Cordery, and NHS Confederation’s chief executive, Matthew Taylor, explore how digital can help deliver ICS ambitions. 

This autumn, leaders of the new integrated care boards (ICBs) will be convening, often for the first time. These boards are still “forming and norming”, establishing relationships, discussing their approaches to risk and laying the groundwork for effective governance and decision making.

As unitary boards, they must balance the immediate operational challenges facing their systems alongside the longer-term strategic aims. Central to these discussions will be the ICB’s four core purposes: improving health outcomes, tackling inequalities, enhancing productivity and value for money, and helping the NHS support broader social and economic development.

Clear understanding of the opportunities 

Embracing digital technology and associated ways of working will be fundamental to achieving change and enabling ICBs to achieve their core purposes. ICB leaders must therefore have a clear understanding of the conditions for successful digital transformation along with the confidence – and capability – to harness these new opportunities. Evidence from provider trusts – as well as learning from other sectors – suggests this requires board buy-in and ownership of the agenda, rather than delegating all things digital to a chief information officer.

And when it comes to digital, the task for the ICB is to add genuine value to the work already underway in the ICS’s partnership organisations. ICBs have important system convener roles, ensuring that all parts are pulling in the same direction. So, when it comes to digital, as well as agreeing a system-wide strategy, ICBs will need to set the overall culture and tone, ask the right questions and understand the challenges and complexities of digital tools and systems operating across their patch.

Knowing what to expect

With this in mind, NHS Providers and NHS Confederation, in partnership with Public Digital and with the support of Health Education England, is launching our new support programme: ‘Digital ICS: harnessing digital to deliver system ambitions’. As part of our programme for ICB leaders, we will be offering free bespoke board development sessions, peer learning events and quarterly insights reports that share the learning and emerging good practice from across the sector.

To inform this work, we spoke with several ICB leaders about the challenges they expect to face and the choices they will need to make.

These included:

• Achieving consistent maturity across the ICS: with different organisations at different starting points, ICBs are having to map out digital maturity across the system. From there, ICBs are faced with the difficult decision of where to focus their energy and resources: is the priority to ensure those furthest behind can catch up? Or does this risk stalling the development of those already advanced?
• Interoperability: both within and outside of the NHS, getting different IT systems, organisations and people to exchange information and share data can appear a daunting task. But improving interoperability leads to better and safer patient care. It is also fundamental to managing risk: a lack of interoperability can create frictions within a system.
• Resourcing: across the NHS, leaders are struggling to recruit and retain the right digital and data skills, in part because of an inability to compete with other sectors. And unlike other parts of the NHS, they’re often starting from scratch when it comes to building new teams.

Encouragingly however, we’ve heard how some ICBs are already beginning to address these challenges through collaboration. First steps for some ICBs include attending the different digital forums that exist within partner organisations, or agreeing a shared information governance protocol. This is helping the ICBs and their partners better understand each other.

We also heard about more extensive collaboration. For example, one ICB has begun to pool the different digital teams across the system into a single digital ICS team that will remain organisationally agnostic but focus on the system’s digital priorities.

The ambition for many will be to turn early ‘transactional collaboration’ into changes that will begin to address system-wide operational pressures. For example, in one ICS, we heard how the local authority has been working with the community provider to deliver e-observations which is helping alleviate some of the pressures in social care.

The role of the board

Throughout this, the board’s role will be to ensure digital is an integral part of the ICB’s strategy. It will need to align priorities across the system, empower digital leaders and their teams to deliver and ensure that system partners, including trusts, are clearly sighted on how ICBs are advancing and enabling this progress.

Our new programme builds on the success of NHS Provider’s Digital Boards offer for NHS trusts, which has now engaged over 1,800 trust board members. It also builds on the work of the NHS Confederation’s Integrated Care Systems Network which provides a range of support for ICB and ICP leaders, non-executive directors and their executive teams.

Our board sessions for ICBs will be bespoke to ensure they are based in the reality facing each system and its leaders.

We will draw on learning from across the NHS and other sectors to stimulate debate, provide challenge and agree next steps, including how we can tailor further support to meet the digital challenges facing each ICB.

We are excited to be working with our partners to deliver this offer for system leaders. ICBs face an exceptionally busy period, and we will remain sensitive to the operational pressures in the sector. We know different people will be at different starting points on the digital agenda. But we remain committed to supporting the development of collective board ownership so that digital is a key enabler for the ICS’s immediate and long term ambitions.