Kay Chand and Clare Auty are partners at Law Practice Browne Jacobson. Here they discuss how Integrated Care Boards need to be prepared to ensure adequate integration across systems to meet the needs of patients.
As we know, every area in England now has an Integrated care System (ICS) which are to be governed by Integrated Care Partnerships (ICPs) and Integrated Care Boards (ICBs), being bodies to be created under the Health and Care Bill expected to be passed and become legislation on 1 July 2022. There are many changes being proposed under the Bill which will shake up the health and social care sector including ICBs to succeed sustainability and transformation plans and replace the functions of Clinical Commissioning Groups (CCGs) including those in respect of the provision, processing and sharing of patient and service information.
Clare Auty, Partner at Browne Jacobson
Introducing digitisation in healthcare post-COVID-19
Underpinning the success of ICBs will be digitisation. Digitisation is not new within health and social care. Plans have been afoot for many years to introduce greater innovation and tech within our health and social care services to meet patient demands, improve outcomes and to ensure we remain competitive on a global scale in respect of knowledge of health and social tech and care. The pandemic has taught us that the importance of digitisation cannot be underestimated. When the pandemic began, almost overnight there was a huge surge in the demand for remote care in general practice and General Practitioners had to quickly update their websites and implement technology to hold online consultations to meet the increased patient needs in the new and unexpected world in which we found ourselves. The pandemic has undoubtedly accelerated the adoption of technology in the sector. During and “post” pandemic we have seen an increased demand for health-tech such as remote monitoring services and virtual wards.
In order to achieve a seamless health and social care service and serve communities as envisaged by the Bill, it is clear that integration and implementation of the IT systems that underpin all parts of the system is vital. This will not be an easy task for many reasons, some which are not just related to the technology itself. Stakeholder buy in will be key to the success of the Government’s ambitions and one of its biggest stakeholders is the public. We have already seen a pause on NHS Digital’s General Practice Data for Planning and Research Programme. This underpins one of the key ambitions of the Health and Care Bill namely to centralise data for purposes such as research and analytics.
NHSX’s role will be integral in ensuring ICSs (and in turn ICBs) reach a baseline level of digital maturity including digitised health records, cyber security skills and connectivity.
NHSX’s “What Good Looks Like Framework” aims to provide smart foundations for digitisation of secondary care providers and ICSs. ICSs will be required to reconsider their digital and data transformation plans with a holistic approach and ensure such plans provide a roadmap to ensure that the outputs meet the foundations of the “What Good Looks Like Framework”.
Kay Chand, Partner at Browne Jacobson
By improving healthcare with digitisation and technology, ICBs can meet their objectives
The Framework has 7 success measures:
1. Well led – a clear strategy for digital transformation and collaboration. ICSs owning and driving the digital transformation journey. ICBs building digital and data expertise in their leadership and governance arrangements and ensuring delivery of the system-wide digital and data strategy.
2. Ensure smart foundations – digital, data and infrastructure environments which are reliable, modern, secure, sustainable and resilient.
3. Safe practice – incorporate standards for safe care, as set out by the Digital Technology Assessment Criteria for health and social care.
4. Support people – a digitally literate workforce who are able to work optimally with data and technology. Digital and data tools and systems are fit for purpose and support staff to do their jobs well.
5. Empower citizens - citizens are at the centre of service design and have access to a standard set of digital services that suit all literacy and digital inclusion needs. Citizens can access and contribute to their healthcare information, taking an active role in their health and well-being.
6. Improve care - embeds digital and data within their improvement capability to transform care pathways, reduce unwarranted variation and improve health and wellbeing. Digital solutions enhance services for patients and ensure that they get the right care when they need it and in the right place across the whole ICS.
7. Healthy populations - uses data to design and deliver improvements to population health and wellbeing, making best use of collective resources. Insights from data are used to improve outcomes and address health inequalities.
A lot of due diligence and discovery work has already been undertaken to understand how and where digitisation can be used effectively within an ICS but further work needs to be carried out on what systems are to be procured and how they are to be implemented and integrated. Only through successful implementation and integration can ICBs meet their objectives.
The procurement, implementation and integration approaches will be critical in ensuring systems are able to connect with one another and ensure the exchange of data. This will need to span across health and social care and public and private organisations within each ICS and consideration will need to be given how such procurement, implementation and integration will be funded.
The reality is that this will not happen overnight and ICBs need to be prepared to play the long game, ensuring procurement is carried out on an IT by design basis, to ensure adequate integration across systems resulting in efficiencies in meeting patient needs.