1. NHS Technology Funds: Strategic Investment to support integrated care Paul Rice Head of Technology Strategy NHS England 2 nd July 2014

2. Vision The Secretary of State vision is to achieve full integration of digital patient record across all care settings by 2018. We want local health and care services to use digital technology to ensure that vital, patient-related information is available at point of care, across all care settings. Better use of digital technologies will transform clinical effectiveness and outcomes and reduce the administrative burden on frontline staff; it will enable the integration of care around the person who is being treated; it will empower people to do more for themselves. 2

3. Care Settings – current digital care record position In primary care, digital records have now been implemented in the overwhelming majority of GP practices. However, NHS providers in hospitals and other settings, as well as Social Care providers are at different stages of digital maturity and many still have substantial work to do if they are to provide professional staff with the systems they need to access immediate and comprehensive health and care information 3 Out of HoursGP Urgent and Emergency care Urgent A&E Ambulance Mental Health Acute Community & Residential Care Social Care

4. A personal account 4

5. Those other lose threads The discharge “fax” The missed observations The tto’s/pain relief Scheduling aftercare 5

6. Local routemaps within a strategic framework 6  Paper to paper light to paperless progress  Some significant national infrastructure – spine – N3 – NHS mail that has made a massive contribution  Increasingly about permissive and flexible local solutions within a framework of assurance (standards, architecture, interoperability), governance and benefits realisation Paper based process dominate Some Paper based processes Digital integration within care settings Digital integration across any care setting

7. NHS England Role Management of the Tech Funds – to drive the overall Integrated Digital Care Record strategy and provide the framework to support strategic investment and ensure value for money. Assurance of local projects: progress to plan and benefits realisation Stimulating the market; influencing suppliers to provide a wider choice for local procurement- “boiler plate” procurement toolkits/market devt Commissioning technology and interoperability standards to enable integration (HSCIC) Working closely with DH and LGA colleagues to address key issues across the health and social care landscape. Developing Communities of Practice as a means of knowledge sharing, to signpost local organisations to examples of good practice and innovation. Supporting Accelerator and Pioneer sites to become exemplars for others. 7

8. Technology Funds – targeting strategic investment 8 Open to NHS organisations only. Match funding required. Safe, digital record keeping underpinned by NHS Number as primary identifier Integrated digital care records including information sharing within and between organisations Electronic prescribing and medicines mgt Tech Fund 1 Open to NHS organisations only Digital pens Mobile technology Systems for collection and logging of vital signs Nurse Tech Fund Open to NHS and Local Authorities. Match funding required. Digital care records Integrated digital care records Electronic prescribing Tech Fund 2 Ambition is to open up the second round to Voluntary, Community and Social Enterprise (VCSE) providers of nursing services commissioned by CCGs, Local authorities Defining 10 capabilities that release time to care and help modernise Nursing practice Nurse Tech Fund 2

9. Integrated digital care record programme 9

10. Accelerator sites – what it means Rapid Accelerators: demonstrate information sharing at a local health economy level across many organisations; the approach being taken to information sharing is both repeatable and scalable; are locally led and locally delivered but supported by NHS England both in terms of SHSW funding and also programme support; will work together to share expertise and knowledge; will be exemplars of good practice to other NHS Trusts wanting to develop integrated digital records across health and social care. 10

11. Cumbria Vision 3 related projects, cross cutting information sharing: MIG - The Medical Interoperability Gateway (MIG) is a messaging gateway to service providers which allows the exchanging of data between GP Practice Clinical Systems, (EMIS and Vision) and third party system suppliers e.g. Lorenzo, Adastra, Ascribe etc Strata Pathways – eReferral system which passes minimum required data set from referrer organisation to receiving organisation and matches demand to capacity/capability. An EPR that will provide a shared record across adult community care, mental health, children’s and specialist services. 11

12. Bristol Vision 3 projects related to Accelerator status: Connecting Care is the Bristol, North Somerset and South Gloucestershire programme that is delivering joined-up information to support local care pathways and improved patient care, through a ‘Portal’ (Orion). The Connecting Care programme has already successfully delivered the 1 st phase, which provides a shared record incorporating data from : GP systems (via the ‘MiG’ from Healthcare Gateway); RiO from Bristol, North Somerset and South Gloucestershire; PARIS in Bristol City Council; SWIFT in North Somerset Council; Cerner Millennium from NBT; Medway from UHB; Adastra for End of Life. Next phase includes: Adastra (OOH); Orders and Results NBT and UHB; Bristol CC referrals. EDM a system that will eliminate the historical paper record; Digital Dictation and Speech Recognition; enhanced clinical e-Handover functions; a shared, integrated Clinical System across all of our four Critical Care departments; and tools for sharing information with GPs. EPMA – co-development with KcKesson of a Medway EPMA module, led by Trust Clinicians. 12

13. Bradford & Airedale Vision A partnership approach across Bradford Care Trust, Bradford Council, Airedale Acute, Bradford Teaching Hospital and 3 CCGs to transform care across Bradford, Airedale, Wharfedale and dovetail with services delivered in Craven with North Yorkshire Council. Delivery of an Integrated Digital Care Record (IDCR) through a fully integrated software system (SystmOne). Accelerating the delivery of a common platform across the region allowing an IDCR to be created. The aim is to deliver the right care, in the right place, first time for local people facilitated by effectively sharing information across general practice, community nursing, therapy services, mental health, social work and intermediate and secondary care support services.. 13

14. Rapid accelerators/integration pioneers 14 “Integrated care records are the connective tissue of integrated care” Address Information Governance, Infrastructure and Standards Enhance the maturity models to include interoperability/continuity of care Support the Technology, the People and the Process