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The NHS long-term plan presents a clear strategic role for digital technology, and is ambitious, both in its timeframe for change and its scope. Whereas previous plans acknowledge the role of digital technology as important, analogous to an ‘in-law’, in the latest policy, digital and care delivery are in a deep and meaningful relationship, which is key in achieving the ambitions to transform and leverage primary care, enable self-care and deliver services closer to patients’ homes. Gareth Dellenty, consulting partner at Channel 3 Consulting, explores.
With this in mind, digital strategies need developing now so that organisations can build the capacity, skills and funds to transform and deliver services. But where should this strategy work take place?
Sustainability and Transformation Partnerships (STP) or Integrated Care Systems (ICS) sit above the regional footprint and are well placed to initiate top-down programmes of work.
However, when it comes to digital strategy development, there is a different, and arguably better, role for ICS/STPs to play in guiding the wider health economy, leaving place-level organisations, such as Integrated Care Partnerships (ICPs), to rise to the design and delivery of the digital challenge.
Integrated Care Partnerships (ICPs) – the regional bodies within a broader STP footprint – sit above day to day commissioning and delivery led by CCGs and providers, but are more local in their focus than STPs.
The priorities for a digital strategy must be influenced by the digital maturity of NHS organisations and their patients, the dynamics of the local economy and local population needs, all of which vary considerably across the country.
A one size fits all approach will not work when strategic programmes trickle down to place and provider, which is why developing digital strategies at an ICP level first makes a lot of sense.
ICPs often have an intimate understanding of local needs, capabilities and initiatives already underway and can design digitally-enabled services to fit their patient cohorts.
An app designed to support long term conditions is likely to be of less relevance in an urban centre with a high student population. Likewise, understanding levels of digital aptitude and access in rural communities will help to determine whether a digital inclusion programme is needed to ensure health inequalities are not widened.
Being smaller in nature and closer to local capabilities, ICPs are more agile and able to nurture innovation. As such, they can provide STPs with an ideal test bed for new ideas.
Digital innovation in the NHS comes on top of an already overwhelming day job and can be hampered by the legacy of failed projects. Engaging with stakeholders at place level, who are more directly involved with healthcare delivery, helps to drive a bottom-up strategy based on needs and practical, workable solutions.
Clinicians may also be more willing to engage in developing a locally-focused strategy, where there is a greater chance of being heard and change being implemented. Moreover, place based digital strategies can provide regional balance where traditionally a major city within the STP footprint may have largely led the way.
Does this mean that STPs and ICSs are off the hook? Not at all. There is a crucial, high level strategic role for these bodies to fulfil.
STPs are ideally placed to set the overarching vision for the health economy, provide true strategic guidance and funding to support the development of new commissioning structures to aid the implementation of new models of care.
This would include providing a vision and direction for the role of digital at STP level, with a defined set of standards or principles that everyone should strive to adhere to.
STPs are also well positioned to identify commonality in terms of needs, strength, capability, capacity and weaknesses across their ICPs, to facilitate cross pollination of initiatives that are working well and take steps to end failing projects or those that cannot be expanded beyond local silos.
Based on the successes and challenges we’ve already seen, there is an opportunity to rethink the strategy development hierarchy.
STPs have the potential to empower those closer to local populations to come up with trailblazing solutions which could lay the groundwork for the transformative regional and national digitisation that we urgently need.
Gareth Dellenty is a consulting partner at Channel 3 Consulting