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Digital – A Key Enabler?Sue CookeGP IT Programme LeadNHS England

Michael CurtisSupplier Engagement Manager, NHS England

Lee HarrisonProject Officer, NHS England

9 June 2016

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Content:• Introductions /Key Aims for the session• Scene setting/national context

• Digital as an ‘enabler’• Supporting Mechanisms:

• Revised GP IT Operating Model • Prime Ministers GP Access Fund – learnings• Resources available

• Sharing progress to date/plans for the future• Reflection/feedback• Conclusion

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Introductions/Key Aims:• Digital Primary Care – what is our remit?

• Digital technology for GP transformation• Improving access for patients and citizens• Reducing bureaucracy across General Practice

• Key aims for today’s session:• How can digital….

• Improve patient care?• Improve ways of working/work life balance?

• Format Todays Session:• Presentation• Interactive session & feedback/reflections

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Key Policy Drivers

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General Practice Forward View –Digital Ambitions: What does this mean for practices?

Key Policy Drivers:

5YFV

Personalised Health and Care 2020

GPFV

Transforming General Practice

GPFV - Digital:

Paper Free at the Point of Care – EPS2, GP2GP, ERS, e-discharge

Access to clinical record point of care

Patient OnlineIncreased uptake –

Integrated Care / interoperability

E-consultation

Self care & Prevention

NHS England

GMSPMS

APMSGP Plus

National Frameworks/

Models

GPIT Operating

ModelGPSoC

CCG Practice Agreement

VanguardsNew Models

of care MCP/PACs

Standards/AssuranceCCG IAFMaturity

Assurance

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Standards and Assurance ControlsStandards

Central Technical Standards

Datasets – including core clinical record dataset

Standard Primary Care Provider Contract Requirements

Primary Care IT support Contract specification and KPIs

Accreditation Standards for Primary Care Clinical Systems

ISB Mandatory Standards

Assurance Controls

Digital Primary Care Systems Catalogue

Digital Primary Care Maturity Assurance

Information Governance Toolkit

Accreditation & Assurance for Primary Care Clinical Systems

Framework Contracts

Environment (Assurance)

Capabilities

Utilisation

Benefits (Future)

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Commissioner Responsibilities – digital?

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Commissioning Digital Services:Sources for commissioning of digital services - main determinant is the provider contract.

National Commissioner (NHS England)

Local Commissioner (CCG)

Vendor

Provider/Contractor

Citizen (patient) Value Chain

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Resources/Support Available:

Estates and Technology Transformation Fund (ETTF):

GPIT Funding Arrangements

Regional Digital support

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GP IT Operating Model 2014-16:Provides a supportive framework – effective GP IT services

• Recently revised:– Better align with changing

landscape/transformation– Increased local flexibility– Protect & improve ‘core’– Underpinning assurance mechanism

• Key Revisions– Funding Model Review– Schedule of services

• Core & Mandated• Enhanced & Transformational

– Digital Assurance Model

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Digital Maturity Assurance Model – Primary Care:

Investment in GP IT, GP Clinical Systems and National Digital Assets

Mandated (Contractual) Obligations for

GP IT

Improving Primary Care Efficiency and Effectiveness (incl. Access)

Transforming Primary Care

NHS England(National & Regions)

Assurance on use of central and delegated funds

Assurance on NHS obligations

Tracking strategic delivery and managing levers and incentives

Tracking strategic delivery and managing levers and incentives

CCGs Supports local accountability for use of GPIT funds

Supports discharge of local accountability for GPIT

> and supports CCG responsibility for GP service quality

> and support planning & delivery tracking of local digital roadmaps

General Practice

(Individual & Federations)

Assurance and clarification of expectations and delivery

Supports practice businesses inc. primary care At Scale and Access trends

Supports new care model development and engagement local digital investments

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The ModelA

ssur

ance

Maturity

Core GPIT & Mandated

Requirements

Enhanced Primary Care IT

Transformation in Primary Care IT

Efficiency Effectiveness Transformation

Poor VFM High Risk

Business as Usual

Transitional Transformational

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Data Flows:

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Digital Maturity Views

• The data can be cut in multiple ways in order to provide different views depending on individual need.

• This helps pinpoint data pertinent to different national programmes (e.g. GP2GP) and on national objectives (e.g. Paper-free at the point of care 2020).

For further information about the different functions and applications of the digital maturity assurance module, please sign up to our forthcoming webinars at:

Website link to upcoming webinars

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Sample Data

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Sample Data continued

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Prime Ministers GP Access Fund - Learning

Michael CurtisDigital Primary Care, NHS England

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This session:

• Digital Capabilities• Learning from the PM GP

Access Fund• Supporting the future

objectives• Short table exercise

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GP Forward View –Digital Ambitions: What does this mean for practices?

5YFV

Personalised Health and Care 2020

GPFV

Transforming General Practice

Paper Free at the Point of Care

Digital Medicines

Integrated Care

Elective care

Self care & Prevention

NHS England

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Drivers & TrendsPrimary care access

Primary care at-scale

Primary care in new models of care

Primary care widening scope (e.g. prevention, commissioning, provision)

Virtual primary care

Quality variations in primary care

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Key ChallengesPrimary Care

Ageing population

Increasingly complex patient diagnoses

Slower than required growth in numbers of healthcare professionals

Variations in outcomes

Changing user expectations

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Digital Basics

Access to patient data at the point of care eg GP accessing the medical record in patient home or care home setting

Interoperability to allow data sharing between health and care professionals eg clinical having access to the full medical record

Patient empowerment through the use of endorsed apps and other digital tools eg ‘fit bit’, diabetes monitoring/self care

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How do we Achieve the Vision?Prime Minister’s GP Access Fund – Seven Digital Capabilities

Patient records

Practice infrastructure

Consultation access

Online appointment booking

Online repeat prescriptions

Pre-referral diagnosis

Telehealth, telecare and health living apps

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How do we achieve the vision? Continued

Prime Minister’s GP Access Fund – Seven Digital Capabilities

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Current GP Services Offered Online

Online Appointment Booking

98.7 percent of practices offering

8.5 million patients signed up

12 percent of all appointments are available online

Online Repeat Prescriptions

97.4 percent of practices offering

8.3 million patients signed up

4 percent of all repeat prescriptions requested online

Online Access to Records

97 percent of practices offer patients online access to their Summary Care Record

AND 5 percent to their Detailed Care Record ??????

Over 6.6m people are registered for one or more of these services.

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The Roadmap

Primary care at scale

Interoperability through

standards and

open interfaces

Information governance, patient

consent, identity verification and

cybersecurity

Patient empowerment

Paper-free at the point of care

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Interoperability: Dot’s story

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What is happening locally?Looking at the Enhanced & Transformational areas & GPFV digital ambitions (on your table) and thinking through the key aims for this session:

1. Share what you are doing already – how far are you on that paperless 2020 vision/journey?2. What are you planning to do next?

a. How do you think the digital revolution could help improve the delivery of local services in GP?

b. What are the priorities locally – LDRs/STPs?c. Investment available – BUT what is needed practically on the ground?d. Which digital capabilities do you consider will have the greatest impact on your

practices?e. What key functions could digital technology deliver that will improve patient access to

services within your practices?

NB: Capture each of these points and we will have a quick round the room summary – pick out the key themes & golden threads that run through these – look at what could be needed for the future to inform?

f. Further revisions to the GP IT Operating Modelg. Development Digital Primary Care Maturity Assurance indicatorsh. Digital Transformation

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Feedback & Reflection• Key themes/trends:

• Improving patient care• Improving ways of working/work life balance

• What is needed to support this work further?

• Conclusion

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Get in Touch

england.digitalprimarycare@nhs.net

#PMGPAccess#DigitalPrimaryCare#FutureNHS

https://www.england.nhs.uk/digitaltechnology/info-revolution/digital-primary-care/