New digital excellence regions could be based on STPs

HSJ understands planning is underway for new digital exemplars that cover geographical areas rather than individual trusts. Like the previous exemplars, the placed based versions will be expected to provide a blueprint for other areas to work together digitally.

One source familiar with the process said suppliers and NHS “localities” were already forming consortiums to bid to be the new exemplars, with four or five areas likely to be selected.

The news emerges after NHS England asked academic health science networks to develop ways to measure “placed based” digital maturity, as opposed to that of individual providers.

Barring a drastic change in policy after the general election, a formal announcement about placed based exemplars is expected in the next 3-6 months, HSJ understands.

In response to questions from HSJ, NHS England said it would not “speculate at this time” about future exemplars.

Placed based exemplars would follow the 23 exemplar trusts already announced, comprising 16 acute and seven mental health providers.

Based on the recommendations of Professor Robert Wachter’s review of NHS IT, NHS England’s flagship digital programme focuses digital funding on the most digitally advanced NHS trusts, elevating them to “global exemplar” status. In theory, these exemplars would then provide a range of digital “blueprints” for other, less advanced, trust to follow.

The Next Steps on the NHS Five Year Forward View, published in March, made this requirement more explicit, saying that “fast follower” trusts should replicate 80 per cent of the same IT systems used by a chosen exemplar.

HSJ understands understand some exemplar trusts have selected the first of the follower trusts, and NHS England is currently vetting the nominated trusts.

The move to placed based exemplars is also in line with the priorities outlined in Next Steps, which describes removing “traditional barriers” between providers through more cooperative “place based health and care systems” based around an STP or ACS.

However, regional exemplars would have to wait for central funding behind the exemplar trusts and possibly the fast followers. HSJ understands that acute exemplars, which have each been promised up to £10m in central funding, and their mental health counterparts that will receive up to £5m each, have yet to receive the money. HSJ reported last month that funding for the 16 acute exemplars has been approved by the Treasury.

Meanwhile, NHS England has commissioned academic health science networks, led by Oxford, to develop “place based” digital maturity assessments. The work started in April and will finish in early autumn.

Last year, NHS England asked trusts to self-assess their digital maturity based on readiness, capabilities and enabling infrastructure. This was used to create an index of all trusts, which was then one of the criteria used to select exemplars.

However, an NHS England spokesman said the new assessments were not related to the digital exemplar programmes. Instead they would be a “learning resource to support local improvement”.

Liz Mear, chair of the National AHSN Network, confirmed that the 15 AHSNs had been asked to collaborate in developing ways to measure digital maturity across health and care systems.

She said: “The objective is to produce something useful for STPs that will help them understand how mature they are in their use of digital technologies to support their priorities, and help them develop their enabling digital strategies.”

Mike Denis, information strategy director at Oxford AHSN, said place based digital assessments were “not to support allocation of national funding” or national benchmarking.

“It is intended to be a tool to help local systems develop their long term strategies, including developing new models of care and prioritising their local investment,” he added.

Previous provider based digital maturity assessments would “compliment” the place based assessments, but the latter would be broader, considering the “whole local health and care system rather than the sum of the parts”, Mr Denis said. “Places” could cover an STP or other groupings such as vanguards or test beds.

The reviews would focus on joined up care delivery, integration, population health and prevention, he said.

Several STPs and AHSNs were already developing an assessment process, as were NHS learning networks such as Connected Health Cities in the North.

STPs are already expected to outline how they will use digital technology to transform care through their plans and local digital roadmaps.