Fresh Out Of The Box
Birmingham and Solihull STP: The first STP to be published says Birmingham has done well in consolidating its hospital services and investing in social care “to help people live independently for as long as it is possible for them to do so.”
However, it says it needs to tackle poverty, because “nearly half our population lives in the poorest areas of the country” and “are more likely to have a mental health problem or die from a condition that can be supported.” It says the area needs to invest in GP and community services and innovation, which will not just improve efficiency but “change things for the better.”
Digital: The Birmingham and Solihull STP devotes an appendix to ‘digital’ as an enabler of its plans. This says “digital has the ability to rapidly transform the way in which health and social care is delivered” and “the way in which citizens and patients interact with care and public health services.”
The appendix says the local digital roadmap sets out three ‘priority areas’, which it lists as “digital maturity” [improving hospital EPRs so staff can work without paper notes], “paper free information flow between organisations” and “inclusion of patients, carers and citizens in the use of digital technology”.
Birmingham and Solihull already has projects to build on. These include the ‘Your Care Connected’ shared care record, which the STP wants to reach 1.8 million people within nine months, and an electronic document transfer project, which it wants to turn into a structured data sharing platform.
The STP also says it wants “patients and citizens to access information through websites, apps… and [technology to] support self-management and prevention.” It identifies funding and information governance as challenges to achieving its vision.
North Central London STP: The second STP published says the area has “some excellent health and social care services” but also some areas of “poor practice.”
To address this, it wants to consolidate specialist and hospital services, while “shifting our model of care so that more people are cared for out of hospital settings”. The STP also wants to shift attention from caring for people when they are ill to making more effort to keep them well.
Digital: The STP identifies digital as a key enabler of its plans, arguing that there is “a significant and immediate opportunity for digital to transform our current delivery models and seed completely new, integrated models of health and social care.”
A digital section indicates that the area’s local digital roadmap identifies a need for improved IT at its hospitals but, more ambitiously, lays out plans for a population health management system.
It says this would deliver better data or “insight”, which is needed to predict future demand, create new patient pathways, and ‘risk stratify’ the population [work out who is most at risk of a hospital admission, so they can be cared for in the community].
It would also support ‘integrated’ health and social care. The STP says it wants “seamless” shared care records, as well as a personal health record for patients, backed up by remote monitoring and self-care tools, so they can “actively manage their own health and wellbeing.”
These ambitions come with a big price tag. North Central London says that “to deliver on our digital strategy we will need to invest £159 million, with a further £21 million in 2020-21.” It says this money will need to come from central pots, such as the estates and technology transformation fund, which was set up to transform GP and primary care.