Digital key to future success

by Seamus Ward

17 May 2022

A robust digital infrastructure is essential if the NHS is to address its challenges, including tackling inequalities, enhancing outcomes, and improving value for money, the HFMA Delivering value through digital technologies conference heard.

sonia patel lSonia Patel (pictured), NHS England and NHS Improvement system chief information officer and director of levelling up, told the online conference that the service must ensure access to four data assets, covering care (clinical information), workforce, estates and equipment, and finance data.

To support the use of data and drive efficiencies, she said the NHS has three pieces of guidance, two of which are published and the other in development.

The first document – the What good looks like framework – sets out success measures for every frontline system and organisation. ‘The document was designed not just to be the technical guide for chief information officers but very much to empower frontline leaders on the board, including our finance leaders,’ she said.

The second piece of guidance is Who pays for what proposals, giving clarity on responsibility for funding.

‘We’re very good at putting new stuff in, and not so good at considering the ongoing monetary effects of digital and data, in particular. The guidance set out the first stepping stone, but there’s a lot more work to do on who pays for what.’

Ms Patel told the conference – organised as part of the HFMA Delivering value with digital technologies programme – that the third, as yet unpublished, guidance will clarify which services are likely to be delivered or supported nationally, regionally and locally. Underpinning this, there is work on unifying the data architecture, which will support the strategic and operational needs of health and care.

Interoperability will be important, and she hoped the formation of integrated care systems (ICSs) would lead to a simplification of the digital landscape – for example, ICSs running no more than one finance system or only one or two electronic patient record systems.

‘Only once we’ve simplified do we have a chance to advance some of things we’re not using in health and care but have been used in other industries,’ she said. This could include artificial intelligence, robotics and genomics, which are still developing in the NHS.

The HFMA and its members could help the digital agenda, for example by supporting strategic costing of digital transformation. She had three requests on working together in the future.

‘We really need to work together to find sustainable financial solutions for digital and tech. We have started to have those conversations, but too often we put quite a lot of good investment in, and run and maintain isn’t thought through in terms of upkeep.

‘I feel we shouldn’t be in three- to five-year cycles where we need to secure national funding just for the upkeep of kit. We need to find sustainable solutions locally in the way gas and electric as utilities just work.’

Her second request was a plea for collaboration to provide clarity and consistency on the treatment of capital and revenue in digital development. Thirdly, she said work was needed to ensure digital is seen as a value asset. ‘We’ve never really seen digital and data as assets; we’ve seen them as cost pressures. How do we see and treat digital as value and how do we use that in terms of determining the ongoing value of that asset?