Most Integrated Care Systems are struggling to reach digital maturity. Learning from the best could help them catch up, write Catherine Davies of the Digital Healthcare Council, and Alyson Scurfield of TEC Services Association

Embracing digital transformation offers us an opportunity for improved patient outcomes, greater efficiency, and a sustainable future for the nation’s health and care services. But to achieve widespread adoption, Integrated Care Systems (ICSs) need to take a leading role in driving the implementation of digital innovations.

ICSs and the partners they bring together should champion the adoption of digital technologies through both short and long-term planning

NHS England revealed recently that it has given each ICS a rating for the digital maturity of its providers. With ratings out of five, the report highlights some ICSs that are doing well and some that are still establishing themselves. Only three of the 42 ICSs in England scored over three out of five, with the rest struggling with poor results.

While this is a valuable snapshot of current progress, it is also useful to examine the longer-term plans.

Analysis reveals good examples

To understand ICSs’ priorities and plans, the Digital Healthcare Council and the TEC Services Association have worked together to review systems’ overall strategies, Joint Forward Plans (JFPs), and digital strategies. We have analysed how digital technologies are tackling operational challenges, integrating health and care services, and personalising care.

Our evaluation shows significant variation. Almost all (93%) systems include digital in their integrated care strategies in addition to shared care records, which is a nationally mandated priority.

While there are still many gaps in the plans, we’ve identified some systems with clear commitments to digital health and care. Amongst these systems we’ve found good examples which could be helpful for others to learn from.

  1. Set measurable targets
    In the digital section of their JFP, Sussex Integrated Care Board (ICB) has set specific data and digital targets over years one and two. These targets set out what it will do, what it aims to achieve and when.For example, the ICB’s JFP highlights that by March 2024, it will have rolled out extended digital services including virtual care, self-referral platforms and enhanced digital primary care services – allowing people better access to the care they need. This target-led approach encourages accountability, ensures key services and sets expectations for stakeholders. This is not widely done across other JFPs.
  2. Focus on digital transformation to address key operational challenges
    Many ICSs discuss the pressures they are facing across their services. This includes workforce shortages, lack of capacity (access to beds, GP appointments) and backlogs for diagnostics, elective care, and cancer services. Some systems identify digital technologies as a solution to these pressures.For example, Cheshire and Merseyside ICS’s digital strategy explains how increased use of accredited apps for mental and physical health support will support the elective recovery of its services.Cambridgeshire and Peterborough ICS also outlines plans to use Virtual Wards to improve patient flow (and experience), as well as using technology enabled care to help people access care in their own homes.
  3. View digital technology as an integral part of overall plans
    While a comprehensive digital strategy is to be encouraged, it works best as part of an overall strategic plan, rather than a separate workstream. Technology can help ICBs facilitate collaborative working with system partners.Greater Manchester ICS has taken a joined-up approach, creating a specific digital strategy but threading it throughout its JFP. This should help to ensure that digital activity supports its overall vision and work programme.
  4. Acknowledge challenges but be ambitious
    Some ICSs appear more apprehensive about the use of digital technologies across their services, recognising the risk of digital exclusion and a need to “level up” before technology is implemented more broadly. There is also a recognition that the use of digital is unlikely to work for everyone and therefore a balance needs to be struck.
  5. Make digital and tech part of service delivery models
    Services have been shown to be most effective when digital and in person services work together. Greater Manchester ICS has a clear plan for the role of digital technologies within primary care, helping to improve access. It also highlights plans for Primary Care Networks within the ICS footprint having a Digital Change Champion to support the use of digital technologies in their community.
  6. Co-produce with people with lived experience, practitioners, and partners
    To improve adoption of digital technology, it is important to involve people with lived and learnt experience from the outset. This will help to ensure that digital strategies reflect the needs of local populations.For example, North East and North Cumbria ICS co-produced its Housing, Health and Care Programme with people who have lived experience, practitioners on the ground and partners from social care, housing, health and the voluntary sector.

Unlocking the transformative potential of digital technologies will help us to meet current challenges and provide the services required of a modern health and care system.

Catherine Davies is director of the Digital Healthcare Council. Alyson Scurfield is chief executive of TEC Services Association