Foreward
A key aspiration for our health and care system transformation, will be the delivery of high quality, cost effective Information and Technology Services (I&TS), otherwise known as ‘Digital Services’ that will enable and support our people and populations.
Our vision is to have secure, resilient, accurate and timely information at the point of patient care. This will be delivered through an integrated application suite, combining clinical and line of business applications, underpinned by a robust and cost effective information infrastructure.
Our digital services will address key health and care objectives from a, national, regional and local perspective, many of which are outlined in the NHS Long Term Plan and more recently within the NHS People Plan these objectives will be aligned to and converged
with priorities and objectives set out in the North East and North Cumbria Integrated Care System (ICS) and at an Integrated Care Partnership (ICP) level.
Our aim is to enable and deliver secure and legitimate information sharing supporting users (Citizen, patient and clinician), to have healthy lives, receive responsive care, and as a system work together to deliver collaborative care. We will develop digital services that will shift healthcare from isolation to integration.
Over recent years we have been laying down the solid foundations on which to build these digital services – to help us meet both the technical challenge of linking complex systems together, putting in the right infrastructure and standards.
By working collaboratively across the region, we can make far greater gains, particularly with digital solutions.
Julie Gillon
Chief Executive Officer
Dr Deepak Dwarakanath
Medical Director/Deputy Chief Executive Officer
Chair – Digital Strategy Committee
Prof Graham Evans
Chief Information and Technology Officer/SIRO
Chief Digital Officer
North East North Cumbria Integrated Care System
Our Vision
We will digitally enable health and care service transformation to support our populations and the patients we serve.
Our vision is to have secure, resilient, accurate and timely information at the point of patient care. This will be delivered through an integrated application suite, combining clinical and line of business applications, underpinned by a robust and cost effective information infrastructure.
Our key focus areas will be:
Infrastructure, integration and interoperability
- Within the organisation as a result of our digital programmes delivery and continuing digital maturity improvements
- Unlocking the power of information to improve safety and decision support at the point of care
- Across the North East and North Cumbria (NENC) through the broader Integrated Care
System (ICS) digital care programme, including the Great North Care Record (GNCR) and population health management and digital collaboration initiatives - Keeping patient and service user’s information safe, secure and up to date, and only used with appropriate governance and controls
Workforce
Supporting a digitally enabled workforce, improving user digital literacy and competencies to maximise the benefits of digital solutions.
Personalisation
Exploiting digital technologies to enable greater self care and independence through citizen/patient centred solutions in neighbourhoods and communities.
Context
National context
The NHS Long Term Plan sets out ambitions for a future proofed NHS with a clear focus on a digital first approach that empowers patients to get on board with this journey, furthermore, the NHS People plan makes clear reference to the use of digital systems and services to enable new and innovative ways of working, by supporting our workforce through digital flexibility, agility and utility.
The long term plan also sets a challenge to explore opportunities for closer working with partner organisations and to put measures in place to achieve a more robust workforce model Many of the measures are already being developed, explored and in numerous cases, not least as a consequence of the COVID 19 pandemic, these solutions are already implemented within our Trust.
Our Trust is helping patients get home safer and sooner by giving them the appropriate tools for self care as well as training our community care teams to monitor patients in their homes and other out of hospital locations, in addition, we are accelerating our focus on population health management, ultimately resulting in less hospital admissions, easing the pressure on our core services and creating a more personalised health and care offer.
Complimenting all of this, we are continuing our Global Digital Exemplar Fast Follower ambitions and utilising new technologies to digitise patient records and create a digital first model of clinical service delivery.
Furthermore, we will revolutionise the way we recruit staff, enable staff to work more effectively with digital tools and on line services, and ensure that staffing levels and patient flow processes are more efficient than ever before.
We are a medium size NHS Foundation Trust with huge ambitions and the long term plan lays down the foundations for even further digital innovation and delivery.
Regional context – North East and North Cumbria Integrated Care System
The North East and North Cumbria Integrated Care System (NENC ICS), is the largest ICS in England, serving a population of circa 3.2 million citizens Our ICS is made up of four sub regional footprints, known as Integrated Care Partnerships (ICPs).
By sharing resources, developing our workforce and making better use of technology, our ambition is to significantly improve the health and wellbeing of people in all of our communities, through the provision of safe and sustainable services and the prevention of ill health.
We are designing services which suit the needs of individuals, help people to stay well and avoid unnecessary stays in hospital We will achieve this by working alongside our communities and through our staff, and by collaborating across organisations As an integrated care system, we need to transform population health and deal much more effectively with the operational challenges we face on a day to day basis.
More information can be found at nhsjoinourjourney.org.uk
Organisational context
Doing what we have always done will result in getting what we have always got, and given the increasing demands on the heath and care services this will potentially not meet the needs of the population we serve. We all need to better manage the health of the
population to ensure our communities will be healthier fitter and less reliant on hospital services in the future.
- To achieve our vision, we will:
- Focus on groups in society
- Deliver interventions across an integrated health and care system
- Manage the health of our population better
- Demonstrate strong and effective collaboration, and trust
- Improve and integrate our services
- Deliver services that are clinical effective, quality and safe
- Promote innovation and inclusivity
- Maintain financial stability
As an organisation, we ensure that our strategic direction, and the decisions we take, will inform our future direction, based on solid evidence not only from within
the Trust but from other external sources such as strategic partners and clinical and non clinical stakeholders. We follow a proven methodology to develop our strategic aims and objectives, considering external and internal factors, policies and drivers.
From this our key functions develop their respective functional strategies and annual plans, resulting in our staff having their individual and personal objectives vertically aligned and fully connected.
Excellence as our standard
We will continue to focus on the key areas of our business to measure our success, whilst looking to the future and exploring how we can improve what we do, and how we operate as a successful NHS Foundation Trust.
- Putting our Population First
- Health and Wellbeing
- Valuing People
- Transforming our Services
We continually review, improve and grow our healthcare services whilst maintaining performance and compliance with required standards. This includes developing and embracing digital solutions, supporting the full integration of the Great North Care Record, and ensuring we address the ever present financial challenges without compromising safety or quality.
Technology and Digital
A key, and significant enabler in our priority of Transforming our Services will be linked to Technology and Digital solutions.
As an organisation, we have recognised the value of technology as an enabler for transformational change over many years The Trust has made a range of significant investments to continually improve our essential infrastructure, data and digital security services as well as clinical and line of business information systems.
Our digital evolution
Our journey to date
The Trust has been on an ambitious digital journey since the early 2000s as one of the first NHS organisations to implement a range of technology solutions under the National Programme for IT (NPflT) which was, and remains the largest civilian IT programme in history. Our digital journey has had a clear and consistent aim to make our digital and technology solutions Patient Centric whilst at the same time supporting our clinicians and broader staff groups to work more efficiently and effectively.
From 2004 up to present day the Trust has delivered some novel and ground breaking technologies demonstrating vision, foresight and committed leadership.
We recognise that as we move to becoming more ‘digitally dependent’, technology cannot be just seen as a cost of doing business, but needs to be considered a strategically important asset that requires continuous investment, clinical and business engagement and board level leadership.
Our digital programmes
Long Term Plan deliverables – digital interactions
The NHS Long Term Plan outlines and signposts a range of digitally enabled opportunities, ranging from using digital technology as a primary point of access (digital by default), in order to reduce physical appointments and substitute these (were necessary and appropriate), with digital alternatives. The use of remote and virtual technologies for patient to clinician engagement is now a reality within our organisation,
this has been facilitated and supported by a range of complimentary digital tools and services.
Digital interactions
- Consultations
- Digital first access to primary care
- Digital models to reduce outpatients*
- Video consultations*
- Apps – NHS Apps becomes ‘front door’
- Personalisation – self-care/remote monitoring*
- Increased use of apps (diabetes/respiratory/maternity/online therapies)
Digital infrastructure
- All Trusts fully digitised by 2024
- Standards: Info sharing and cyber security
- Development of shared records (GNCR)
Digitisation – paperlight 2020
Our organisation will be fully digitised ahead of the national deadline of 2024 this will not mean being ‘ but will be paperlight, this will compliment our Digital Hospital of things programme as well as our digital maturity ambitions.
Personalisation
As an organisation, we are working in collaboration with other stakeholders to improve patient and citizen experience by developing tools and capabilities to promote personalisation and increase self care.
COVID-19
The COVID-19 pandemic gave the impetus to develop or re purpose a series of digital solutions from existing plans and priorities, essentially fast tracking how we were able to interact and communicate virtually to protect our staff, patients and communities whilst maintain quality and integrity of care.
As a result of the COVID-19 pandemic the I&TS directorate and associated functional teams implemented a series of digital and technology solutions in response to emerging challenges. Our overarching goal being to protect our people (patients and visitors), whilst at the same time, fast track new and innovative solutions enabling information exchange, provide collaborative communication capabilities as well as supporting staff and patient experience The illustration below, provides a snap shot of such initiatives.
Collaboration and communication
Our “V” suite solutions, includes a range of Virtual technologies, to facilitate staff, patient and visitor virtual communications using video, voice and content collaboration platforms. Virtual patient consultations have been supported using the AttendAnywhere national solution, together with internal team collaboration provision using tools such as Cisco and Microsoft Teams technologies.
Infrastructure and tools
During the initial phase of the pandemic, there was a high demand to facilitate
remote and home working for staff. As a result, our external Wide Area Network
(WAN) was promptly upgraded with a ten-fold increase in bandwidth capacity.
Remote working tools, including; laptops, mobile devices and secure Virtual Private
Network (VPN) services were also implemented at an unprecedented pace.
Innovations
Real time remote clinical surveillance tools were deployed allowing patient vital sign monitoring and data flow into the EPR, remote video equipment was also installed in higher risk locations, minimising the need for staff to enter these areas unless physical attendance was unavoidable.
Furthermore, the ability to access external patient information ‘in record context’ within the EPR from external sources via the regional Health Information Exchange part of the GNCR, took place during the early phase of the pandemic.
Finally, we re purposed our CareScan+ platform to enable critical ventilator/oxygen concentrator asset tracking in real time, ensuring equipment was available in the areas of greatest need.
Electronic Patient Record
Our digital transformation journey significantly increased impetus with the implementation of the Electronic Patient Record (EPR) platform, InterSystems TrakCare, the first of type EPR implementation within the English NHS The EPR programme continues to progress enhancing patient centred care throughout the enterprise within the clinical care platform.
Digital Hospital of things
The Digital Hospital of things programme has enabled a number of key transformational change projects to be identified, prioritised and delivered using matched GDE funding
opportunities Key transformational projects planned for imminent delivery includes.
- Electronic Document Management (EDM) phase 2 as part of our Paperlight 2020 initiative
- Expansion and EPR integration of the internal communications and collaboration platform Vocera
- Further deployment of our point of care scanning solution (CareScan+) further improving patient safety, quality and process efficiency
System-wide initiatives
North Tees and Hartlepool NHS Foundation Trust (NTH) is fully committed to supporting integrated care at both a system and partnership level As a result, NTH are hosting a number of digital services under the NENC ICS banner of Optimising Health Services. Two examples of such initiatives include Digital Imaging for Pathology and the regional Radiology Global Worklist (GWL).
The Trust is also a member of the NHS HealthCall regional collaborative developing a range of clinical service pathways and applications to facilitate self care, closer to home. A further example of regional collaboration includes the connection and adoption of the Great North Care Record, enabling secure and legitimate clinical information
exchange across the regional health and care landscape.
Going forward, Population Health Management (PHM) will be enabled digitally and fully integrated in our decision making processes to further improve patient and population outcomes.
Programme plan and digital maturity
The Trust was delighted to have been appointed as a participant in the Global Digital Exemplar (GDE) programme as a Fast Follower (title may become National Digital Leader to the Royal Liverpool and Broadgreen NHS Foundation Trust. Over a three year period, we implemented our Digital Hospital of things programme rapidly advancing our patient centred digital transformations and being able to invest in a range of digital innovations resulting in the achievement of the Healthcare Information Management Systems Society (HIMSS) EMR Adoption Model (EMRAM) level 5.
Our aspiration is to now build on this solid foundation, and aim to achieve the independently assessed HIMSS level 6 accreditation during financial year 2021 22 and potentially move to HIMSS level 7 by 2025.
GDE Blueprinting
One of the significant opportunities resulting from the GDE programme was the concept of “blueprinting”. The trust has uploaded a range of GDE blueprints to the national
repository and welcomes all opportunities to learn from others, whilst at the same time,
share with others in the spirit of collaboration.
Within the next two years
We will build upon our foundations, to further enhance our digital services Ahead of
our EPR upgrade TrakCare 2020, in the spring of 2021, we will adopt a Quality
Improvement methodology – TrakCare Advance – providing insight and analysis of
EPR performance, identifying areas of improvement. During 2021 we aim to achieve
a series of externally accredited standards; (a) HIMSS level 6 EMRAM standard,
which will further raise our digital maturity status and improve clinical service
capabilities and delivery, (b) the Cyber Essentials Plus data and Cyber security
standard, and (c) ISO/TR 13028 2010 digitised records standard, as part of our
Electronic Document Management services.
Within the next three years
We will continue to increase our vertical integration and system-wide interoperability
supporting regional initiatives such as the GNCR, by contributing to, as well as
consuming, patient centric information, in context within our EPR platform. This will
also support the increase of our personalised care offer, with the delivery of the regional
Patient Engagement Platform. Further elements of personalised care, will include
further self care and care closer to home developments as part of the NHS HealthCall
platform. We also acknowledge that not all citizens and patients will have the means or
capabilities to interact digitally, in such instances we intend to develop place based
Digital Hubs to allow access to locality based services with digitally enabled virtual
care solutions.
Within the next five years
A range of clinical and line of business services will be transformed with the implementation of Robotic Process Automation tools together with the delivery
of Machine Learning and Artificial Intelligence technologies potentially within our highly digitised diagnostic services. Population Health Management will be supported with digital solutions as well as providing our workforce with the tools and capabilities
to work in a mobile and agile manner, building on lessons learned from the COVID-19 experience.
Governance and accountability
Digital strategy development and oversight is governed by the Digital Strategy Committee (DSC) a sub-committee of the Trusts Board of Directors (BoD) in addition, a line of reporting into the Trusts Transformation Committee exists, creating a link to the Transforming our Services strategic aim.
Digital and information risks are managed at all governance levels, and where necessary and appropriate, are brought to the attention of the BoD via the responsible Executive Director, the Chief Information and Technology Officer (CITO) who is also the Trusts Senior Information Risk Owner (SIRO). The Board Assurance Framework (BAF) is regularly monitored for strategic risks as well as our appetite to manage such risks Monthly I&TS progress and exception reports are also tabled on a monthly period at the Executive Management Team.
Clinical leadership is a key component of the Trusts Digital strategy, with several governance groups being chaired by senior clinical leaders.
Delivery
The Trusts strategic objectives, described within the corporate strategy and annual business plans, are translated into a portfolio of digital programmes, projects and on going business as usual infrastructure activities Specific digital programmes and projects have their own governance arrangements, and report into the Digital Programmes Steering Group.
Structure
The Information and Technology Services (I&TS) directorate, comprises four functional teams, each support and enable the spectrum of digital services within, across, and when necessary external to the Trust.
I&TS functions
Information and Communications Technology
Information Communications and Technology (ICT) comprises three main areas:
- ICT Operations – delivering the day to day running of ICT systems and services, provision of ICT Helpdesk, and specialist support Digital, data and Cyber security
- Infrastructure – provision and support of core networks, including data centres, servers and data storage facilities, together with firewall and perimeter defence security services
- Telecommunications – management of a broad range of desktop, and mobile devices, aiding audio visual communication to the Trust, in addition to providing the Trusts switchboard services
Key objectives:
- Infrastructure developments – Cyber and data security, customer experience improvements
- Cyber Essentials Plus accreditation
- Regional hosting services delivery
Digital Programmes
The Digital Programmes Team are responsible for driving forward the Trusts Digital Agenda’ in line with the NHS Long Term Plan, including the commitment that, by 2024 there would be “fully interoperable electronic health records so that patient’s records are paperless”. This was supported by a Government commitment in Personalised Health and Care 2020 that “all patient and care records will be digital, interoperable and real time by 2024.
There are a number of interrelated projects running at any one time in order to achieve these objectives, the first phase of the EPR Programme was complete in 2015 this provided the Trust with a modern, flexible Electronic Patient Record system called TrakCare, this has set the foundations for interoperability and integration to become possible.
Key objectives:
- EPR and associated transformation delivery
- HIMSS level 6 (progress towards HIMSS level 7)
- Regional interoperability programmes
Information Governance, Healthcare Records and Electronic Document Management
Information Governance (IG) – responsible for the management, monitoring and compliance of the critically important IG agenda within the Trust, ensuring compliance with Information Commissioner’s Office, Data Protection and Data Security Protection Toolkit requirements.
The Healthcare Records department – manages the Trusts physical and increasingly electronic healthcare records ensuring the information contained within, can be used effectively when required. Ensuring we meet legal requirements for subject access requests, retention and disposal of records and child protection alerting. The Electronic Document Management team manage the transformation and digitisation of
paper based healthcare records into legally permissible digital facsimile versions accessible electronically.
Key objectives:
- Paperlight 2020 EDM2 delivery (including formal ISO accreditation).
- DSPT and Cyber essential plus delivery.
- Regulatory compliance of IG deliverables.
Information Management, System Administration and Clinical Coding
Information Management – responsible for data accuracy, completeness and associated processing, ensuring fit for purpose information can be transmitted to national collection centres and also examined locally for trends and target compliance. This role is a crucial part of service commissioning and activity payment process Clinical Coding responsible for coding patient clinical notation which get converted, along with other factors into payment groupings and determine how a patient’s treatment is costed, this is a
crucial role in ensuring the Trust is recompensed for the clinical activity provided In addition, codes are also crucial to the GPs in ensuring continuity of care for their patients.
System Administration – responsible for the configuration and systems management end user support, training and day to day operational administration of a wide range of mission critical clinical systems within the Trust, including ERP and diagnostic service platforms.
Key objectives:
- Clinical coding and active clinical noting
- Automation of analytical IM services
- Strategic reporting capabilities
What this strategy means
For our patients and population
- “I will not be excluded, I have a choice to use digital services if I want to and am able to”
- “I know my information is stored securely and only shared when and where it is needed”
- “I can use my own device to manage my care and interact with services”
- “I can use assistive technology to help me manage my care”
- “I have a choice to use online, audio and video consultations when I need them”
For our organisation and staff
- “Digitally maturity enables service transformation and improved patient care”
- “Improved patient experience and outcomes”
- “Technology is seen as an investment, not a cost”
- “Reduction in the duplication of work for staff”
- “Improved and integrated data and information, helps me to make better clinical decisions”
- “As a member of staff, I will need to take some personal responsibly with digital
adoption”
For our Integrated Care Partnerships
“working in a digitally connected health and care partnership, will enable staff to become more mobile and agile, and patients will receive more integrated and joined up health
and care services”
For our Integrated Care System
“Patients are not restricted to geographic boundaries for their health and care services,
interoperable digitally enabled health and care services can be delivered where they are needed, allowing workforce and estate opportunities to be strategically managed and delivered, moving our system from isolation to integration.”
Awards
The Trust is very proud to have been recognised for a range of national awards and accolades relating to digital systems, services and innovations, some examples of these are listed below:
- InterSystems Client Reference Site 2017 2019
- Department of Health and Social Care Scan 4 Safety Accreditation 2018
- AHSN Bright Ideas Awards CareScan+ Finalist 2018
- NHS 70 Parliamentary Awards NHS Futures Dr Graham Evans Nomination 2018
- InterSystems Client Reference Site 2019 2021
- Heath Technology News (HTN) Impact of the year Winner 2018
- Heath Technology News (HTN) CareScan+ Supporting Healthcare Teams Winner 2020
- Heath Technology News (HTN) Best use of EPMA Winner 2019
- Heath Technology News (HTN) Team of the year Winner 2019
- Health Services Journal (HTN) Patient Safety Award Finalist 2020
- GS1 UK CareScan+ Approved Product 2020
Summary
North Tees and Hartlepool NHS Foundation Trust continues on an ambitious digital transformation journey, and whilst we can take pride in our achievements to date, there is so much more to do.
Our digital evolution and history affirms our commitment to continuous improvement and transformational change, we see challenge as opportunity, through our open appetite to risk and our ambition to deliver patient centred care enabled by technology and digital innovations.
Our success so far has been a function of strong and committed leadership, from the board of directors and our critical mass of inspirational clinical leaders, who, working in partnership with our information and technology services teams, enable our clinical and service transformations to be delivered for the benefit of the people and populations we serve.
Our digital aims and ambitions can only be achieved, when we have constancy of purpose, a clear compelling vision and the determination to deliver world class information and technology services, we recognise that we may not always get it right first time, and on occasion accept that be may make mistakes, but we will learn from our mistakes and move forward with our continuous improvement ethos.
As an organisation, we are a key part of the emerging integrated care system and partnership and our part is to ensure we have, secure interoperable digital systems and services, that support our clinical services, patient pathways and workforce agility and mobility requirements.
An integrated care system will only be as good as the weakest link, our links, like our organisation and our people, are robust, resilient and reliable.
The next five years will see even greater digital innovations, whatever opportunities or challenges arise, we will respond and continue to move from isolation to integration.
Strategy document PDF
Click the link below to view or download our digital strategy 2020 to 2025 in PDF form:
Digital Strategy 2020 to 2025 (2MB pdf)
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