Can we have more “T” please?

The commissioning landscape is changing – it is a complex system for suppliers and service providers to navigate; but it is also a crucial time to engage with these key stakeholders as the Sustainability and Transformation Partnership (STP) agenda evolves.

As I reflect on the three themes coming out of the NHS Confederation conference the other week – Money, Workforce and Transformation – it’s obvious that we need to do more to support those leaders and teams who are working incredibly hard to deliver excellent patient care. But there is general agreement that without changing the way we deliver health and care, the NHS is not sustainable. However, realistically, often the S can overwhelm the T.

Our roundtable was the beginning of a series of meaningful engagements which are all about gaining a better understand of this landscape – as a health and care technology community, we are keen to listen to see how we can best support the delivery of STPs and to examine how the use of technology can help solve some of the problems faced.

Where and how can the techUK STP Working Group make a difference?

In terms of STPs nationally, three main challenges were set. These relate to:

PREVENTION – improving health and wellbeing: Addressing the causes of illness will help keep our population healthy and in turn reduce the need for health and social care services
CARE IN COMMUNITY – improving the care provided and the quality of services: All partners are committed to moving resources from hospitals to the community
FUNDING – tackling the growing pressure on health and social care budgets: We have to do things differently, reduce any unnecessary costs and ensure we get the best value for money from every pound spent. Ensuring that people receive the right care, in the right place, at the right time will be essential to our plans.

Our vision for the STP Working Group is to position technology and personal digital care as a key enabler in:

Delivering efficient services
Improving patient outcomes and safety
Enabling system to work in an integrated way

The roundtable offered a great opportunity to understand the priorities and challenges, and gain insight into where technology can act as an enabler to support delivery.

Contributors at the event covered a wide range of issues. STPs have been successful and we are now moving into partnerships and ACS (accountable care systems) which provide accountability for population health management. The whole system was a key theme – It is important to consider social prescribing and sign posting to a wider range of interventions such as voluntary sector and housing.

Whilst big challenges include the complexity of talking to the vast array of different platforms out there, one contributor highlighted the massive changes in clinical behaviour. For example a 75 year old lady who had a stroke visited her GP, who was able to view the CT scan that A&E carried out the day before alongside the scan from 2 years ago and see the bleed in the brain was the same size as 2 years ago so no action was needed.

We heard about what patients want:

Services to be designed with people
Genuine choice and control
Reassurance on security
Control over their own record/plan – e.g. they need help managing timesheets for personal budgets

We also discussed that whilst we have STP leadership in place we must make sure that those with less momentum are not left behind and culturally there are many challenges in terms of change.

We also heard from local government that their issues continue to be around:

Sustainability – how do we move everyone up to the same speed
Care providers – we have 18000 care homes and 9000 home care providers – how do we support of all them
Information sharing – we miss lots of opportunity when it comes to information outside of health and care e.g. housing and voluntary sector

In conclusion, the vast majority of the attendees wanted the working group to focus on increasing awareness of best practice examples and how to do it (scale, culture). Taking a national view is also a key theme e.g. what other partnerships / stakeholders should be engaged. Finally strong linkages came up with the other two techUK Health and Social Care working groups – safe and effective data sharing and digital citizen engagement.