The NHS’s integrated care systems aim to build a more cohesive approach to healthcare across the UK. To be successful, there are technological challenges that must be tackled.
In 2015, the NHS began testing new models of care, with the intention of creating a more joined-up approach to healthcare in the UK. These models developed into integrated care systems (ICSs), in which “NHS organisations, in partnership with local councils and others, take collective responsibility for managing resources, delivering NHS standards, and improving the health of the population they serve”.
Since April 2021, every part of England has been served by an ICS, and while much progress has been made to provide a better level of care, they still have challenges to overcome. Here are four areas that ICSs must focus on in order to succeed.
1. Cybersecurity must take precedence
The close of 2020 saw many nation-state cyber-attacks. These highlighted the growing threats posed to public and private organisations alike. While large, successful attacks make it into the news, there are plenty of attempts that do not get reported in the media.
Accordingly, ICSs must ensure that they have strong security systems that can stand up to ransomware. This must also be complemented with backup storage, in order to prevent data loss.
Elsewhere, redundant server infrastructure (such as distributed data centres) can keep data and services online for patients, even in the event of other data centres failing. Cloud servers, meanwhile, can improve the NHS’s security, thanks to their ability to be updated regularly. The full adoption of updates for devices connected to the cloud means oversights are less likely.
Finally, a focus on encryption and authentication can help. At its basic level, encryption ensures data cannot be used by those that lack verified access and should form the foundation of any organisation’s security. Adding multifactor authentication, meanwhile, reduces the chances that an organisation’s security can be breached from stolen or lost devices.
2. Technology must be coordinated and interoperable
As the NHS developed over the years, offering a widening range of services across different regions, its operations and technology took different paths. The result has been that legacy IT systems and new technologies are often separated and are unable to interact with each other.
Correcting this will be no mean feat. In fact, the House of Commons Public Accounts Committee report Digital transformation in the NHS identified interoperability and limited capacity for information sharing as the two biggest challenges faced by the NHS.
As critical information remains on unconnected servers, clinical systems and databases, navigating patient journeys across different departments is very difficult. Accordingly, migrating IT infrastructure to the cloud is a logical way to drive efficiencies in patient care. Doing so would make data easier to manage and to coordinate, reducing pressure on supply chains and procurement. The data generated by these services can also give leaders a better overview of collaboration between departments. By having this visibility, a more joined up service could be offered.
Cloud technology can also be more powerful than on-premises IT. As the NHS is such a large organisation (it’s the sixth biggest employer in the world), vast quantities of data are generated, and all of it must be verified, stored, managed and analysed. Getting ahead on cloud technology now will pay dividends in the long run.
As well as having advantages for employees working within the NHS, creating more coordinated and interoperable data sets has the potential to improve patient outcomes. If departments are able to share information more easily this can benefit users on an individual level, as well as on a wider societal level. If implemented effectively, the NHS will have the opportunity to use linked data pools to better understand national challenges such as Covid-19, obesity or Alzheimer’s, and react accordingly.
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3. An open health ecosystem must be built
Another area for improvement will be to build open platforms and open solutions into ICSs. This will allow different parts of the NHS to adapt their existing systems to work together, rather than creating new systems from scratch.
Speaking to digitalhealth.net in April 2021, Will Smart, the former NHS national CIO and now global director of external relations at healthcare provider software business Dedalus, said: “.
4. A baseline maturity must be reached
Underpinning all this, though, must be a digital maturity across all ICSs. They must reach a common level of technological advancement in order to create a connected and cohesive service.
Speaking to Digital Health News, Hamza Drabu, commercial law partner at DAC Beachcroft, said putting ICSs on a statutory footing could encourage similar levels of digital maturity across regions, but only if the right funding and governance was in place.
“If you’re looking at technology on a system-wide basis then there should be a baseline that everyone would need to be reaching,” he explained.
“You would hope that, if anything, it [the creation of ICSs] encourages more harmonisation and everyone to have a more similar level of maturity in terms of digital.”
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