Henry Rex, Associate Director for Government and Health at techUK, looks at February’s Ten Point Plan for Healthtech and why digital technology should be at the forefront of improving outcomes for patients
In early February 2021 techUK published our Ten Point Plan for Healthtech, where after careful and extensive engagement with our members and external stakeholders we came to ten essential recommendations for the health and social care sector. These recommendations are not exhaustive and do not cover all the challenges that suppliers and the service face, though they do fundamentally address what we believe to be the priority areas.
Now, we look to provide further context to the barriers discussed in the report and, crucially, additional thought on the direction of travel for health technology above and beyond the response to Covid-19.
Covering empowering the public, embedding standards, digitising social care, supporting the workforce and reforming procurement; our report closely reflects what techUK members believe to be the pertinent issues du jour. Initially conceived in 2019, and following on from the successful launch of our previous paper in 2018, a Manifesto for Matt, the paper began to take shape during the summer of 2020 as lockdown eased and we all took a collective deep breath. After initially conducting one on one interviews with our elected Health and Social Care Council, we expanded the engagement out in a series of thematic roundtables that allowed stakeholders and members to input in a group session. Over the subsequent months as we put virtual pen to paper, the council worked through the final ten recommendations and helped us to distil what was an enormous amount of information into something readable and useful.
Once the paper had been published, our priority was how to take it forward and ensure that it becomes something of a living document rather than a historical artefact. To this end, we are currently working closely with the teams at NHS Digital, NHSX and NHS England and Improvement to help deliver the recommendations and fulfil the industry compact that we committed to in our Ten Point Plan. Whilst many of the recommendations place the call to action on local NHS organisations, or more often, the Arm’s Length Bodies, it is equally critical that techUK and our members play their part where necessary and needed.
Since publication the pace of change brought on by the response to Covid-19 has meant that some of these recommendations have either already happened or are likely to be happen in the not-too-distant future. First and foremost is recommendation nine, the call for Integrated Care Systems (ICS) to be made legal entities, which through the Health and Care Bill will become a reality de jure later on this year. Although it will take some time for all Sustainability and Transformation Partnerships (STPs) to go through the metamorphosis, the end result of 42 cocoon fresh ICSs will play an important role in reforming the provider landscape.
“Enshrining the role of the Integrated Care System into law in line with the Long Term Plan’s recommendation to establish Integrated Care Systems (ICSs) nationally by April 2021, techUK calls on the Secretary of State for Health and Social Care to implement plans to establish the role of the ICS in law. This will help to simplify and codify the provider landscape, making it easier for suppliers to engage with the health and care system.”
With the added benefit of the publication of the Bill, it will be important for the Department of Health and Social Care to engage with industry to ensure the wider legislative proposals are both understood and agreed upon with the healthcare IT supplier community, which will ultimately have to navigate and access the new look system in England. As we recognised in the paper, simply making the legal change to ICSs is not the end of story and much work will remain on establishing a positive and inclusive culture or collaboration among these new organisations who will be expected to work across new boundaries and populations.
Our second recommendation called for NHSX to continue to work with suppliers to ensure that the Digital Technology Assessment Criteria (DTAC) is fit for purpose. The team at NHSX have continued to diligently engage with industry pre and post launch of DTAC, and we are optimistic that the success of the programme will go from strength to strength.
“NHSX should continue to work with industry to ensure the Digital Technology Assessment Criteria (DTAC) is fit for purpose; raise awareness and support commissioners to understand and utilise the DTAC; work with third-party assessors to maintain a pipeline of innovation; and engage with the relevant stakeholders to realise a functional reimbursement model for citizen-facing digital health technology.”
Recommendations four and five looked more specifically at standards and interoperability, the collective bête noire of the healthtech industry. Both the teams at NHS Digital and NHSX have been open and receptive to working with suppliers, as evidenced by their participation in our Digital Health and Interoperability Showcase and more behind the scenes participation in roundtables and user research opportunities. techUK also understands that NHSX are moving forward with the interoperability standards registry, which is currently under development.
“The Department of Health and Social Care should centrally mandate, assess and enforce the use of interoperability standards through NHSX and NHS Digital. Standards should be locally implemented and co-developed with both industry and the service itself. These should then be collated into a single, searchable interoperability standards registry. This standards registry should be transparent and accessible by end users so they understand what they should adhere to.”
Work on commercial and procurement activity has been ongoing since before publication and the teams at NHSX and NHS Digital, including the Chief Commercial Officers David Howie and Nic Fox, have shared their Category Strategy for Digital and Procurement Target Operating Model (PTOM) with our Health and Care Council. Recommendation ten identifies a number of key changes that the centre could make to ensure a more efficient system and to promote excellence in procurement.
As part of a comprehensive plan to reform procurement, the health and care sector should pivot towards outcomes as the primary success factor for digital transformation; signpost suppliers to existing frameworks; provide an accurate estimate for their total value; offer specialist training for procurement staff who are buying technology; and prioritise the streamlining of existing and future frameworks by committing to reducing their proliferation.
As we look ahead to the future, and as alluded to in the paper, one of the key components of successful digital transformation is establishing an answer to the perennial question of: what does good look like? Seeking an answer to this question is Sonia Patel, Chief Information Officer at NHSX, who is developing a programme of work in this area, with one of the potential answers being the establishment of a reliable digital maturity model that measures outcomes rather than inputs. techUK is working with SOCITM, BCS and others to help establish a practical and useful system to address this question.
“Measuring digital maturity in healthcare is a challenging but necessary task that aims to demonstrate the real-world impact of information systems that enable process transformations and to identify gaps and investment priorities. Digital maturity comprises multiple dimensions, incorporating infrastructure, application capabilities, workforce capabilities and patient/service user outcomes.”
Overall, the recommendations of the Ten Point Plan will form the basis for the work of our Health and Social Care programme for the next few years, with two immediate outcomes likely to be the establishment of more formal Interoperability and Commercial & Procurement working groups. If any stakeholders, members or other suppliers would like to be more involved then we would be more than happy to have a conversation about how we can work together to move some of these recommendations forward.
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