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Lessons from the localities

Tied into that, Singh continued, much of the

recent work NHS England has been doing has

involved working alongside localities to

understand their key needs and priorities in

order that national delivery roadmaps can be

tailored in accordance with what is being heard

on the ground. “I think this is where, for the first

time, we’ve got the ability to make sure that

national, local and regional are coming together

in sync,” he said.

The first of these ground concerns involves

“actually having simpler and more integrated

access to the national systems and services

that we already have” – in other words, making

the most out of the national services already in

place but also making sure they are fit for

purpose. “We still hear stories about how it’s

hard for local authorities to get access to the

NHS number, how it’s still difficult to be able to

get hold of demographics information, or the

need for smart cards when you’re trying to

access things like a summary care record,”

Singh explained. The question now, then, is

“how do we create a more simplified approach

and integrate the pros to the national services

that we have?”

New models of care

A second area of action involves looking at new

models of care, e.g. clinical hubs, which aim to

provide timely, expert advice to patients and

clinicians via a single point of access, 24/7, or

GP federations, groups of GPs or surgeries

working under the same local umbrella with the

intention of sharing responsibility for the delivery

of high quality, patient-centred services.

According to Singh, the advantages and

practicalities of these new models are as much

about “integrated workflow” as they are

“information sharing”, and cover such

questions as: “How do I enable appointment


the UK’s largest e-health exhibition, EHI Live is designed

to bridge the gap between technology, the clinician and

the patient. The 2016 edition, which


attended in

November, saw e-health leaders from across the NHS and other

healthcare organisations come together for a dedicated two-day session

on integration and interoperability, which focused on the various

challenges facing the healthcare community when it comes to sharing

and communicating patient data and information.

Healthcare integration standards and integration

Kicking off this discussion with an address on healthcare integration

standards and regulation was Inderjit Singh, the head of enterprise

architecture at NHS England. Singh began his presentation by

highlighting the importance of thinking about interoperability and

integrated care as more than simply a technological issue and instead

looking also at the “service design, the people process implications, the

change in the pathways that we want to make and how information

fundamentally underpins that”.

In line with this, Singh then turned his attention to the role of sustainability

and transformation plans (STPs), which were first announced in NHS

England planning guidance in December 2015. STPs have been

produced by local health and care systems across England and are

defined as multi-year, place-based plans built around the needs of local

populations and designed to accelerate the implementation of the NHS

Five Year Forward View towards better health and wellbeing, improved

quality of care, and stronger finance and efficiency. According to Singh,

the STPs drive home the importance of working “across care settings,

across organisations, and on a locality and geographical basis”.

He continued: “Fundamentally, in order to be able to achieve the STP

outcomes”, there is a need for “effective information sharing and

interoperability”. Now is a good time to be having this discussion, Singh

added, as there is a range of perspectives already in place – the “overall

national view around ‘Personalised Health and Care 2020’”, the

government’s 2014 report on how best to use data and technology to

transform patient outcomes, a CCIO (chief clinical information officer)

perspective around the fact that “interoperability needs to baked in right

from the start”, as well as, from a “government’s accountability

perspective”, ideas around “how we take forward systems of healthcare

at an STP level”.

I S S U E 1 3

H O R I Z O N 2 0 2 0 P R O J E C T S : P O R T A L


E - H E A L T H

Integration and interoperability


reports from EHI Live 2016, where Inderjit Singh and Richard Jefferson

outlined the work of NHS Digital and NHS England in pushing towards

interoperability and integrated care