Case for Change (published July 2021)

Section 8: Our infrastructure does not support our future digital technology ambitions

The NHS in Lancashire and South Cumbria has a well-established reputation as a leader in digital technology adoption. We have already made significant progress in implementing digital innovation and our Covid-19 response is accelerating this change. More than 30% of outpatient appointments are now offered virtually and we have adopted innovations in robotic surgery. We have set out an ambitious digital strategy for change, which harnesses the benefits of technology for patients and staff, underpinned by a system wide approach.

The New Hospitals Programme is an opportunity to maximise the potential of digital in our region’s hospitals to:

• Improve operational performance
• Support the delivery of our sustainability
• Optimise patient care and experience
• Maximise care closer to home
• Support us to use our scarce resources more effectively, in particular across sites
• Reduce the size of the hospital estate footprint.

Embedding the expected impact of digital technology into the fabric of the estate will ensure that new hospital infrastructure is right-sized and will enable smart building specifications to be included from the outset.

It will be a crucial enabler for delivering our ambitions as an integrated care system and for a networked system of Lancashire and South Cumbria hospitals, which can deliver care closer to home.

Digital technology will be a key enabler for realising the integrated care system ambitions and is vital for the delivery of sustainable, high quality, accessible acute care

We have already made significant progress. The uptake in digital healthcare has been demonstrated within the population of Lancashire and South Cumbria, with almost 500,000 people across the region having downloaded an app that helps them connect with their GP surgery (source: Lancashire and South Cumbria Health and Care Partnership’s Strategy [opens in a new window]).

Covid-19 has been an important catalyst in the adoption of digital outpatient consultations: more than 30% of outpatient (OP) appointments are now being undertaken by video or phone. Robotic surgery systems are currently in use in Lancashire and South Cumbria and their use is accelerating within the field (source: Lane, T. (2018). A short history of robotic surgery. Volume 100, Issue 6, May 2018. Royal College of Surgeons in England (opens in new window). There are also a growing number of international examples of robotic surgery being undertaken remotely and these are exciting potential developments for the future.

As an integrated care system, we have set out an ambitious digital strategy around five key themes, with a focus on making information and data easy to use, and providing functional infrastructure that supports integration across our system. We are working towards an organisationally agnostic approach to create greater flexibility for remote working and ensure a pan-regional integrated care system approach.

During the Covid-19 pandemic, we have seen the emergence of digitally facilitated hybrid working – especially amongst the support and managerial staff base. In many instances, this has both increased productivity and delivered savings (in personal commuting time and the payment of travel expenses). There is now the opportunity to make many of these changes to agile working practices permanent, delivering a significant saving and reducing the floor space required for non-patient facing administrative and management functions.

The diagram below illustrates the five high level collaborative themes, which underpin our digital priority areas.

Figure 18: Five high level collaborative strategic digital themes

1. Empower the person
2. Support the frontline
3. Integrate services
4. Manage the system more effectively
5. Create the future

Source: Lancashire and South Cumbria Health and Care Partnership’s Digital Future Strategy (opens in new window)

The principles underlying each of the five themes are described as follows:

• Empower the person – developing digital solutions in partnership with the people who will be using them and judging our progress against this digital strategy from the public’s perspective
• Support the frontline – creating an environment that empowers our frontline
• Integrate services – using data to prevent, predict and respond to ill-health
• Managing the system more effectively – working together to reduce complexity, to improve quality and safety and provide care closer to home
• Create the future – engaging with academia, industry and others to accelerate innovation.