From smart hospitals to smart health and care – five ways to scale impact

These ambitions, alongside a broader shift to preventative healthcare, are intended to transform the NHS and improve the health of the population across the next decade.

The 10 Year-Plan (10YP) also marks a step-change from the focus on acute hospitals, with the hospital-centric approach now criticised as resulting in multiple fragmented silos. Yet there are ongoing national programmes – such as the New Hospital Programme (NHP) that specifically target digital transformation in hospitals that risk perpetuating a hospital-focused perspective.  So, whilst the 10YP outlines a great ambition for digital, there is a risk of siloed approaches if digital plans and investments are not system-oriented and focused firmly on reimagined care models.

The question then becomes, how can the NHS progress and maximise the opportunity to digitalise and transform, without undermining the ambitions of new models of care outlined in the 10YP?

The answer is to re-focus and create more streamlined synergies to scale smart health and care systems, not solely a smart hospital. With considered and deliberate action, progress can include how the wider health and care system integrates to deliver a smart health and care ecosystem, with patients firmly at their centre.

As the NHS looks to achieve this wider transformation to a smart, digital future, here are five ways to shift the focus:

1. Redefine the narrative to foster collaboration

Digital technologies should be a fundamental component of designing care at the system level. The narrative around smart hospitals needs to be redefined to smart health and care, focusing on implementing smart technologies across care settings and enhancing patient journeys and experiences. To shift mindsets from organisations to systems, fostering a culture of openness and collaboration across local systems is essential in achieving the shifts set out in the 10YP. Prioritising partnership working in new NHS operating models will enable the design and implementation of collaborative models of care underpinned by technology. Greater Manchester is an area of the NHS we have had the pleasure to work with on several occasions, and they serve as a great example of the impact healthcare collaboration can have.

2. Design cohesive models of care

Shifting care to the community and establishing neighbourhood health services with patients at the centre means redefining care models and care pathways. It will see the role of the hospital change dramatically, focusing more discretely on urgent and critical care, and local neighbourhood services will focus more on preventing ill health for their population. These redefined care models need to be digital by default. Digital and data plans should be established as part of care model redesign – not leading or simply being seen as an enabler for a completed design. From our first-hand experience undertaking service re-design, it is clear that when pursued in parallel, digital care models can be established to re-position services to be fit for the future.

3. Focus on simplicity and integration

With more technology in patients' hands and more complex health conditions spanning multiple care providers, simplicity for patients and staff is key. An organisation-based approach can segment the patient journey and deliver sub-optimal results and experiences, often putting the burden of care coordination and collaboration on the patient. A patient with complex health needs must often interact with at least four different health apps – one to manage appointments and communication with each care provider (GP, community care, acute hospital) and then ordinarily at least one additional app specific to their condition (often used for diabetes and respiratory conditions) – with no communication or sharing of data between each system. An integrated and more consistent approach to designing digital and data solutions improves the experience and delivery of care for patients and staff alike – the expansion of the NHS App is a great example of how a holistic approach to common needs can drive engagement and efficiency.  

4. Prioritise data early

Digitalisation is key to unlocking the power of data, which is essential for understanding and improving services, population health, and health outcomes. Often in the NHS, data is deprioritised and considered after digitalisation. This frequently leads to challenges such as multiple digital systems being used that inevitably capture data differently. Local systems must commit to focus on data transformation, as early consideration of data standards and data capture methods is key to providing actionable evidence on which further changes can be planned and tested. This data backbone becomes the foundation for more transformational work, such as AI-driven healthcare research or implementing predictive bed management.

5. Pool and stretch funding ambitions

Many NHS Trusts struggle to support the required level of investment to implement fully digitalised and data-led services that transform care delivery and business operations. The benefits of redefined and collaborative care models are systemic – often a transformation in one area of the local system leads to benefits elsewhere. However, to unlock investment today, Trust Boards need to see tangible return on investment, often in-year and certainly within their own organisation, to preserve their financial situation. The traditional methods of budgets being attributed to an organisation no longer make sense. To ensure progress, budgets should be pooled and managed at a system level to drive benefit across care pathways.

Capitalise on collaboration and consensus – why the opportunity is now

The precedent and mandate for collaboration and digital transformation are there to capitalise on. Many Integrated Care Boards (ICBs) have established shared digital strategies and shared approaches to developing Electronic Patient Records (EPRs), as well as collaborative plans for shared care records and population health management. At other levels, General Practices are collaborating in Primary Care Networks, and place-based teams are providing multi-disciplinary services centred around local needs.

As the new NHS operating models evolve for Regions and ICBs, and neighbourhoods emerge, placing digital firmly as an area of focus and collaboration is key to success. To progress digitalisation and smart initiatives, and maximise their potential, we must define new models of care at a system level, foster a culture of openness and collaboration across health and care partners, and redefine the narrative to focus on smart health and care. The place to start is building a coalition(s) around models of care. This approach will ensure that smart technologies are implemented across care settings, focusing on patient journeys and experiences, and ultimately support an accelerated shift to digital, community, and prevention.