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Finally, we know what good looks like for a digital ICS

The UK health sector waited with bated breath for What Good Looks Like to be published by NHSX. Here, Channel 3 reviews the document and breaks down the implications for ICSs.

It is finally here! After months of trailing and numerous presentations, What Good Looks Like is published and we can start to understand how integrated care systems (ICSs) will be directed, supported and assessed in reaching digital maturity.

As a framework, it contains no surprises and little that anyone could or would argue wasn’t a good idea.  But it launches with a sister statement Who Pays for What, and the two combined documents make it clear that ICSs have a lot of work to do – and a start needs to be made now.

So, what does WGLL and WPFW (yes, they are already recognised acronyms) mean for ICSs, how should we react and what does the future hold?

What does WGLL and WPFW mean for ICSs?

WGLL is a broad framework of seven ‘success measures’ that, if achieved, constitute ‘good’ for an ICS. There is a similar set of success measures for individual trusts within an ICS under the same seven headings:

  1. Well-led – Your ICS has a clear strategy for digital transformation and collaboration.
  2. Ensure smart foundations – Digital, data and infrastructure operating environments are reliable, modern, secure, sustainable and resilient.
  3. Safe practice – Organisations across the ICS maintain standards for safe care, as set out by the Digital Technology Assessment Criteria for health and social care (DTAC).
  4. Support people – Your workforce is digitally literate and is able to work optimally with data and technology.
  5. Empower citizens – Citizens are at the centre of service design and have access to a standard set of digital services that suit all literacy and digital inclusion needs.
  6. Improve care – Your ICS embeds digital and data within their improvement capability to transform care pathways, reduce unwarranted variation and improve health and wellbeing.
  7. Healthy populations – Your ICS uses data to design and deliver improvements to population health and wellbeing, making the best use of collective resources.

Implied within the framework, and made more explicit by Matthew Gould, Sonia Patel and others, is an assessment approach to measure how close to ‘good’ an integrated care system is – broadly a new approach to digital maturity.  It replaces the self-assessment approach to maturity with a proposed peer review regime.

Rather than generic aspirations, most of the success measures are practical, measurable and should be attainable with the right support – and the right funding!

It does however steer clear of describing how to attain the measures or how to measure the current level of attainment – preferring at this stage to use peer experience and subjectivity over empirical measures or maturity matrices.

WPFW starts with a statement of the current problem facing ICSs when it comes to digital funding, then promises some digital tools to help digital leaders in ICSs prepare for discussions with their colleagues on funding digital initiatives. 

It makes a big play for the unified tech fund with a single portal to bring together a range of existing digital funding streams worth £680M across two key themes – digital enablers and digital clinical systems.

WPFW funding streams – digital enablers and digital clinical systems. Source: NHSX Unified Tech Fund Prospectus published 31st August 2021.

The vast majority of funding is still capital, so ICSs will need to budget for the ongoing revenue costs – and none of it is new money.  What this provides is a ‘one-stop shop’ to apply for those funds relevant to your needs. 

In reality, the original premise of describing ‘Who Pays for What’ has been replaced with a statement that ‘You’re paying for it, here’s how to secure the money’.  WPFW also makes it clear that ICSs will have a greater say over how technology funding in their geography is allocated.

How should ICSs react?

There are two urgent actions to take:

Action 1: If your ICS doesn’t yet have a digital strategy and digital route map, you should start developing them now. They will be essential tools for demonstrating what you plan to do locally and for gaining buy-in from key stakeholders. In Channel 3’s experience, the best results come from creating these in a highly collaborative way with stakeholders across the ICS so you can help unify the organisations’ approach to digital

Action 2: Review the prospectus for the Unified Tech Fund – although you may have already applied for some of the funding pots there may be new opportunities to bid for.  The work of developing the business case, building the project plan, marshalling the local support and ensuring patient voices are heard in your bid still has to be done. In co-developing several of these bids recently with ICSs our advice to those applying for funding would be to focus on patient needs in your ICS and swiftly build a broad coalition of stakeholders in support of your bid.

What does the future hold?

Be ready for an assessment by one of your peers. During this assessment, our advice is to help them to understand what good really means for your ICS and its staff, as much as being guided by the framework.  This will be a ‘voyage of discovery’ for NHSX, and their interpretation of ‘what good looks like’ will develop as they see local good practice in action.  Your digital route map will be crucial to the assessment, it is the plan for delivery of digital transformation by the ICS, so factor in how you plan demonstrates and measures digital maturity as you improve care and outcomes for your patients.

What Good Looks Like describes the things many integrated care systems are already doing to improve digital maturity.  ICSs have a wide range of digital challenges to address at the same time so prioritising and planning the activities will be vital.  ICSs need to bring together many stakeholders in support of building and delivering the digital strategy and digital route map.  It is a task requiring expertise and independence to balance the needs and aims of the range of partners in an ICS.

If you have a question about What Good Looks Like or Who Pays For What and the implications for your ICS, contact Channel 3 using the form below and we will be happy to support you on the path to success.

Get in touch to discover how Channel 3 can help your ICS capture and realise your digital vision.

Call +44(0)20 3866 4838 or email info@channel3consulting.co.uk

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