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In a series of eight reports as part of the Build the Future We Need campaign, techUK examined how we can harness digital innovation to build a better future in the wake of the COVID-19 pandemic.

In 2021, the Health & Social Care team has made it a core part of our programme to look at the state of digital transformation across the UK, focussing on how we can work with stakeholders and members to best support digital innovation across the regions in this sector.

Having provided opportunities for our members to hear from and speak to the Scottish Government, Welsh Government, regional services such as the Yorkshire Ambulance Service, and representatives from ICSs across the North West, West Midlands, and South East, we wanted to reflect on our learnings and ask what we should be doing in 2022 to continue to drive forward digital transformation in health and care. 

Below we have outlined 4 themes which ran through each of our regional engagement sessions and will now guide our approach in 2022.

• Recognising shared goals

​During our industry briefing with the Interim Director of Digital Health and Care for the Scottish Government, Jonathan Cameron highlighted the collective focus and unifying objective that arose from the COVID-19 pandemic. The continued willingness to pull together and collaborate across the NHS, local government, third sector and industry, was a clear theme of our engagement across the country. The shared goals of driving a preventative, population-based approach to health and care that utilises local resources and enables effective recovery from COVID-19 continue to be front and centre.

With the advent of ICSs, members are hopeful that we will see significant defragmentation within the system, enabling greater progress on these shared goals. ICSs should aim to encourage conversations around value, outcomes and problem-solving, taking advantage of the opportunity to collaborate with industry and think about how they can support the local economy, engage with local authorities, and focus on community well-being.

However, it would be counterproductive for ICSs be viewed as a silver bullet. They should instead be viewed as the first step to reform, and there is a need to acknowledge that while some systems will lead the way, others may lag for some time. ICSs should be about more than breaking down the barriers between different aspects of the health and social care system and should also look to break down barriers between the public and private sector. Suppliers and ICSs should work to challenge each to meet their shared goal: providing better, more efficient health and social care.

• Improving clarity around funding and function

​Across our engagement in different regions, it was clear that is a concerted frustration around the current lack of clarity regarding the roles allocated to ICSs, local authorities, and national bodies. Suppliers across the country, big and small, have difficulties tracing who is responsible for where funding ais available. It is also clear that within adult social care and local government the impact of ICSs is still unclear. Early engagement between the NHS, social care providers, and suppliers in light of these newly formed systems will help to provide clarity around the allocation of funding and decision-making

It is evident that this lack of clarity around funding and function is exacerbated by the proliferation of frameworks, with the current disconnect in the purchasing landscape leading to a stifling of innovation. techUK have worked closely with NHSX over the past year to improve this and have seen significant progress. We will look to continue to work with the Transformation Directorate in 2022 to drive forward this development and are confident that ICSs present an opportunity for funding to be spent in a different way, with a focus on collaborative working.

• Varying levels of digital maturity

One concern raised across our regional industry briefings and roundtables was the significant variance in digital maturity between ICSs, some of which have been established for four years now, while others are yet to appoint a CEO.

For instance, when hearing from Ifan Evans, Director of Technology, Digital & Transformation in Health & Social Services for the Welsh Government, he outlined that in Wales they are hoping to expand the content, availability and functionality of their digital health and care record to improve treatment quality. This stands in contrast to the fact that in England, five ICSs have yet to establish any shared care record at all.

Alongside the existing variance in maturity levels, many stakeholders highlighted the importance of the individual – whether an ICB Chair or Chief Executive – in determining the success of a particular ICS. Force of leadership and willingness to push forward technological innovations will be crucial. Between now and April, many ICSs will be treading a line between enacting the necessary change with as little disruption as possible, with little scope to focus on true transformation.

There was consensus that it is likely ICSs will fall into three groups: those that seek to integrate health and social care, those that attempt to encompass a much wider variety of systems that impact health (such a housing, transport, and education), and those that are newly formed and trying to establish the basics.

As ICS chief executives are appointed, they should look to work with the technology industry early on to work out how suppliers can help establish integration as well as meet other targets on health inequalities and digital inclusion.

• Moving from a transaction relationship to a true partnership

Across our engagement we heard both that suppliers can often be naïve in their belief that they can develop a product behind closed doors, presenting it as a finished product to the NHS, as well as that many NHS trusts and ICSs need to be educated around specific procurement of digital.

The primary improvement in both respects should be to encourage greater elasticity of thought. It is clear from current procurement practices that those using the technology acquired are largely not consulted by procurement teams, who should be encouraged to delegate downwards, sitting within digital teams and speaking to frontline users. Suppliers also expressed concern that the NHS had an expectation that digital health technology would fix all the ills. The reality is that the industry can provide tools to optimise delivery but cannot fix everything. Bringing in people from commercial backgrounds can help ICSs tackle this, as well as help combat concerns that ICSs may consider SME providers too small to deal with the bigger systems and populations they present.

The techUK Ten Point Plan for Healthtech highlighted that there is a mismatch in industry and system understanding. As opposed to other industries, digital health and care innovators are seen as suppliers and not partners to the NHS. There is a mismatch between their expectations and a lack of understanding, transparency and, most importantly, trust between industry and the system.

The NHS should view contracts as partnerships in which building a strong relationship is essential. Furthering co-design between NHS and industry and forming relationships based on trust will go a long way towards dissolving he current tensions between the NHS and the commercial sector.  

ICSs are an opportunity to deliver this kind of care and to reorganise systems to work in the interest of the patient, with the potential to bring in transport, employment, and other aspects of life that have a huge impact on health.

In 2022 techUK will be looking to help foster partnerships between industry and ICSs to help tackle some of the challenges seen in driving forward the digitisation agenda

If you are a member of techUK or public sector stakeholder and would like to be involved in techUK’s work on regional engagement and Integrated Care Systems, please get in touch with alex.lawrence@techuk.org.