Exclusive Cambridgeshire and Peterborough ICB is looking for an ‘IT partner’ to realise the first step of a plan to radically overhaul its local care model.
The ICB has put out a pre-notice for a potential £10m contract to ‘deliver a digital front door (DFD) as a single entry-point for citizens managing their care’.
The new digital platform would allow patients to communicate with their GP and book appointments, but the ICB has said patients will still be able to contact their GP directly.
The digital front door forms part of wider plans, revealed in July this year, which aim to move care out of hospital influenced by the vision set out in the Fuller stocktake.
As previously reported, the plans include patients needing an appointment to attend A&E; and neighbourhood health hubs being set up to manage acute triage.
A draft timeline for the plans, which were published in July, had set a final implementation date of October next year, with pilots for ‘selected components’ due to start from December this year. It had also said DFD plans would be presented by last month.
According to a prior information notice published last week, the DFD app aims to ‘support, enable and simplify services’ for patients.
A prospective £10m contract, aimed at providers of software and IT solutions, ‘would be across a five-year period’ with an ‘extension option’, and ‘the value being split across this timeframe’.
The platform should – among a host of other things (see box) – enable patients to:
- Book an online consultation with their GP or other practice professional including video;
- Book a GP appointment;
- Follow care navigation – e.g. book pharmacy services, or NHS 111 “option 2” mental health crisis support;
- Order prescriptions;
- View their patient record; and
- Interact with digital patient communications – e.g. Receive /send in-app messages.
The notice said: ‘The DFD aims to provide access to a set of products, services, and relationships with partners in the delivery of health and care which help us co-ordinate care, personalise interventions and actions and enable us to centralise some services to make them more efficient.
‘It is vital that we can meet the care management needs of our population through our digitally enabled new model of care.
‘Our case for change covers improved patient outcomes, enhanced efficiency, improved accessibility, better information, personalised care options, cost effectiveness and data driven insights.’
The ICB said that the aim of the plans is to ‘reduce current fragmentation and variation’ so that that patients and staff ‘enjoy a consistently better experience wherever they live or work in our ICS’.
It added: ‘We want to enable citizens to take more control over their health and care by using technology provided by proactive and responsive partners who understand and can react to their needs.
‘Similarly, we want to enable digital and data-driven approaches to anticipating health needs and be more pro-active in providing earlier support to citizens.
‘We will be especially interested in the potential for outcome-based contracts where partners are offering, for example, services that enable our technology to be supported and to become integrated in clinical services.’
A spokesperson from the ICB told Pulse: ‘We are indeed looking for a partner to help us develop and deliver a digital front door (DFD) as a single entry-point for local people to manage their healthcare and personalised support for health and well-being.
‘The prior information notice relates to this digital front door solution only, rather than wider services.
‘With regards to how people will be able to contact their GP practice, the intention of the digital front door app is about providing people with an easy to use the digital front door.
‘It does not mean that it is the only way people will be able to engage with healthcare services in the future. We have no plans to change traditional routes to primary care that would sit alongside this digital option.’
The draft plans published in July also revealed plans to bring in locally-negotiated GP contracts, which would top up the funding for practices that lose out from the Carr-Hill formula.
‘An integrated neighbourhood team’ will ‘provide intensive support’ for the ‘most complex’ patients and ‘pro-actively’ manage their care, the plan said.
They will have ‘additional capacity available outside of the practice’ to do tasks ‘not needing’ to be done in the surgery, without ‘negative financial impact on practice sustainability’.
Pulse has asked the ICB whether this would remove acute care from GP practices but the ICB has not responded to the question.
For emergencies, patients will still be able to call 111 or an ambulance and they will be given assessment by ‘a trained person’ who will be a ‘single point of access’ for them while they are ill.
Pulse has also contacted Cambridgeshire LMC for comment on the progression of plans but they declined to provide one.
In a July newsletter, the LMC had said they had ‘listened and challenged’ when presented with the draft plan, but it said it was still awaiting ‘robust answers’ to ‘questions and concerns’.
The LMC also said it was ‘concerning’ that the ICB had reached this ‘decision’ – with ‘the level of impact it will have on general practice access and clinical processes’ – without a ‘wider engagement and risk assessment’.
Following pilots of components of the plan in December, the ICB plans to monitor the pilot programmes ‘closely’, collect feedback from participants, and make ‘necessary adjustments to improve effectiveness and scalability’ ahead of the winter season.
It is planning to expand the pilot initiatives ‘to additional sites or communities’ in June next year, and conduct ‘training sessions for healthcare professionals’ and staff members to ‘familiarise them’ with new workflows, technologies, and protocols.
The launch of a ‘full-scale implementation’ of this new care model across all relevant departments and facilities is planned for October next year.
The services requested in digital front door pre-notice
Primary care
A citizen could be enabled to:
- Access clinical advice online.
- Book online consultation with my GP or other practice professional including video.
- Book a GP appointment.
- Follow care navigation – e.g. book pharmacy services, or NHS 111 “option 2” mental health crisis support.
- Order prescriptions.
- View their patient record.
- Interact with digital patient communications – e.g. Receive /send in-app messages.
- Access or seamless link to health information e.g. NHS 111 online.
- Access or seamless link to social prescribing apps.
- Benefit from a future AI triage pathway for the above functions over time.
HEALTH APP CAPABILITIES
With citizen consent the app:
- Learns about individual health-related behaviour.
- Offers individualised information and content to modify behaviour (e.g. weight, smoking, exercise, sleep).
- Has the option to link to mobile /wearable devices.
- Uses data to identify risks and engages in health optimisation programmes.
- Accesses or seamlessly links to their condition specific apps e.g. asthma, COPD.
- Enables citizens to provide service experience feedback.
- Provides ‘waiting well’ support and advice.
- Has a development path for the potential use of genomic sequencing to identify risk and improve care.
Virtual ward and remote monitoring
Citizens receiving care on virtual wards or accessing remote monitoring will:
- Benefit from access or seamless link to my virtual ward and remote monitoring apps.
Digital interoperability
- In addition, we would want the provider(s) of the above functions to enable direct access or a seamless link to hospital portals, such as MyChart, which already provide a wide range of appointment booking, information and record viewing capabilities.
Source: Cambridgeshire and Peterborough ICB prior information notice of prospective contract
While a “digital front door” can streamline access for some patients, it does risk excluding others. Many patients, especially older adults, those with limited digital skills, and some with disabilities, may find it challenging to navigate digital systems. To ensure equity, integrated care boards should maintain diverse access points, such as phone lines, face-to-face appointments, and in-person support, alongside the digital pathway. This approach can help balance innovation with inclusivity, ensuring no patient is excluded due to digital barriers.
Not sire there is any problem with the rreal ‘model’ of primary healthcare provision.
The problem is wmore with the model of managers and quangos wasting money on ‘planning’ consultants for changes when the money would be better spent supporting the real GPs in the real model to actually provide real serrvices to patients.
First and foremost, Digital Solutions are increasingly being used a shield for NHS managers & ICBs to hide their inability to deal with the underlying issues of the fragmentation and disintegration of the NHS , they continue to jointly cause by their ongoing waste of NHS funding and resources in my view.
Most of this already exists but I personally doubt many ICBs have the self-awareness to recognise this.
Anyway, if there’s £10 million of NHS funding sloshing around, let’s see how quickly an ICB can make this disappear and see if this scheme is still around in a few years’ time.
The scheme will be gone in my opinion as part of the same NHS cycle of waste but the managers may still be there waiting for next £10million.
More doors on the bus but no more seats. We need more seats and more buses. You can’t get on the bus because it is full idiots.
“Book an online consultation with their GP or other practice professional including video;”
Are video consultations still a thing?
I would echo Professor Majeed’s comment. My father is a 98 year old retired GP of sound mind. Despite being looked after by a very good practice he feels that he has no GP service at all because he can not manage existing methods of remote and digital access. However good a new digital front door may be it will not address the needs of patients like him.
A further problemI would foresee is that access to a practice’s appointments system by a digital interface outside its control will make it even harder to optimise access so that appointments are allocated according to clinical need.
Duncan Keeley GP ( Retired)
More BS bingo
‘Benefit from a future AI triage pathway for the above functions over time.’
I think you’ll find this is what it’s for.
Developing AI health tools on our population because we have a public healthcare system so the government can let lobbying multinationals access our patients (sorry ‘citizens’) to develop AI tools on harvest useful data, develop digital tech tools (‘Has the option to link to mobile /wearable devices.”).
Patients (sorry ‘citizens’); you are the product not the services users.
Public healthcare system=access to salivating multinational companies to use us as they will.
USA, EU, etc.=Private healthcare. Those companies will not be able to offer up their patients (‘citizens’).
Why pay for expensive trials to recruit patients when you can develop whatever you want when your government offers you up as part of the ‘digital front door’.
How about paying GP surgeries more, getting a few more GPs and receptionists hired and let patients book the appointments with us they want.
You can take your digital front door and shove it where the sun don’t shine.