PCNs urged to talk with ICBs about autonomy around digital tools

Clinical directors have been encouraged to talk to their integrated care boards (ICBs) about how much autonomy they will get when procuring digital tools.

Dr Tom Micklewright, clinical lead for digital transformation in primary care at Cheshire and Merseyside ICB, said PCNs should be having these conversations now, ahead of the publication of the digital pathways framework.

The framework is designed to help PCNs improve standardised digital systems and is expected later this year.

The tool was set to launch in February, according to a webinar at the start of the year, but has now been delayed until at least June. It was unveiled as part of the GP recovery plan and is set to include tools to address booking, messaging and online consultations.

Speaking at the Pulse PCN Birmingham event in April, Dr Micklewright said the tool would be a bit of a ‘free shopping catalogue’ for primary care, but it was unclear what level of autonomy would fall onto PCNs.

He said that clinical directors should be having these conversations now to be ready for the rollout of the framework.

He said: ‘The framework will be an NHS catalogue of products that relate to online video consultation, admin requests and SMS messaging. Basically, if you choose a product from that catalogue, you get it reimbursed, which is fantastic.

‘What remains to be seen though is the level of devolved autonomy that will fall onto PCNs or practices and it’s something we’re wrestling with.’

He said it was not a matter of control, but more who would be responsible for the technical expertise, making sure interoperability works and that there’s been clinical safety, due diligence and technical security considerations.

‘All of that is a big burden to fall on practices, and it’s sometimes easier to coordinate at scale. That’s not to say that the decision should be made at scale because ICBs don’t know the population as well as we do at practice and PCN level,’ said Dr Mickelwright.

‘Call out the interplay between the benefits of autonomy and local ownership and the benefits of working at scale early,’ he urged.

‘Have those conversations now, because you don’t want that framework coming out in six months’ time and conversations are then happening too late.’

Alternatives in the meantime

Prior to the framework coming out, NHS England said alternative buying approaches should be pursued.

On an update on its website, NHS England said: ‘Following recent challenge to the new DP framework, legal action is ongoing and progress has been delayed. On this basis we believe earliest date the framework would be awarded is June 2024.

‘Given the uncertainty about the new DP framework timeframes, alternative buying approaches should be pursued in the meantime as set out in this framework. 

‘As a result of the new DP framework delay, the national support offer is being enhanced. This will enable ICBs to take advantage of the available funding to support uplifted digital tools (in line with the Modern General Practice model (MGP) throughout 2024/25.’

It added that ICBs should work with PCNs to ensure that requests for specific products and capabilities are ‘given due consideration to achieve a collaborative decision on a choice of solutions aligned to local digital strategies’.

It comes as Dr Micklewright also called on PCNs to get access to data security teams at the neighbourhood level, in order to avoid risk.