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NHS North Central London needs £180m to enable digital health and care

The North Central London local health and care economy submits its draft sustainability and transformation plan to NHS England, but criticises the process for lack of focus on social care

North Central London (NCL) health and social care economy claims it needs £180m to be able to realise its digital strategy of becoming paperless at the point of care.

The NCL health economy, whose footprint covers four clinical commissioning groups (CCGs), five local authorities and 11 NHS trusts, submitted its sustainability and transformation plan (STP) to NHS England last week.

All 44 local health and care economies have had to submit the plans, of which the local digital roadmaps form part, to NHS England. The plans outline how the area aims to transform its delivery of health and social care, and also act as the main source of gaining access to central funding.    

NHS England has asked local health economies not to publish their STPs until independent scrutiny of the plans has taken place, but North Central London has gone against this advice.

Camden Council is one of the four local authorities involved in the plan. Camden Council leader Sarah Hayward said the decision to publish the plan was due to a lack of “political oversight and minimal public and patient engagement”, adding that she has “serious reservations” about the process.

“At present, there is a lack of appropriate focus on adult social care. That lack of public, patient and political involvement is why I am publishing [the STP]. It is vital that there is full transparency in Camden as this work progresses,” she said.

In its plan, North Central London said it aims to use digital technologies to deliver “proactive, predictive, participatory, person-centred care”, including shared care records across health and social care.

“There is significant and immediate opportunity for digital to transform our current delivery models and seed completely new, integrated models of health and social care,” the plan stated. “We recognise the strength of both the clinical and financial case for digital and its potential impact in strengthening productivity, providing ease of access to our services, minimising waste and improving care.”

North Central London also plans to create a population health management system to support prevention, service transformation and productivity, and to enable it to meet the national mandate of operating paper free at the point of care by 2020

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One of the area’s key issues is money. It has a projected £876m deficit by 2020/21, however its STP said it aims to cover that gap, with technology as a key enabler.

However, the main problem with North Central London’s plan is that it needs digital funding of £159m over the next four years, with a further £21m in 2020/21.

NHS England has promised a £1.8bn in funding for going paperless, split between £900m in capital investment, available to frontline NHS services, with £400m in revenue funding to support the running costs of the investment.

North Central London said it expects its entire £159m investment to be covered by NHS England’s estates and technology transformation fund, however it recognises that further work is needed to develop business cases for its plans.

“In developing these schemes we will seek to maximise the use of existing buildings and other assets, and minimise the need for new capital investment, together with applying a robust requirement for return on investment for each scheme,” the plan stated.

“However, we fundamentally believe that investment in primary care and digital technology is central to the transformation of services that is needed in North Central London to address the gaps in service quality, access and finance, and wholly consistent with the Five Year Forward View and requirement to be paper-free at the point of care by 2020.”

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