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 our sister title 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’.
The ICB has been asked whether this would remove acute care from GP practices but it 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.
Cambridgeshire LMC were also contacted 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
A version of this story was first published on our sister title Pulse.
