Slides from the day's presentations. See the agenda document for more details.

2. Matthew Williams
Programme Manager Primary Care Innovations
Wessex AHSN

3. Wifi
Smartphone
Broadband Tablets
Wearables
Social
Media
Smart
Watch
Connected
Home
Smart
Appliances
Laptop
Implementing Innovation – My Journey

4. Implementing Innovation - Standardisation

5. Implementing Innovation - Standardisation

6. Implementing Innovation – Standardisation in NHS

7. Video - Explaining Primary Care Demonstrator sites
https://wessexahsn.org.uk/videos/show/229

8. Implementing New Technologies - NHS
Technology can improve patient outcomes
Technology can provide cost & time efficiencies for the NHS
Generate little evidence on the full-scale potential
Implemented without rigour, disciple or evaluation
Innovations tested in isolation from complementary services
Reach and impact are the biggest challenges
No shortage of innovation in the NHS

9. Wessex AHSN Primary Care Demonstrator Sites
Tier 4: Spread -
Supporting the
adoption of an
innovation at system
level
Tier 3: Efficacy Trial -
Determining whether
the product or service is
better than the
alternative;
comparative outcomes.
Generating evidence of
sufficient quality to
present to NICE
Tier 2: Functional Trial
- Confirming that a
product or service
works as intended;
i.e. does it function in
primary care and
impact the ‘need’ at
all?
Tier 1: Needs
Validation -
Confirming that the
‘need’ identified by
the innovator is real,
i.e. is there really a
problem or
opportunity to tackle?
Provide opportunity to
combine new technologies
with changes in service
delivery
Primary Care Providers from:
GP, Community Pharmacy,
Community Services, Mental
Health, Optometry, Dentistry
Explore demonstrator sites at
locality, federation and
system level supporting STP,
CCG and PCN

10. Wessex AHSN Primary Care Demonstrator Sites

11. Primary Care Innovations Programme
Current Projects

12. AyogoT2D
Description:
• The Ayogo App to promotes confidence and enhance self-
efficacy for those living with T2D
• Behavioral management and educational content from
multiple sources (NHS, Diabetes UK, Leicester Diabetes
Centre).
Benefits:
• Patients gain confidence in self management of their
condition resulting in better health outcomes.
• They are also regularly signposted to relevant healthcare
services, most specifically Retinal Screening, Foot Checks
and attendance on structured education course
(Desmond).
Current Status:
• Three pronged evaluation is currently in progress with
results due to be completed Summer 2019.
• Patient surveys
• Practice data on attendance of 3 key services
• App Usage data
Tier 2: FunctionalTrial -
Confirmingthat a
product or service
works as intended; i.e.
does it function in
primary care and impact
the ‘need’ at all?
Locations being tested:
7 Practices across SE Hampshire

13. Cardionetics
Description:
• 24/48 hour ambulatory ECG monitor designed
specifically for use in Primary Care to assist in the early
detection of cardiac arrhythmia in adults.
Benefits:
• Investigation for patients with symptoms of heart
disease, such as palpitations, dizzy spells, shortness of
breath, and fainting.
• Tests to be undertaken and analysed in general
practice, which can reduce the number of referral.
• Improved local treatment for patients and cost savings
for the NHS.
Current Status:
• Provision of hardware to practices and training has
been completed as well as initial usage.
• We have now started to collate data for evaluation.
Tier 2: FunctionalTrial -
Confirmingthat a
product or service
works as intended; i.e.
does it function in
primary care and impact
the ‘need’ at all?
Locations being tested:
Park & St Francis Surgery
St Mary’s Surgery

14. Diasend
Description:
• Diasend is a tool designed to work with a wide range of
glucometers, to download blood glucose level data into a standard
format.
• A ‘plug in’ cloud based solution that seamlessly uploads and stores
all diabetes patient data centrally.
Benefits:
• Self-monitoring of blood glucose (SMBG) in type 2 diabetics has a
positive impact on HbA1c and long-term effects of the disease.
• The detailed record of blood glucose levels taken over months, that
will be available through use of the Diasend tool, can assist
clinicians and patients with the identification of blood glucose
trends.
• Resulting direct alterations in treatment regimes help to manage
diet and nutrition plans and inform exercise schedules.
Current Status:
• 94% of Paediatric Clinics and 85% of Adult Clinics currently use
Diasend in Diabetic Review Clinics in Secondary Care.
• Provision of Diasend hardware directly to primary care practices
within a CCG where the device is already utilised within the local
secondary care facility.
• Project evaluation will focus on project implementation process as
well as product success indicators.
Tier 2: FunctionalTrial -
Confirmingthat a
product or service
works as intended; i.e.
does it function in
primary care and impact
the ‘need’ at all?
Locations being tested: (TBC)
One CCG and one PCN Proposed

15. Primary Care Digital Exemplars
Description:
To develop the digital maturity at two GP practices and develop a
framework for other sites to achieve the same standard.
AHSN Role is to :
• Facilitate the adoption of digital innovations in the sites
• Evaluate the project, contributing to the framework for
Southampton City CCG GP sites to adhere to for achieving Digital
Exemplar status.
Benefits:
• Improved online resources
• Access to digital innovations to improve quality of care through
preventative treatment.
Current Status
• AHSN arranges innovation demos at steering groups for sites to
ask practical and clinical questions to ensure the innovations
are meeting an unmet need
• AHSN implements innovations on site and coordinates
evaluation activities with AHSN colleagues and external
evaluators R-Outcomes
Locations being tested:
St. Mary’s Surgery
Shirley Health Centre

16. Dermicus
Description:
Teledermatology Solution provided through an intuitive phone-
based Application as well as a web based platform for referrals.
Benefits:
• Reduced timescale of referral to consultant dermatologists.
• Reduction in unnecessary face-to-face consultations, with
side benefit of reduced cost of travel to
patients/environment.
• Increased primary care awareness of results and associated
competencies.
• Provide future solution for remote consultation
Current Status
• The Dermicus platform is scheduled to launch 3 initial
Champion Site in July 2019
• Subsequent rollout to the remaining GP locations on the
Island.
• This will be initially evaluated by AHSN 6 months after
launch.
• Further work will then be done with integrating the
platform with NHS systems with a view to further spread
and adoption.
Tier 3: EfficacyTrial -
Determiningwhether the
product or service is
better than the
alternative; comparative
outcomes and costs.
Generatingevidence of
sufficient quality to
present to NICE
Locations being tested:
All 16 general practices on the Isle of Wight
plus central dermatology centre at Lighthouse
Medical.

17. Lifelight
Description:
• Lifelight uses a camera on an iPad to scan a patient’s face and provide a
reading of vital signs (blood pressure, oxygen saturation, heart and
respiration rates) within 40 seconds – entirely contactlessly.
• The AHSN is able to provide valuable real-world evaluations to
demonstrate how Lifelight is more effective than current methods of
taking clinical observations and how it can lead to preventative care
measures.
Benefits:
The benefit for patients is that there will be a foundation of evidence to
determine where Lifelight is most effective and why.
• For example
• Taking vital signs before a GP appointment so there is more time
to discuss conditions or symptoms
• Taking vital signs of a patient on a ward while they are sleeping
to avoid disturbing them
• Hosting Lifelight in dental practices or care homes could spot
something such as high blood pressure a patient may not have
known about until their next GP appointment
Current Status
• Lifelight implemented at Dorset dental practice SmileKind for a Health
Education England funded Quality Improvement project
• Becoming part of the innovations trialled in the Primary Care Digital
Exemplars
Tier 3: EfficacyTrial -
Determiningwhether the
product or service is
better than the
alternative; comparative
outcomes and costs.
Generatingevidence of
sufficient quality to
present to NICE

18. Mind Over Matter
Description:
• Mind over Matter is developing technology that gives you more control over the
brain health that you can expect in your retirement years.
• It aims to delay the onset and slow down the progression of dementia in
millions across the world.
• The equipment is designed to be used in either the waiting room or
consultation room during the NHS Health Check visit (available to anyone aged
40-74 and registered with a GP) with risk scores displayed during the
consultation.
Benefits:
The technology comes in two parts:
• A device that works out the health of the your brain tissue (known as white and
grey matter) by imaging your brain activity.
• An app that helps you to lead the life that reduces your chances of developing
dementia. Lifestyle changes could PREVENT one third of people from
developing dementia.
Current Status
Wessex AHSN supported in gaining approval for Digital Health Catalyst funding and
is supporting this innovation with sourcing a practice for feasibility study and
coordinating clinical and patient focus groups.
Tier 2: FunctionalTrial -
Confirmingthat a
product or service
works as intended; i.e.
does it function in
primary care and impact
the ‘need’ at all?
Locations being tested:
Currently planning towards Tier 2
Feasibility study in Q3 2019/20

19. 3. Current Footprint
CCG Number of
Demonstrator Sites
Isle of Wight 16
Southampton 2
South East
Hampshire
7
West Hampshire 1
Portsmouth 16 (TBC)
North
Hampshire
TBC - One PCN
Primary Care
Digital Exemplars
PCDS Current Footprint

20. Primary Care Innovations Next Steps
Deliver on existing projects
Build Portfolio of willing Demonstrator Sites
Develop across various Primary Care Providers
Identify Innovations ready for Primary Care
Match Innovation with correct location
For more information – email: Matthew.Williams@wessexahsn.net

21. Common Approach to Children’s Health
http://www.catchapp.co.uk @catchapp_uk
Primary Care Innovations EXPO
Elevator Pitch

22. DERMICUSTeledermatology
Platform: www.dermicus.com Company: www.gnosco.com Contact: philip@gnosco.se
For fast and secure diagnosis of skin cancer and wound management

24. Healthy.io
Web: https://healthy.io
Twitter: @Healthyio1
Primary Care Innovations EXPO
Elevator Pitch
Smartphone
enabled
home testing
• Early intervention
• Reduced health inequalities
• Digital self-management
• Population health savings

25. Website - www.droplet-hydration.com
Facebook - https://www.facebook.com/DropletUK/
Twitter - https://twitter.com/Droplet_UK
Dehydration is an problem which increases risks of infections
and falls, putting extra demands on GPs, carers, and
Hospitals.
Droplet® is the first visual and verbal hydration aid created to
tackle this challenge
• Droplet monitors the frequency of drinking. If the patient forgets
to drink, Droplet’s flashing lights and voice messages are an
instant reminder.
Droplet has been awarded entry onto the 2019 NHS Innovation
Accelerator programme.
Primary Care Innovations EXPO
Spearmark Health Ltd
introducing

27. Pharmacy is Changing

28. Pharmacist role in Community pharmacy
improves adherence to
treatment regimens
pharmacists are a
valuable, easily
accessible resource for
advice and support
helping patients take
ownership of their health
Answer questions about
related health related
conditions
Offer guidance on the proper
use of medications

29. Community
pharmacy as a
retail business
Pharmacy Cuts?Retail stores closing down
Online services to your door step
People don’t want personalised
service
People know what they want
People have access to information
 Amazon ?

30. HOW
WHAT
WHEN
WHERE
HW3
Community pharmacy needs to change and
innovate into a new service model

31. WHAT-Social Media (SM)

32. What about services ?
 Bank services
 Post Office
 Goods are available online
 Telemedicine
 Safe environment to exchange information
 DVLA is a great example
 Patient needs that safety
 Supply model doesn’t work no more

33. Customers need more information

34. What’s pharmacy done for innovation
Websites
SCR
NUMSAS
Medication delivered to your
door steps or to your convenient
store

35. Innovation

36. www.askhala.com

38. Integration

39. NHS 111

40. Latest updates
https://www.chemistanddruggist.co.uk/news/pharmacies-gp-dmirs-14-pounds-per-consultation

42. www.fourteenfish.com
Making appraisals easy for you and
your organisation

43. HORIBA UK Ltd
‘Microsemi CRP’ Near-Patient Testing Analyser
http://www.horiba.com/uk/medical/products/point-of-care/microsemi-crp/
Primary Care Innovations EXPO
Elevator Pitch
 Only analyser currently on market capable of a combined FBC
& CRP measurement from a whole blood sample
 Results available in just 4 minutes
 Ideal for GP surgeries & community hubs
 Can assist to streamline existing patient pathways
 Promotes more judicious antibiotic prescriptions
 Earlier sepsis detection
 Reduction in pressure on local acute sites
 Please come and see us in the Mayflower Suite or contact
enquiries.uk@horiba.com for further details

44. What if all the workforce in a region was all in one place?
What if…
you could give them access to vacant shifts across your ICS that meet their skills?
you only had to go through one recruitment process and receive a passport to work in
all other organisations in the ICS?
you could develop a more mobile workforce with greater diversity of skills by giving
people access to work in different ways and different parts of your ICS?
you could access volunteers and 3rd sector services through the same passport to
book a package of support?
Why wouldn’t you do that? We are, and you can too!
Lantum.com
Transforming the workforce with technology
ourdorset.nhs.uk

45. Lifelight
www.Lifelight.care
Primary Care Innovations EXPO
Elevator Pitch

46. Liva Healthcare
Website www.livahealthcare.com
Facebook https://www.facebook.com/LIVAHealthcareUK/
Twitter https://twitter.com/LIVAHealthcare
Linkedin https://www.linkedin.com/company/livalife/
Primary Care Innovations EXPO
Elevator Pitch

48. INNOVATION AND
PRIMARY CARE
2019
Dr Anthony Leung
Partner, Badgerswood Surgery

49. Video - Working together to improve anti-coagulation in Atrial Fibrillation
https://wessexahsn.org.uk/videos/show/187

50. Video - BBC South Today News new mobile ECG devices that detects irregular heart rhythms
https://wessexahsn.org.uk/videos/show/227

51. Video - MISSION COPD - an innovative approach to respiratory care (full version)
https://wessexahsn.org.uk/videos/show/171

52. Respiratory COPD Carousel - 5 Month Results
REAL OUTCOMES
Dr Anthony Leung
TOTAL
BEFORE
MEAN TOTAL
AFTER 5
MONTHS
MEAN ANNUALISED % REDUCTION
ON ANNUALISED
FIGURES
STEROID/
ANTIBIOTICS
USE FOR CHEST
31 1.63 10 0.55 24 23
UNSCHEDULED
GP VISITS 61 3.21 10 0.55 24 61
111/OOH CALLS
2 0.125 0 0 0 100
A&E ATTENDANCES
FOR CHEST 6 0.31 0 0 0 100
HOSPITAL ADMISSIONS
FOR CHEST
1 0.05 0 0 0 100

53. PATIENT ENGAGEMENT
PATIENT SUPPORT
Dr Anthony Leung

54. AHSN
A VISION FOR HEALTH IN BORDON NEW TOWN
Dr Anthony Leung
• Carousel Clinics
• QA Respiratory
• Atrial Fibrillation
• NHH Haematology
• Alivecor
• Dementia Friendly Surgery
• MSD & Ayogo
• Lifelight
• Demonstrator Site

55. AYOGO
Dr Anthony Leung
AYOGO

56. BORDON HEALTH HUB
PATIENT SUPPORT
Dr Anthony Leung

57. Video - The Role of Community Pharmacists in Supporting CVD Care
https://wessexahsn.org.uk/videos/show/232

58. A VISION FOR HEALTH IN BORDON NEW TOWN
Dr Anthony Leung
STRETCHING OUT GP TIME

59. PARTNERSHIPS
BORDON LOCATION
Patient Focus
•- Highest clinical standards
•- Travel together
•- Moral Compass
Partners
- Most efficient way for system
- Pull not push
- Win-win (Right design)
Toolkit
- Multi-disciplinary (> medical)
- Diversification
- Commitment yet nimbleness
Evolution
- Continuously learn & adapt
- Can-do
- Self-actualisation
Culture
- Take responsibility
- ‘Proud to work here’
- Celebrate Success

60. PRIMARY CARE IN CRISIS:

61. SO WHAT
BORDON LOCATION
Savings to System
Good PRGood Clinical Outcomes
• Collaborate w/ Hospitals
• Engage Patients
• Enable Innovators
• Fire up Staff

62. UK MEDICAL INNOVATION AWARDS
INNOVATION

63. DEVELOPING YOUR IDEA
DEVELOPING YOUR IDEA

64. ALL ABOUT PEOPLE
ALL ABOUT PEOPLE

65. MONEY
INNOVATION
• Concept / Pre-seed
• Seed Capital
• Angel Investor Funding
• Venture Capital Financing (Series A, B, C Rounds, etc)
• Mezzanine Financing
• IPO (Initial Public Offering)

66. EXEMPLAR
GOOD MEDIA COVERAGE
Dr Anthony Leung
• Press
• GP Nationwide
Partnership Review
• Goldberg report
• Commonwealth report

67. Mind over Matter
Dr Melissa Kapoor
melissa@mind-medtech.com
www.mind-medtech.com
Primary Care Innovations EXPO
Elevator Pitch

68. Mush
Sarah Hesz- Co-Founder
sarah@letsmush.com
@mushmums
www.letsmush.com
Primary Care Innovations EXPO
Elevator Pitch

69. OurPath
www.ourpath.co.uk – Mark Davies
mark@ourpath.co.uk @Mark_T_Davies
Primary Care Innovations EXPO
Elevator Pitch

70. quiqsolutions.com
admin@quiqsolutions.com
01948 841116
A paperless approach for:
• Quality Assurance
• CQC Compliance
• Audits
QUIQSOLUTIONS
• Surveys
• Policies
• Action Plans

71. RIVIAM Digital Care
Paul Targett, Managing Director
Paul@riviam.com www.riviam.com
Primary Care Innovations EXPO
Elevator Pitch
Working with referrers, providers and
citizens to improve lives through the
delivery of digital, ​co-ordinated care

72. Accelerating digital primary care
transformation at scale-what does it
take?
Dr Ruth Chambers OBE, Clinical lead for
Staffordshire STP’s technology enabled care
services (TECS) programme, digital workstream
board

74. •Improved clinical
outcomes
•Quality/savings
targets attained
•Wealth creation eg
patients stay in work
•Upskilled patients &
workforce
•Patients stay
independent
Technology enabled care
underpinning general practice at
scale - the future
Patient populations Outcomes
Current Practice
NHS/patient/public
Commissioning/
providers
NHS /social care
Cluster
Re-Design
Technology enabled care
under-pinning service
re-design

78. Manage Your Health
A new App for managing your
long term conditions
Available now on:
Search for ‘Manage Your Health’

79. 79
Setting up Skype (clinician/patient)
• Practice/other protocol: patient selection; patient
consent; key steps
• Champions – doctor, nurse, administrator
• IT help – lift firewall, load Skype
• Confirm medical defence cover
• Organisational support: IG, connectivity, Caldicott
Guardian

80. Skype in practice
• GP practices to care homes
(pictured) via Skype
• Consultant to care home via
Skype
• Skype asthma reviews
• Community pharmacist link to
frail patient recently
discharged from hospital &
carer with meds use review

83. 5. Person selects and purchases own technology to support or improve their own health
and/or social care and/or lifestyle habits: they may include goal setting, reminders, records of
feelings/bodily measurements etc, action plans, information about best practice. They may or may
not share their personal information/record keeping generated by the technology (eg health app)
with a health/social care professional.
4. Shared delivery by individual professional with patient/carer: TECS initiated & delivered
by health /social care professional who updates other health/social care professional(s) or teams
involved in the patient’s care (ie giving information rather than interactive decision making
between professionals). It might be that a patient requested the inclusion of their personal
technology such as an app in their health or social care, that the initiating health/social care
professional has adopted; with shared care plan agreed by patient, that optimises patient
responsibility for their own care.
3. Shared multidisciplinary protocol with one TECS operator: ≥2 clinicians/ social workers, of
different disciplines, in same organisation or setting; sharing (delegated) responsibility for providing
TECS directly (≥1 mode of technology) for continuing care of same patient/≥ 1 conditions via
agreed care plan. (This might be by the most senior/expert defining patient pathway and endorsing
TECS protocol(s) for others to provide with real time support eg advice in person/by email; with
shared care plan agreed by patient, that optimises patient responsibility for their own care.)
2. Shared sequential responsibility: ≥2 clinicians/ social workers, in different
organisations/settings interface; so one hands over responsibility to the other for providing TECS
directly (same mode of technology or different) for continuing care of same patient/same condition
via agreed care plan.(This might be by the most senior/expert defining the patient pathway and
endorsing the TECS protocol for others to provide with real time support eg advice in person/by
email; with shared care plan agreed by patient, that optimises patient responsibility for their own
care.)
1.Shared real time responsibility by ≥2 clinicians/ social workers, in different
organisations/settings share TECS directly (same mode of technology or connected if
different) for delivery of an agreed shared care plan of same patient/ same condition at
same treatment phase (clinicians/ social workers have agreed responsibility via shared
care plan agreed by patient, that optimises patient responsibility for their own care)
Extent of responsibility for delivery of integrated & connected care via TECS

84. LTC
pathways
&
Technology
enabled
care
Patient –self
care
Evidence
base
Clinical
teams
Focus on ‘hot
spots’ using
data
Technology -
modes
Digital
innovation
Minimise
duplication –
shared care plan
Workforce
training/
upskilling
Digital Clinical Champions
Developing confidence, competence, capability, continuity and
capacity for delivery of technology enabled care
General practice
digitally able teams
General practice TECS –
accessible and
available to all

85. Health Education England definition
“Digital literacies are those
capabilities that fit someone for
living, working, learning,
participating and thriving in a
digital society.”
What is digital literacy?
@NHS_HealthEdEng

86. www.england.nhs.uk
Comparison of 19 practices where 24 general practice nurses participated in digital
upskilling programme; modes of TECS used before and after their action learning set
(ALS)
Case Study
Staffordshire STP TECS

87. Benefits vary according to the practice and their adoption of
specific mode of TEC and purpose. By February ’19, of 152 general
practices across Staffordshire:
92 practices were using Facebook
21 practices undertaking video-consultations
28 practices using interactive telehealth
11 practices promoting apps
80 practices using ‘AliveCor’ for AF screening (smart phone
compatible portable handheld ECG heart rate monitor)
23 practices undertaking online clinical consultation triage
What do we seem to have achieved?
Technology-enabled care services by general practice teams provided as
routine patient care including via apps, video-consultation, telehealth,
social media, GP Online.
Expected / achieved benefits: enhanced productivity (practice teams);
patient empowerment to self care and thus improved clinical outcomes;
minimised unwarranted clinical variation; increased patient convenience.

89. Making digital delivery happen at scale in
general practice settings
Aim – Adopt
technology enabled
care as usual practice
Scope – Which type(s) of
technology will you use to
achieve planned
outcomes/ what LTCs and
adverse lifestyle habits will
you focus on/ what
population health &
wellbeing?
Resources – Who/what do
you/teams need –
infrastructure, equipment,
competence, practical
support, capacity,
communication, integrated
working, clinical
consultation triage?
Outcomes – Improve
patient /clinical
management of long
term
conditions/adverse
lifestyle habits –
efficiently and
effectively

90. Whzan Digital Health & IoT
www.whzan.com
paul.westbrook@whzan.com
Primary Care Innovations EXPO
Elevator Pitch

91. The Development People
Contact: Lucy Hadley
Email: lucy@thedevelopmentpeople.co.uk
Website: www.TDPhealthcareplus.co.uk
Twitter: @TheDevPeople
Primary Care Innovations EXPO
Elevator Pitch

92. mg.khan@writtenmedicine.com @WrittenMedicine
Accessible
Medication
Information for
Partners
Academic evidence shows we;
• Increased patient safety by 55%
• Improved communication from 38% to 89%
• Improved adherence by 82%
• Improved patient experience by 80%
ALL

93. YOURmeds
www.yourmeds.net Dr Nitin Parekh
(nitinp@marsoftware.co.uk)
Primary Care Innovations EXPO
Elevator Pitch

95. The Digital revolution in Primary Care
Dr Mark Kelsey
GP
CCIO for HIOW Digital Transformation Programme
Clinical Lead for Wessex Care Records
Chair Southampton CCG

96. What is the digital revolution in health?
• Think about how you use technology in your daily lives
• Now think about how you or your patients can use technology to
manage their health
• What would the NHS be like if Amazon, Google or Uber ran it?

98. •41.8 million adults (aged 16 and over) used the
Internet daily in Great Britain;
•51% of users looking for health related
information,
•only 15% of adults made an appointment with
a doctor or a health practitioner via a website
in 2016
ONS reported in 2016 that:

99. • 85% of households in Great Britain with at
least 1 adult aged 65 or over had an Internet
connection in 2016,
• fewer than 30% of adults over 65 years used
the Internet for health-related purposes
• 59% of people with no internet access at home
said that they didn’t need it because they
weren’t interested or saw no use for it
• Several reports and academics have argued
that it is people living with long-term conditions
that would benefit the most from accessing
eHealth tools in the management of their
health

100. http://nhs.goodthingsfoundation.org

101. http://nhs.goodthingsfoundation.org

102. ‘just installing computers
without altering the work and
workforce does not allow the
system and its people to reach
this potential’
Dr Robert Wachter

104. Southampton Primary Care Exemplar
• Explore what interventions are most successful in improving
the uptake of existing projects
• Test out the implementation of new innovations
• Ascertain what future digital developments are necessary to
meet the changing demands on primary care.

106. Long Term Plan
• In ten years’ time, we expect the existing model of care to look markedly
different.
• The NHS will offer a ‘digital first’ option for most, allowing for longer and richer
face-to-face consultations with clinicians where patients want or need it.
• Primary care and outpatient services will have changed to a model of tiered
escalation depending on need.
• Senior clinicians will be supported by digital tools, freeing trainees’ time to learn.
• When ill, people will be increasingly cared for in their own home, with the option
for their physiology to be effortlessly monitored by wearable devices.
• People will be helped to stay well, to recognise important symptoms early, and to
manage their own health, guided by digital tools.

107. ‘The future is already here — it's just
not very evenly distributed.’
- William Gibson

109. Integrated
Health and Care
Records
Clear and consistent
information governance
arrangements across HIOW
•Health and Care professional will have easy access to a richer set of shared data
in near real-time
•Citizens will have access and be able to contribute to their own record
•Health and Care professional in HIOW will have access to data in the Dorset Care Record
Information
Governance
Comprehensive longitudinal
care record accessible at
the point of care.
•A more integrated approach to Information Governance
•A joint group to overcome barriers to sharing
•Removing confusion and complexity in issues relating to data sharing
Digitisation
and
Infrastructure
Foundation for information
being recorded and viewed
digitally at the point of care
•Wider use of common system technologies such as video conferencing
•Enhancing digital maturity to better enable local system transformation
•Reducing reliance on paper records and fax machines to improve patient safety
Intelligence
and Analytics
Better use of data to to drive
substantial improvements in
health and care
•Improve the health of our population by planning services around our population needs
rather than providing a “one size fits all” service.
•Helping care professionals quickly identify patients which would most benefit early
intervention.
•Improve understanding of the quality of care delivered across different parts of HIOW
Digital Access
and
Empowerment
Enabling patients to interact
with their record and
collaborate in their care
•To have safe, on-line access, to their own health data
•The ability to use a range of on-line services to book appointments, seek medical advice
(e.g. 111, e-consult) and interact with health and care professionals
•To enable patients to take a more proactive role in managing their care
Public and
Clinical
Engagement
Ensuring involvement of
professionals and citizens in
the development of our
digital plans
•Greater awareness across our population of the digital alternatives to the traditional
means of accessing health and care services.
•Improving the confidence of our care professionals in the use of digital solutions
•Easing pressure on care professionals by use of digital solutions.

110. Digital Access and Empowerment – GP Contract Requirements
• All practices will ensure at least 25% of appointments are available for online booking by July 2019. 2019
• New registrants will have full online access to prospective data from April 2019 2019
• All practices will be offering and promoting electronic ordering of repeat prescriptions and using
electronic repeat dispensing for all patients for whom it is clinically appropriate, as a default
2019
• All patients will be able to order repeat prescriptions electronically as a default from April 2019. 2019
• All patients will have online access to their full record, as the default position from April 2020. 2020
• All practices will need by April 2020 to have an up-to-date and informative online presence, with key
information being available as standardised metadata for other platforms to use (for example the
Access to Service Information (A2SI) Directory of Services Standard);
2020
• All practices will be giving all patients access online to correspondence by April 2020, as the system
moves to digital by default (with patients required to opt-out rather than in);
2020
• All patients will have the right to digital-first primary care, including web and video consultations by
April 2021
2021

111. Digital Access and Empowerment – LTP Targets
• Patients able to participate/register interest for health research via NHS App 2020
• Every patient with a long-term condition will have access to their health record through the Summary
Care Record accessed via the NHS App
2020
• By 2020, we aim to endorse a number of technologies that deliver digitally-enabled models of
therapy for depression and anxiety disorders for use in IAPT services across the NHS
2020
• Cancer patients able to access care plans, assessment and HWB info & support 2021
• Summary Care Record functionality will be moved to the PHR held within the LHCR systems, which
will be able to send reminders and alerts directly to the patient.
2023
• People will have access to their care plan and communications from their care professionals via the
NHS App
20/21
• Online Digital GP Consultations available for all patients 23/24
• Digitally re-designed hospital support (outpatients). Reduction in Op appointments by 30% 23/24
• All women will be able to access their maternity notes and information through their smart phones or
other devices.
23/24
• All women will be able to access a digital version of the ‘red book’. 23/24

112. GP Online consultations
• National funding 2017-19
• Hampshire & IOW wide procurement Oct 2017
• 100 live practice March 2018
• Currently 146/182 live practices
• Utilisation remains low in many practices though...

113. Electronic Prescription Service
• Part of NPfIT – so started 2002
• Very slow development and uptake nationally…
• 2016 aspirational target of 60% prescriptions to be sent
• We are now approaching 90% prescriptions in most areas
• Only around 40% patients have adopted though…
• How does this link with Patient Online / NHS App?

114. What is a Local Health and Care Record?
114
A LHCR is a group of health and care organisations working collaboratively to create an information sharing environment to help service
improvement.
Shared records are not new, there are currently over 60 instances of
shared record solutions in operation today, but they vary in terms of
the scope of data and the range of their uses and not operating to
common standards.
In spring 2018, NHS England and the Local Government Association
(LGA), invited proposals from NHS and local government partner
organisations to participate in the Exemplar programme.

115. Who are the Wave 1 LHCRs?
The five first wave LHCRs are: Greater Manchester, One London, Thames
Valley & Surrey, Wessex and Yorkshire & the Humber.
They will:
• Ensure information is collected consistently and made available across
local areas to support joined up and safer care.
115
• Enable people’s information
to be accessed by their
health and care team, safely
and securely, as they
move between different parts
of the NHS and social care.
• Build on and learn from
existing local initiatives.

116. LHCR draft milestones
• Citizen access and contribution
• Joining across boundaries
– Dorset / HIOW
• Comprehensive longitudinal record
– Depth and breadth of data
• Realtime structured data
– for secondary use / intelligent use
– research ready

117. Lessons…
• It’s easy to innovate in primary care…
in a small way!
• It’s much harder to spread innovation
even when you can prove the benefits…
• Having the right support infrastructure helps

118. Questions?

119. Hampshire & Isle of Wight
STP Innovation Hub
Dr Sunil Rathod
Wessex AHSN Primary Care Innovations Expo
3rd July 2019
119

120. • Provide a forum where:
 Knowledge of existing pilots and products
used are shared
 New ideas and products are assessed and
evaluated
 Digital Leads contribute local knowledge to
assess suitability and fit with individual
organisations
 Cross organisational solutions can be
assessed
 Solutions can be considered for pan
Hampshire adoption
Purpose

121. • Reduce duplication - target resources to robustly pilot,
evidence and adopt (or reject) ideas and products
• Work with suppliers in a cohesive way
• Support local innovations - access to technology experts
and a framework supported by the STP
• Support, not stifle, momentum and enthusiasm at a local
level
• Support health and care professionals to make informed
decisions about technology
• Achieve better value for money by implementing at scale
where practical
• Provide common tools for services and patients that are
robust, well supported and sustainable
Goals

122. • Report directly to the HIOW STP Digital Transformation
Portfolio Board
• Representation from:
• Acute
• Community and Mental Health
• Primary Care
• Social Care
• Ambulance
• CCGs
• Local Authorities
• Wessex Academic Health Science Network
Membership and Governance

123. • The Innovation Hub has provided a valuable forum for
sharing a complex digital agenda across multiple trusts
• Sounds simple but keep abreast of everything that is
happening is a challenge
• 28 different solutions have been reviewed and product
overviews shared
• A Video Consultations pilot took place and supported
securing of NHSE funding for Southern Health and
Solent to be the first to implement patient video
consultation
Achieved