NURSING TECHNOLOGY FUND Second Round Prospectus

FUND

Publications Gateway Reference: 02337

Document Purpose Guidance

Document Name Nursing Technology Fund Second Round Prospectus

Author NHS England

Publication Date 4 November 2014

Target Audience Care Trust CEs, Foundation Trust CEs, Directors of Nursing, Local Authority CEs, NHS England Regional Directors, NHS England Area Directors, NHS Trust Board Chairs, Directors of Finance, NHS Trust CEs, Directors of Children’s Services, Directors of Adult Services, CEs of Voluntary/Community/Social Enterprise Providers

Additional Circulation List

CCG Clinical Leads, Medical Directors

Description This document invites applications to the second round of the Nursing Technology Fund. It sets out the focus, priorities and eligibility criteria for funding, and the process that applicants need to follow.

Cross Reference Compassion in Practice Superseded Docs

(if applicable)

Nursing Technology Fund First Round Prospectus Action Required Submission of applications to the second round Timing/Deadlines

(if applicable)

Submission by 2 December 2014 Contact Details for

further information

Paul Rice

Head of Technology Strategy Room 7E14 Quarry House Leeds LS2 7UE [email protected]

Document Status

This is a controlled document. Whilst this document may be printed, the electronic version posted on the intranet is the controlled copy. Any printed copies of this document are not controlled. As a controlled document, this document should not be saved onto local or network drives but should always be accessed from the intranet

1. An Introduction to the Nursing Technology Fund 3

2. The Eligibility, Priorities and Focus for the Second Round 6

3. The Application, Evaluation and Award Process for the Second Round 13

Annex 1: First Round Outcomes 18

Annex 2: Public Dividend Capital 19

Annex 3: Grant Payments 20

Annex 4: Capability Matrix 21

Annex 5: Capital Classification 24

Annex 6: Technology, Architecture and Standards 25

Annex 7: Evidence Sought in Applications 28

Foreword

In autumn 2012 the Prime Minister announced investment for nursing technology, enabling nurses, midwives and health visitors to make better use of digital technology in all care settings. The

Nursing Technology Fund enables the delivery of safer, more effective and more efficient care, while supporting and caring for individuals, families and communities and promoting the public health and health outcomes of the population we serve. In year one of the funding we were delighted to see a range of practitioners receiving funding to improve nurses and midwives access to modern technology. The investment will support those people caring for people to offer modern nursing and midwifery care in ways that were not possible a decade ago.

Nurses and midwives are central to the transformation of care, and the need to continue to extend the use of technology and digital solutions has never been more important. It is unanimously agreed that we need better, more integrated and preventative person-centred care. We need to support people in their communities and homes, reducing the need for hospital care, and technology is a key enabler to make this happen. Not only is it a way of us helping to meet the demands of the future, but the public expect nurses, midwives and health visitors to be able to access information about them and to care in new, different, more effective ways.

In December 2012 ‘Compassion in Practice – the vision and strategy for nurses, midwives and care staff’ was published, and in Action Area 1 there is an explicit reference to the use of technology – ‘Ensuring practice is supported by appropriate technology to optimise information sharing and decision-making with people in their care’. The Nursing Technology Fund is targeted specifically at this group of staff. It sits alongside the Integrated Digital Care Record Fund, as both funds contribute investment to support the creation, and routine use of, integrated digital care records.

Investment in technology that nurses and midwives use also supports the creation of an environment where greater transparency and participation can occur. The ability to demonstrate the contribution of nursing and midwifery is dependent on our ability to show how we are doing and to be able to bench-mark ourselves against others in a meaningful way – the use of systems to capture information makes a real contribution to this. Access to evidence based information at the point of care is

essential to enable an excellent response to the sometimes complex needs of the people we care for. Technology can also enable new ways of working and process improvements that increase the productivity of clinical staff, reducing delays and eliminating duplication of effort. The delivery of ‘harm free care’ needs good information to support it, a bedrock on which to practice.

The original aim of the first round was to reduce the burden of paperwork for nurses and midwives and release more time to spend with patients and service users. We are delighted to announce further funding for the second round – £35 million of investment to enhance the ability of the nursing and midwifery professions to harness the use of technology for the benefits of patients and service users. The range of capabilities for which people can apply for funds has been extended in recognition that technology can support care and reduce the burden of bureaucracy in many ways. We are also delighted to announce that we have been able to extend the range of eligible organisations that are able to apply to the Nursing Technology Fund, recognising that care in communities is provided by a variety of NHS Trusts, local authorities and voluntary, community and social enterprises.

This fund demonstrates our continued support for nurses, midwives and health visitors to enable access to appropriate technology to deliver compassionate, improved, modern nursing and midwifery care.

Jane Cummings

Chief Nursing Officer for

England

Viv Bennett

Department of Health’s

Director of Nursing and

the Government’s Principal

Advisor on Public Health

Nursing

Beverley Bryant

Director of Strategic Systems

and Technology, NHS

1. An Introduction to the

Nursing Technology Fund

1.1 Programme Overview

The Department of Health has made capital funding available to be distributed to health and care providers to spend on eligible projects, selected through a rigorous application and evaluation process managed by NHS England and supported by the Health and Social Care Information Centre. The fund is focused on nursing. This term is used throughout the document, and unless otherwise stated, is intended to include nurses, midwives, health visitors and health care assistants, working across all care settings including acute, community, mental health and urgent care.

A total of £30m was distributed in FY2013/14, and the awarded organisations are now forging ahead with their projects. Further information on the outcomes of the first round is provided in Annex 1. In the second round, £35m is available. We expect to distribute £20-25m of this to spend in FY2014/15 and £10-15m to spend in FY2015/16, based on the profile of funding available.

There is no matched funding requirement, although where applicable, organisations must be able to afford the NHS capital charges, depreciation and any other consequential revenue or capital run-on costs arising from the initial award.

RECORDING PATIENT VITAL SIGNS AT THE BEDSIDE

King’s College Hospital NHS Foundation Trust

In the first round King’s College Hospital NHS Foundation Trust gained funding of over £500,000 to extend a successful vital signs system.

The trust had already piloted and developed Wardware, an electronic method of recording vital signs, in a range of acute wards. The funding received will enable the trust to progress this to support the use of mobile technology to record patient information at the bedside.

This means that staff will be able to spend more time with patients by reducing paperwork and improving access to patient information.

Dr Geraldine Walters, Director of Nursing and Midwifery at King’s College Hospital NHS Foundation Trust said:

“We are really pleased to secure this investment. The money will allow us to further utilise modern technology in our hospital, to help our patients and staff. We are extremely proud of Wardware, and we are excited to be given this opportunity.”

1.2 The Second Round of the Nursing Technology Fund

Applications are now being invited to the second round of the fund. All applications should be aligned with the focus, eligibility criteria and priorities set out in section 2. The application and evaluation process is set out in section 3. Up to £35m of awards will be announced in early 2015. Applications are invited from all eligible organisations, subject to the funding limits detailed in section 2.4. The evaluation of second round applications will be undertaken without reference to the content of any first round applications (whether successful or not) or to any second round expressions of interest.

Applications are welcome from organisations irrespective of their current level of clinical digital maturity or technical capability. Indeed, applications are particularly welcome from providers who are less digitally mature than their peers, although all applications will be assessed to the same quality threshold.

Applications are welcome for proposals with a specific solution and supplier identified, and also for proposals that have not yet reached that stage. At a minimum, the proposal needs to be advanced sufficiently to secure senior-level endorsement and to allow costs to be reasonably estimated. All proposals need to be able to identify and quantify the impact on practice and the resulting benefits that will be realised, and provide confidence that awarded funding can be spent before the end of the relevant financial year. In order to ensure we secure value for money for taxpayers, successful applicants will be challenged on their procurement approach, with support available as set out in section 2.8.

Applicants who participated in the first round process should note the changes in the second round, particularly in terms of organisational eligibility (see section 2.1), the focus on a broader range of technology-enabled capabilities (see section 2.2), the limits on applications and funding (see section 2.4), and the targeting of an application at either FY2014/15 funding or FY2015/16 funding (see section 2.5).

ENABLING REMOTE WORKING FOR HEALTH VISITORS AND

COMMUNITY NURSES

Staffordshire and Stoke on Trent Partnership NHS Trust

The funding Staffordshire and Stoke on Trent Partnership NHS Trust received will provide its community nursing staff with equipment to enable easy access to the clinical and corporate systems they need.

The benefits of this include reducing the number of trips back to their base, supporting paper light working and improving decision making. The technology that will enable this includes laptops, clinical tablets and smartphones.

Amy Freeman, Chief Information Officer at Staffordshire and Stoke on Trent Partnership NHS Trust, said:

“We are delighted to receive £1m from the Nursing Technology Fund to help support our plans to provide our nursing staff with a remote working solution. The additional funding will allow staff including our community nurses, health visitors and adult social care workers to record, access information, order equipment and prescriptions while out of the office and in real time when they’re with patients and service users; saving their time and ultimately improving the patient experience.”

1.3 Enabling the Delivery of Modern, Safer, More Effective and

More Efficient Care

Awarded funds will be spent on technology that will support modern nursing, midwifery and health visiting practice. These new capabilities will be exploited to modernise and transform nursing practice, in conjunction with ‘people’ and ‘process’ change. Changes to practice will deliver a range of benefits and outcomes.

Safer care may arise from technology to support safer clinical interventions, such as positive patient identification solutions for nurses administering medicines or blood transfusions, from solutions that automatically alert relevant clinicians to a deteriorating patient, or from software that supports staffing level decisions based on patient acuity.

More effective care will be delivered through, for example, mobile access to digital care records enabling community nurses, midwives and health visitors to make informed decisions when with the patient, or nurses capturing and sharing images of wounds to facilitate a discussion with specialist tissue viability teams.

More efficient care will result from a range of capabilities that enable, for example, data to be recorded once by a midwife equipped with a digital pen, or allow a mental health nurse to save travel time by interacting with a service user through videoconferencing technology, or an early warning score to be automatically calculated for a nurse on an acute ward.

1.4 The Legacy of the Nursing Technology Fund

Beyond the distribution of funding to enable many organisations to progress specific projects, the programme aims to leave a broader legacy in order to continue to advance and support technology-enabled change into the future, including:

•

Stronger partnerships between nursing and informatics professionals;

•

A track record of successful delivery from a cohort of organisations who have delivered a return

on technology investment;

•

A nursing technology knowledge base, regularly added to and frequently accessed; and

•

A vibrant community of practice where nursing professionals, informatics professionals and

2. The Eligibility, Priorities and

Focus for the Second Round

2.1 Eligible Organisations

NHS Trusts and Foundation Trusts in England are eligible to apply. This includes acute, community, mental health and ambulance trusts. Awards will be distributed as Public Dividend Capital (PDC). Further information on PDC is provided in Annex 2.

Local authorities in England are eligible to apply on behalf of nursing-led services directly provided by the authority. Awards will be distributed as Capital Grant Payments under section 31 of the Local Government Act 2003. Further information on Grant Payments is provided in Annex 3.

SUPPORTING BETTER COMMUNICATION WITH PEOPLE WITH A

LEARNING DISABILITY

Devon Partnership NHS Trust

Effective communication with people with a learning disability is fundamental, so using mobile devices in their care can not only greatly reduce anxiety and stress but also enable as much face-to-face contact as possible.

Devon Partnership NHS Trust, which provides Learning Disability and Mental Health Services to people in Devon and Torbay, was successful in both its bids in the first round of funding, receiving almost £400,000.

Their Learning Disability Teams will benefit from 136 iPads, complete with specialist ‘apps’ that are tailored to the needs of people with a learning disability, helping reduce anxiety about their treatment and improving their experience.

Funds from the second bid (200 Windows 8 hybrid tablets) will enable the Trust’s community and inpatient nursing staff to carry out their record-keeping and administrative tasks on a mobile basis, ensuring they can spend as much time with patients as possible.

Commenting on the award, Vanessa Moir, Clinical Nurse Specialist in Learning Disability Services, said:

“Being able to communicate clearly is fundamental to the relationships that we have with the people we support. Having already used it, and been very impressed, I know that this technology will radically improve the care and support that we are able to provide to people with learning disability needs.”

Voluntary, community and social enterprises (VCSEs) who operate in England are eligible to apply. VCSEs are defined by Government as ‘Non-governmental organisations that are value-driven and which principally reinvest their surpluses to further social, environmental or cultural objectives’. Specifically, eligible VCSEs must be one of the following types of organisation:

•

a company limited by guarantee and registered as a charity in England;

•

a community interest company registered as a company limited by guarantee;

•

a charitable incorporated organisation (within the meaning of section 69A of the Charities Act

1993(a)); or

•

a social enterprise whose constitution meets a number of criteria (defined in the Health and

Social Care (Financial Assistance) Regulations 2009) concerning distribution of profits, community benefit and distribution of assets on winding up.

Awards to eligible VCSEs will be distributed as Capital Grant Payments under the provision for

financial assistance to health and social care providers set out in sections 149 to 156 of the Health and Social Care Act 2008. Further information on Grant Payments is provided in Annex 3.

For applications from VCSEs, references must be provided from NHS commissioners / providers with whom they have a working relationship. Any awards will be dependent upon satisfactory references. The template to be completed by referees is part of the Application Pack (see section 3.2).

Eligible organisations may apply to the fund as a lead partner on behalf of a consortium or partnership of local health and care providers. In such scenarios, technology procured with

funding may be deployed across a number of providers including providers who did not submit the application. Should the application be successful, the lead partner who submitted the application will be held accountable for the obligations in the Award Agreement, must own the assets procured with the funding, and will be responsible for any consequential costs arising from the award. This may necessitate local arrangements between the lead partner and the other organisation(s), but this will not be a consideration in the evaluation process. Benefits should be tracked across all organisations in which they arise.

Please note that joint applications are not an appropriate route for groups of organisations seeking to procure similar solutions. In such scenarios, separate applications should be submitted and will be scored individually.

2.2 Technology-Enabled Capabilities

Applications are invited that deliver one or more of the following capabilities:

•

Mobile access to digital care records across the community

•

Digital capture of clinical data at point-of-care

•

Digitally-enabled observations management

•

Real-time digital nursing dashboards

•

Remote face-to-face interaction

•

Digital images for nursing care

•

Equipment tracking and monitoring

•

Safer clinical interventions

•

Smart workforce deployment

•

Digital transformation of pre-operative assessment

Annex 4 provides further detail on these capabilities. It sets out the minimum elements we expect to see within a proposed project, and also makes explicit what we do not expect to see as a primary focus of any proposal. The matrix also highlights example clinical workflows/care settings where the capability could be deployed, and direct benefits arising from the capability. These examples are by no means exhaustive.

The capabilities in the list share the following characteristics:

•

Putting solutions ‘in the hands’ of front-line nursing practitioners

•

Potential to release ‘time to care’

•

Proven to deliver benefits

•

Evidence of demand (from either first round applications or second round expressions of interest)

•

Established supplier market

•

Potential to deploy across a number of clinical workflows and care settings

We recognise that there are other technology-enabled capabilities not listed which could benefit nursing in some way. However, we do not believe that they are sufficiently aligned with the policy intent of the fund. Projects which do not have a primary focus aligned with one of the capabilities listed above will not be considered eligible.

2.3 Nursing-Focused

The fund is aimed at nursing, including nurses, midwives, health visitors and health care assistants, working across all care settings including acute, community, mental health and urgent care. Nursing practitioners should be the primary users of the technology procured with any funding, and any efficiency or effectiveness benefits should predominantly arise around care delivered by nurses and midwives.

It is recognised that nursing care is often delivered by a multi-disciplinary team working for a provider organisation. Applications submitted on behalf of such multi-disciplinary teams will not be excluded, so long as they comply with the previous paragraph.

2.4 Limits on Applications and Funding

With demand expected to be high, organisations are restricted to two applications each. Where two applications are submitted, applicants need to identify which is their highest priority at submission. Applicants should not seek to circumvent this constraint by submitting applications containing multiple but clearly distinct projects.

No organisation will receive more than £1.5m in total from the first and second rounds of the Nursing Technology Fund combined. No organisation will receive an award from the second round of the Nursing Technology Fund that would cause them to exceed a limit of £4.5m of awards from the Nursing Technology Fund, Safer Hospitals Safer Wards Technology Fund and the Integrated Digital Care Fund combined. Applicants should also note that the part-funding of a project may be proposed during the finalisation of the award portfolio, as detailed in section 3.6.

USING SPEECH RECOGNITION SOFTWARE TO UPDATE PATIENT

RECORDS IN MENTAL HEALTH NURSING

South Essex Partnership University NHS Foundation Trust

Mental health nurses at South Essex Partnership University NHS Foundation Trust will soon benefit from using speech recognition software thanks to the Nursing Technology Fund. The system, called Mobius Dragon Speech Recognition software, will be given to nurses working in mental health secure services to enable more efficient and accurate recording of patient information and without the need for double recording.

Neil Gallagher, Charge Nurse on Alpine and Lagoon Wards, explains:

“Dragon is being piloted on the two secure services wards I currently manage. As a team we are continually using more of the software capabilities – already the patient experience is being enhanced, and clinicians can manage their caseloads more efficiently and effectively.

“Clinicians are finding many benefits, in particular for larger pieces of work such as reports, which are completed more quickly and as a result they can be more responsive to patients’ needs or wants and provide better patient care. For clinicians, having the assistance of the Dragon software to complete patients’ records/paperwork more effectively has created more time for face to face interaction with the patient which is what we all want and which ultimately must speed up the recovery time and reduce lengths of stay of an inpatient, resulting in a positive patient experience.”

2.5 Spending an Award

Awarded funding can only be spent on items that can be classified as capital expenditure according to the applicant’s local accounting rules. General information on capital classification is provided in Annex 5.

Awards cannot be used for any NHS capital charges, depreciation charges or any other consequential revenue or capital run-on costs arising from the award.

Awards of funding for an application will be made for a specific financial year. In the Application Form, applicants are asked to indicate which financial year they are requesting funding for. In making this decision, applicants should note the following: the expected overall profile of awards set out in section 1.1; the potential for an application requesting FY2014/15 funding to be offered funding for FY2015/16 instead, should FY2014/15 be over-subscribed when finalising the portfolio (see section 3.6); and the requirement that an award must be fully spent by the end of the financial year for which it is made. Funding was recovered from a number of organisations successful in the first round who spent a FY2013/14 award in FY2014/15. ‘Spent’ typically means that the goods have been ordered and delivered, but refer to local finance teams for further guidance.

In spending an award, organisations will be expected, where appropriate, to utilise the procurement resources detailed in section 2.8.

There is no matched funding requirement in the Nursing Technology Fund.

Eligible categories of spend include hardware, software licenses, and spend on resourcing for software configuration, project management and implementation support, subject to local capital classification guidelines.

Funding should not be used for infrastructure development, such as installing or upgrading a wireless network.

For funding to be spent on application development, the applicant will need to provide evidence that a suitable Commercial Off-The-Shelf (COTS) or Open Source product does not exist, and provide a proposal as to how the investment in development can be used to benefit other health and care providers. Such proposals should include, as a minimum, making new source code open and reusable and publishing it under appropriate licenses. Further information on Open Source is provided in Annex 6.

Applicants may incorporate non-recoverable VAT charges in the total amount of funding requested from the Nursing Technology Fund. Organisations will not be funded beyond the amount requested in the Application Form.

Discrete elements of larger capital projects are eligible to apply for funding from this capital fund. Applicants must make it clear how the funding for the rest of the project is being secured.

NHS Trusts will need their capital spending proposals endorsed by the Trust Development Authority (TDA) before they draw down any awarded funding.

DIGITAL PENS FOR MIDWIVES MEANS MORE TIME TO CARE

Northern Lincolnshire and Goole NHS Foundation Trust

Following a successful application to the first round of the Nursing Technology Fund, midwives and their patients at Northern Lincolnshire and Goole NHS Foundation Trust will benefit from more time to care.

The trust received £36,550 of funding which will purchase digital pens for community midwives to write patient notes, without the need for re-inputting the data at the end of each day. This means more time free to look after their patients.

Julie Dixon, head of midwifery and gynaecology across the trust, explains:

“The digital pens are a first for our maternity departments. The aim is for them to free up the time midwives spend on paperwork and thus giving them more time to look after their patients.

“Once a midwife has written down their notes, they will simply place the pen into a docking device where software converts handwriting into text and the information is transferred securely. In addition to giving midwives more time to care, the pens will also cut down on duplication of work and errors that can happen from manual transcription of data in the system.

“It is all about improving our work and providing patients with a quality service. Women will still be able to retain a copy of their own maternity record with the necessary information they require when attending antenatal appointments.”

2.6 Capital Funding Programmes

The Nursing Technology Fund is one of a number of central capital funding programmes that could support technology-enabled change. Potential applicants should consider whether it is the most appropriate route to apply for capital funding.

The investment priorities for the current round of the Integrated Digital Care Technology Fund include digital care records, integrated digital care records and e-Prescribing. Proposals with a primary focus on one of these areas should have been directed to the Integrated Digital Care

Technology Fund. Further information on the fund is available at http://www.england.nhs.uk/

ourwork/tsd/sst/tech-fund/.

The GP IT Capital Approvals Process is intended to allow CCGs to bid for capital funding on behalf of their associated GP practices. Any proposals that are primarily focused on practice nursing should be directed in to the GP IT Capital Approvals Process. The deadline for applications for FY14/15 funding has now passed, but the details of the process for FY15/16 funding will be published early in 2015.

Further information is available at http://www.england.nhs.uk/ourwork/tsd/sst/it-pc/.

2.7 Realising Benefits and Value for Money

Proposed projects should aim to deliver a value for money return of at least 2.4:1 discounted benefits to costs, in line with the Department of Health expectations of major capital funded projects.

Applications for projects that propose a return of less than 1.5:1 will not be evaluated further. Those projecting a return of between 1.5:1 and 2.4:1 will be fully evaluated, but the overall application may need to score relatively highly to be awarded funds. A VFM Analysis template is provided in the application pack, which will automatically calculate the VFM ratio based on projected costs and benefits. Guidance on completing the VFM Analysis is also available to download, alongside the template.

The Capability Matrix in Annex 4 identifies some example benefits against each capability. The examples are by no means exhaustive. Efficiency and spend benefits can be quantified and included in the economic case. Quality benefits cannot be directly included, but may give rise to ‘downstream’ health system benefits which may also be appropriate to include in the economic case and contribute to a higher VFM ratio.

Applicants should note that a VFM credibility analysis will be undertaken on a sample of applications during the evaluation process. Any benefits that contribute to the VFM ratio need to be valid and credible, in terms of how they have been calculated and any assumptions made. Applicants should also note the requirement, if successful in receiving an award, to track the actual benefits delivered by the project.

2.8 Procurement Support and Value for Money

We are developing a range of resources to support effective local procurement, supplementing existing procurement resources and frameworks. These include: mechanisms to procure Apple mobile devices, Dell mobile devices and accessories for mobile devices; guidance on tablet devices and digitally enabled observations management solutions; and advice on routes to procure other specialist solutions. We will also help facilitate joint procurements and the sharing of market intelligence where appropriate. Providers will continue to be responsible for the selection and procurement of suppliers/solutions that meet their requirements.

Successful applicants will be expected to use these where appropriate, and to secure ‘value for money’ in procuring products and services with awarded funds. Further information on these

resources can be accessed at http://www.england.nhs.uk/ourwork/tsd/sst/nursing-technology-fund/.

Applicants should note that assurance of procurement plans will be undertaken on a sample of projects post-award.

2.9 Technology, Architecture and Standards

Applicants will need to demonstrate how the new solution fits with the existing solution architecture of the organisation, and that the overall architecture is viable.

Applicants will need to confirm their intention to comply with the Clinical Safety Standards relating to the development and deployment of health IT systems.

A number of architecture considerations and standards underpin effective digital healthcare systems. Applicants will need to demonstrate, where applicable, how the proposed project will:

•

Make use of the NHS Number;

•

Utilise or provide Open APIs;

•

Utilise GS1 standards for automated data capture and identification;

•

Adhere to relevant standards in the Interoperability Toolkit (ITK); and

•

Achieve effective Information Governance (IG).

3. The Application, Evaluation

and Award Process for the

Second Round

3.1 Key Dates

The deadline for submitting applications is 17.00 on 2nd December 2014.

Our ambition is to inform organisations of the outcome of their applications in January 2015. Successful organisations will be expected to return a signed Award Agreement at the earliest opportunity after they have been notified of an award, and in advance of drawing down funding.

3.2 The Application Pack

An application will comprise the following documents:

•

Application Form

•

Value for Money Analysis

•

Financial Analysis (for applications from NHS Trusts and Foundation Trusts only)

•

Solution Diagrams

Information Flow Diagram Technology Diagram

•

Reference(s) (for applications from VCSE organisations only)

•

Latest Annual Accounts (for VCSEs not registered on the Charities Commission website only)

Where an organisation is submitting two applications, separate documents must be completed for each proposed project.

The Application Form, Value for Money Analysis, Financial Analysis and Reference Form templates

must be downloaded from the NHS England website at http://www.england.nhs.uk/ourwork/tsd/sst/

nursing-technology-fund/. Applicants must not change the format of the templates – for example, do

not convert a Word document into a PDF, as this will not be accepted.

Further guidance for completing the VFM Analysis and Solution Diagrams should also be downloaded from the website (URL/link above).

For VCSEs operating in a single locality, then a single Reference should be provided. For those whose proposal would impact operations in a number of localities, two References should be provided from NHS commissioners/providers from different areas.

3.3 Developing and Submitting an Application

Evidence from the first round suggests the key factor for a successful application was nursing and informatics colleagues working together from the beginning. Organisations are advised to identify and secure early and explicit support of the relevant governance mechanisms within the organisation. Experience also shows that having clarity as to which individuals and teams will need to collaborate to prepare an application and being clear how content is ultimately approved are essential to produce a high quality application. Nursing leaders from across the organisation, information technology expertise and colleagues from finance and transformation teams are likely to be needed to provide significant input into the development process.

When developing an application, applicants should pay particular attention to the criteria detailed in section 2 – alignment with these is required to pass a screening stage – and the evidence sought in applications (see Annex 7), against which they will be scored.

Applicants must also ensure they respond to the specific questions, and not just seek to highlight the features of their proposal that they believe are most important. Applicants must also adhere to the word limits in the application form.

‘Frequently Asked Questions’ (FAQs) will be published and updated periodically on the NHS England website (see URL/link on previous page) where we see a wider benefit in sharing the answers we have provided to queries from individual organisations.

If the answer to a query relating to the application process cannot be found in an FAQ, then queries

can be sent to [email protected]. Applicants must note that whilst we aim to

respond to these enquiries quickly, a specific response time cannot be guaranteed, especially for enquiries submitted immediately prior to the closing date.

Applications should be submitted to [email protected] by the deadline. A single

e-mail should provide all the required documents for a single application. Different applications should be submitted in different e-mails. Applications will only be accepted from mailboxes linked to the applicant organisation or from an nhs.net address.

Document naming conventions must follow the format below: NTF2 [Organisation code] [Priority] [Document] – [Project title] (e.g. ‘NTF2 RHD 1 Application Form – Vital Signs Monitoring’)

(e.g. ‘NTF2 VSG 2 VFM Analysis – Mobile Working in the Community’)

For NHS Trusts, Organisation code is the 3-letter ODS code of the Trust. Local authorities must use the three-digit ODS code introduced by the Information Standards Board for Health and Social Care in June 2013. These codes can be accessed in column A of a spreadsheet that can be downloaded by

clicking on the lauth.zip link at http://systems.hscic.gov.uk/data/ods/datadownloads/nonnhs. VCSEs

must use a three-letter acronym starting with ‘V’. (We will watch out for duplicates, and if they occur, will rename accordingly and notify the applicant).

Priority would be the priority of the application – ‘1’ or ‘2’ as appropriate.

For the e-mail subject, Document would be ‘Application’. For the file names of the application documents, Document should be the type of document (e.g. ‘Application Form’).

Project title should be a short title for the project, as entered on the Application Form. Filenames must not exceed 60 characters.

Organisations submitting an application to the fund will receive an e-mail within two working days confirming receipt.

Upon receipt, a compliance check will be undertaken to confirm that the correct documents have been submitted from a valid e-mail address in the requested format and naming convention, the organisation is not at its funding limit and that no more than two applications have been submitted per organisation. We reserve the right to reject any applications that fail this check.

Compliant applications will proceed to the screening stage.

MOBILISING FOR A SUCCESSFUL APPLICATION

King’s College Hospital NHS Foundation Trust

In the first round King’s College Hospital NHS Foundation Trust were successful with two applications to the Fund. The development of one of these was led by Moira O’Toole, Senior ICT Project Manager and a Registered Nurse by background.

Moira explains:

“We started by looking at the focus of the Fund and comparing this to our ‘roadmap to paperless’, identifying what could help us get there. We had already deployed iPods for vital signs recording, but recognised we could exploit a larger device at the bedside for positive patient identification and completing risk assessments.”

Moira took the lead in co-ordinating the development of the application, and identified lead people from different areas of the organisation, setting up regular meetings. She continues:

“When I saw the application pack and the Value for Money Analysis, I had no idea about discounted benefits and costs, but I knew that my Finance colleagues could help me out. I also had to take advice from IT colleagues on timescales and data security, and Procurement helped us find an appropriate route to buy the devices.”

Moira believes early engagement ‘from board to ward’ was key. She explains:

“We got early engagement from the Director of Nursing, and also consulted with our IT Nurse Reference Group, getting their ideas and exploring the solutions available. We got some different devices in and took them round some wards, letting nurses try them out. This helped us decide which device to go for. We consulted with other clinical colleagues through our CCIO to ensure what we were proposing fitted with the bigger picture – we didn’t want nurses having to use several different devices on the ward.”

King’s applications scored highly in the evaluation process, and were awarded £590,000 from the first round of the Fund.

3.4 Application Screening

Applications will be screened against the focus, priority and eligibility criteria set out in section 2. Applications that are successfully screened will proceed to the scoring stage.

Decisions to screen out applications at this stage will be confirmed by a panel including a number of senior nursing stakeholders.

3.5 Application Scoring

Applications will be scored in a series of Evaluation Workshops. Each application will be scored by a pair of evaluators – a senior nurse or midwife working together with a senior ‘generalist’ with service transformation/project management/technology/commercial expertise.

Prior to the workshops, the evaluators will sign a Conflict of Interest Declaration to ensure they don’t participate in the scoring of any application where they have an interest in the submitting organisation or any named supplier. They will also have to attend a briefing session to walk-through the scoring of some sample applications. Scoring guidelines will be provided to the evaluators. Based on the information provided in the Application Form, applications will be scored against four dimensions:

•

Leadership

•

Strategic

•

Impact

•

Approach

Details of the evidence that the evaluators will be looking for against each dimension of an application are provided in Annex 7.

3.6 Finalising the Award Portfolio

Our aim is to support a wide range of projects. Should we be over-subscribed with a high volume of high-quality applications, then proposals to part-fund selected projects or organisations may be developed. The applicants would be expected to bridge the funding gap locally and/or de-scope their projects. If the latter, they would be asked to confirm that the projected economic return would not be significantly impacted.

Should the FY2014/15 funding allocation be over-subscribed with a high volume of high-quality applications, then proposals to defer a project to FY2015/16 may be put to selected applicants. The award portfolio will then be finalised.

UTILISING MODERN TECHNOLOGY FOR FRONTLINE NURSING

Dorset Healthcare University NHS Foundation Trust

Congestion and rural living can both present challenges in Dorset, which is why the funding for lightweight, ultra-portable laptops will be invaluable to support community nurses to do their jobs more easily.

Dorset Healthcare University NHS Foundation Trust received £346,000 of funding for their Community and Child Health Information System project. The laptops will help enable community nurses to spend more time with patients by reducing the number of times they have to return to their base.

Fiona Haughey, Interim Director of Nursing and Quality, explained:

“We want to constantly improve for our patients and giving our staff access to modern technologies is one important way to support them in their day to day roles. Having a laptop rather than carrying around reams of paper should make life easier for staff. A community nurse can work on-the-go without needing to make as many trips back to the office, which means more time spent with patients. But more importantly, mobile IT devices that can be used in people’s own homes puts valuable information at a nurse’s fingertips. Applying for this funding was about enabling our frontline staff to improve the care they provide for patients.”

3.7 Award Agreement and Beyond

Successful applicants will be required to sign an Award Agreement prior to drawing down any funding, setting out a series of obligations that the organisation will be expected to fulfil in return for the award from the Nursing Technology Fund. These will include:

•

Using the award only for the delivery of the project defined in the application;

•

Compliance with State Aid rules (for VCSE organisations);

•

Publishing a notice of award;

•

Providing monthly highlight reports and quarterly benefit tracking reports using templates to be

provided;

•

Identifying any proportion of an award that is no longer required to deliver the project;

•

Utilisation of relevant procurement resources to secure VFM;

•

Providing information on what funding has been spent on, and how these products/services have

been procured;

•

Identifying individuals against key roles for the project;

•

Complying with the Public Sector Equality Duty (see Annex 8);

•

Participating in the community of practice;

•

Supporting media and promotional activity related to the Nursing Technology Fund;

•

Contributing to the evaluation of the overall Nursing Technology Fund programme; and

•

Producing a case study.

Underlying these obligations is a commitment to sharing learning from the projects funded by the Nursing Technology Fund across providers, NHS England, Department of Health and any other interested parties.

A team has been deployed to provide ‘support and challenge’ to recipients of technology funding, including the Nursing Technology Fund. Individual team members will manage relationships with a defined set of awarded organisations, and help them meet their obligations on governance,

assurance and benefits realisation in order to realise the full potential of the award. Responsibility for delivering the anticipated benefits continues at all times to lie with the organisation that has been successful in securing funding for their project.

Awarded funding should not be drawn down in advance of need. This may result in the funding being drawn down in a number of tranches. Further guidance on the process for drawing down funding will be included in the Award Agreement. Applicants should note that funding was recovered from a small number of organisations who drew down some or all of their first round award in advance of need.

It is possible that the awarded organisations will not require the full amount of their award to deliver their project. This may be due to, for example, supplier prices moving downwards, or an

over-estimation of the original costs when specific solutions had not been identified. Organisations will be required to bring this to the attention of NHS England as soon as possible. NHS England may agree an extension of the scale of the original project if applicable, or may decide to offer the ‘spare’ funding to organisations that narrowly missed out in the original award portfolio.

As stated in section 2.8, assurance of procurement plans will be undertaken on a sample of projects post-award, in order to confirm that organisations are obtaining ‘value for money’ in their spending of an award.

Annex 1: First Round Outcomes

The prospectus and application pack for the first round of the Nursing Technology Fund were published on 9th December 2013.

At the submission deadline of 15th January 2014, 226 applications had been received from 139 Trusts, requesting a total exceeding £70m. At the heart of a rigorous evaluation process was a series of evaluation workshops, where senior nurses worked in pairs with other volunteers who provided a combination of commercial, technology and project management insights, in order to score the applications.

The announcement of the successful applicants from the first round was made at the Health and Care Innovation Expo on 4th March 2014. 75 Trusts were awarded funding totalling £29.97m for 86 projects, although one organisation has since declined their award. The funded projects were representative of the full range of care settings and eligible technologies. The highest award for an individual project was £1m, and to an individual organisation was £1.46m (for two separate projects). With regards to the economic case, all projects projected a Value for Money return greater than 2:1, with almost half projecting a return of at least 4:1. The projected economic return was £114m on the £30m investment, which comfortably exceeds the Department of Health VFM threshold of 2.4:1 for major capital projects.

Of the successful projects, 90% will provide solutions for nurses, 23% for midwives, and 10% for health visitors. The majority of projects involve mobile technology, a quarter involves vital signs monitoring solutions, and eight projects involve digital pens.

The awarded organisations are now pushing ahead with implementation. They have reported what they have spent their award on, are submitting monthly highlight reports, and have started reporting on benefits delivered.

The list and descriptions of successful projects is available on the NHS England website at

Annex 2: Public Dividend Capital

Awards to NHS Trusts and Foundation Trusts will be distributed as Public Dividend Capital (PDC). Recipients will also receive an increase to their Capital Resource Limit and External Financing Limit. The PDC funding to successful Trusts will be issued in line with NHS Trust Development Authority Capital Regime and Investment Business Case Approvals Guidance for NHS Trusts (paragraphs 2.20

and 2.21): http://www.ntda.nhs.uk. As funding for this initiative is strategic capital, the normal PDC

rule that Trusts must exhaust their internal cash reserves prior to drawing PDC will be waived.

It is vital in order to meet HM Treasury rules that payments are not drawn down in advance of need. Trusts should draw down funding within the month that initial expenditure is incurred and will be expected to provide an expenditure forecast alongside draw down requests. Funds must be kept in trust Citibank accounts until payments are made.

Recipients of funding will be responsible for the revenue implications of the capital applied for, and must be able to cover the associated cost of capital, depreciation and any other consequential revenue or capital run-on costs arising from the initial award.

Annex 3: Grant Payments

Awards to Local Authorities will be Capital Grant Payments under section 31 of the Local Government Act 2003. Grants will be made in line with guidance provided in “The Preparation of Specific Grant Determinations for Local Authorities”.

Awards to Voluntary, Community and Social Enterprises (VCSEs) will be distributed as Capital Grant Payments under the provision for financial assistance to health and social care providers set out in sections 149 to 156 of the Health and Social Care Act 2008. This mechanism can be used for the following types of organisation:

•

a company limited by guarantee and registered as a charity in England;

•

a community interest company registered as a company limited by guarantee;

•

a charitable incorporated organisation (within the meaning of section 69A of the Charities Act

1993(a)); or

•

a social enterprise whose constitution meets a number of criteria defined in the Health and Social

Care (Financial Assistance) Regulations 2009).

These Regulations relating to Social Enterprises state that their constitution:

•

must contain a statement or condition that the body is carrying on its activities for the benefit of

the community in England;

•

must state, or contain provisions which ensure, that not less than 50 per cent of its distributable

profits in each financial year will be used or applied for the purpose of the activities of that body; and

•

must, where appropriate, contain provisions relating to the distribution of assets which take

effect when that body is dissolved or wound up

requiring that the residual assets of the body be distributed to those members of the body (if any) who are entitled to share in any distribution of assets on the dissolution or winding up of that body according to those members’ rights and interests in that body;

in the case of a company not limited by guarantee and registered as a charity in England and Wales, providing that no member shall receive an amount which exceeds the paid up value of the shares which the member holds in the company; and

designating another qualifying body (for the purposes of sections 149 to section 156 of the 2008 Act) to which any remaining residual assets of the body will be distributed after any distribution to members of the body.

A further rule for section 149 funding is that organisations must not carry out party political activities.

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C ap ab ilit y W h at we e xp ec t t o s ee in cl u d ed i n t h e p ro p o sa l a s a m inim u m W h at we d o n ’t e xp ec t t o se e a s a p ri m ar y f o cu s o f t h e pr o p osa l Ex am p le s o f p o te n ti al c lin ic al w o rk fl o ws /c ar e se tti n g s f o r ca p ab ilit y Ex am p le s o f p o te n ti al (d ir ec t) b en efit s M o b ile a cc es s t o d ig it al c ar e re co rd s a cro ss t h e c o m m u ni ty • Pr ac ti ti o n er s f re ed u p f ro m h av in g t o r etu rn t o b as e t o ac ce ss /u p d ate di gi ta l c ar e re co rd s • M o b ile d evic e r ef re sh p ro g ra m m es • N ew E PR s o lu ti o n s ( as ag ai n st e xt en d in g a cc es s t o an ex is ti ng s o lu ti on ) • M o b ile c o m m u ni ty t ea m s • R ed u ce d t ra ve l e ff o rt a n d ex p ense • B et te r i n for m ed d ec is ion s at p o int -o f-car e • Im p ro ve d p at ie n t ex p er ienc e • R ed u ce d t im e i n su b m it tin g r ef er ral s/ p re sc ri pt io ns /o rd er s D ig it al c ap tu re o f c lini ca l dat a at p o in t-o f-ca re • In te rf ace w it h a di gi ta l ca re re co rd • Da ta e n tr y i n te ra ct io n tai lo re d t o d ev ic e • Pa ti en t e xp er ienc e c ap tu re • R emo te t el emon it or ing • N ew E PR s o lu ti o n s ( as ag ai n st e xt en d in g a cc es s t o an ex is ti ng s o lu ti on ) • El ec tro ni c a ss es sm en ts • C ar e /d is ch ar g e p lan n in g • Au d it • C hi ld h ea lt h s cr ee ni n g • R ed u ce d e ff o rt i n re co rd in g dat a • A vo id an ce of d u p lic ate dat a e n tr y • R ed u ce d t im e i n m ak in g d at a a vai la b le t o o th er s • In cr ea se d q u al it y o f d at a en tr y D ig it al ly -e na b le d o b ser va ti o n s m an ag em en t • A u to m at ed r is k p ro fil in g o f p at ie n ts b as ed o n ob se rv at ion s r ec or d ed • A u to mat ed a le rt in g • R emo te t el emon it or ing • Pu b lic h ea lt h o u tb rea k m an ag em ent • So p h is ti ca te d d ev ice s ( e. g . u lt ra sou n d s ca nn er s) • N u rs in g ro u n d s • Fe ta l mon it or ing ( ac u te / h o m e b ir th ) • In fe ct io n p re ve n tio n a n d co nt rol • M en tal h eal th • In cre as ed a cc u ra cy o f re cor d ing • In cr ea se d a cc u ra cy o f r is k p ro fil in g • Fa st er a n d t ai lo re d re sp o n se t o i m p ro vi n g / d et er ior at ing p at ie n t con d it ion • R ed u ce d e ff o rt i n p ro ce ss ing ob se rv at ion s

C ap ab ilit y W h at we e xp ec t t o s ee in cl u d ed i n t h e p ro p o sa l a s a m inim u m W h at we d o n ’t e xp ec t t o se e a s a p ri m ar y f o cu s o f t h e pr o p osa l Ex am p le s o f p o te n ti al c lin ic al w o rk fl o ws /c ar e se tti n g s f o r ca p ab ilit y Ex am p le s o f p o te n ti al (d ir ec t) b en efit s R eal -t im e d ig it al n u rs in g da shb o ar d s • A t- a-g la n ce in fo rmat io n for n u rs ing p ra ct it ione rs an d /o r n u rs in g m an ag er s • U p -t o -dat e i n fo rmat io n d is p laye d • D is p la y o f i n for m at ion t o the pu b lic • Pa ti ent fl o w m an ag em ent • H ando ver m ee ti n g s • W ar d m an ag em ent • N u rs in g ro u n d s • B et te r i n fo rm ed c ar e d ec is ion s • B et te r p ri or it is at ion • R ed u ce d e ff o rt i n m ai n tai ni n g d as h b o ar d s R em o te f ace -t o -f ace in te ra ct io n • Pa ti en t to p ra cti ti o n er in te ra ct io n • M ai n te n an ce o f p h ys ic al F2 F c on ta ct d u ri ng t he p at ie n t jo u rn ey • Se cu re li n k • Int er ac ti o n s n o t i n volv in g p at ie n ts ( e. g . M D Ts , g ro u p su p er vis ion ) • Pr is on he al th ca re • Sp ecia lis t c en tr es w it h lar g e c at ch m ent ar ea • Int er -h o spi ta ls t ran sf er • Su p p o rt f o r s el f-ca re • R ed u ce d t ra ve l b y p ra cti ti o n er • R ed u ce d t ra ve l b y p at ie n t • In cr ea se d fl ex ib ili ty in sc he d u ling in te ra ct ion D ig it al i m ag es f o r n u rs in g ca re • In te rf ace w it h a di gi ta l ca re re co rd • C ap tu re o f i m ag es b y n u rs in g s taf f • Sp ec ia lis t i m ag ing eq u ip m en t n o t o pe ra ted b y n u rs es • W o u nd m an ag em en t • D ia b et ic f o o tc are • In tra ve n o u s a d m in is tra ti o n • D ermat o lo g y • Saf eg u ar d in g • Q u ic ker a nd b et ter ta rg et ed s pe ci al is t i n p u t • B et te r i n fo rm ed c ar e d ec is io n s a t p o in t o f c ar e • In cre as ed a cc u ra cy a n d con sis te n cy o f m ea su ri ng an d r ec or d ing • R ed u ce d e ff o rt i n m ea su rin g a n d r ec o rd in g • B et te r abi lit y t o id ent if y d et er io ra tio n Eq u ip m en t t ra ck in g a n d mon it or ing • Equ ip m ent t ran sm it ti n g it s l o ca ti o n /s ta tu s, au to mat ic al ly a n d w ir ele ssl y • Tr ac ki n g s ta ff o r p at ie n ts • Tr ac ki n g p ap er r ec o rd s • Eq u ip m en t l o ca ti n g i n a n ac u te f ac ili ty o r c o m m u ni ty set ti n g • St or ag e ( e. g . or g an s, va cc ine s, m ed ic ine s, b lo o d , sp ec im en s) • R ed u ce d e ff o rt i n l o ca ti n g equ ip m ent • In cr ea se d a sset u ti lis at io n • A vo id an ce o f d el ay f o r p ati en t • A vo id an ce of d ete ri o ra ti o n o f s to re d p ro d u ct s

C ap ab ilit y W h at we e xp ec t t o s ee in cl u d ed i n t h e p ro p o sa l a s a m inim u m W h at we d o n ’t e xp ec t t o se e a s a p ri m ar y f o cu s o f t h e pr o p osa l Ex am p le s o f p o te n ti al c lin ic al w o rk fl o ws /c ar e se tti n g s f o r ca p ab ilit y Ex am p le s o f p o te n ti al (d ir ec t) b en efit s Saf er c lin ic al in te rve n ti o n s • Po si ti ve p ati en t id en ti fi ca ti o n • A u d it t ra ils • E-p re sc rib in g s o lu ti o n s • St o ck m an ag em en t ( o n i ts o w n ) • Bl o o d t ra n sf u si o n s • M ed ic ine s a d m in is tr at ion • R ad io logy • A vo id an ce o f ‘ w ro n g p at ie nt ’ i n cid ent s • A vo id an ce o f ‘ w ro n g p ro d u ct /w ro n g d ose ’ in cid ent s • A vo id an ce of a d mi n is te ri n g ex p ir ed /r ec al led /s p o iled p rod uc ts • R ed u ce d e ff o rt i n ad m in is tr at ion Sm ar t w o rk fo rc e d ep lo ym ent • Su p p o rt f o r ro st er in g • Fo cu s o n s af e s ta ffi n g (ac u te d ep lo ym en ts ) • Su p p or t f or a llo ca ti ng vi sit s/ ca se s ( co m m un it y d ep lo ym en ts ) • Tr ai ni n g a n d d ev el o p m en t m an ag em ent • C o m p ete n cy au di ts • St ra te gi c wo rk fo rce p la n n in g • E-le arn in g • Si m ula ti o n in n u rs in g tr ai ni n g • M an ag em ent o f co m m u ni ty n u rs in g t ea m s • M an ag em en t o f a cu te n u rs in g t ea m s • In cr ea se d c o mpl ia n ce ag ai n st s af e s taf fi n g l ev el s • B et te r m at chi n g o f p ra ct it ione r ex p er tis e t o p ati en t n ee d /a cu it y • R ed u ce d sp end o n a g enc y st af fi n g • R ed u ce d t im e c o ns u m ed in r o st erin g , al lo ca tin g vis it s/ ca se s, r es p on d ing t o st af fin g is su es • R ed u ce d t ra ve l e ff o rt a n d ex p ense D ig it al t ra n sf o rmat io n o f p re -o p er at iv e a ss es sm en t • C ap tu ri ng in for m at ion o n ce • A u to m at ed d ec is ion su p p or t a n d r is k s cor ing • Tai lo re d p at ie n t j o u rn ey s th ro u g h t h e p re -o p er at iv e p at h way • R ec or d ing a p re -op er at iv e as se ss m en t ( o n i ts o w n ) • Pr e -o p er at iv e a ss es sm en t fo r e le ct iv e s u rg er y • B et te r i n for m ed d ec is ion s for p re -op er at iv e gu id an ce , su rg er y an d p o st -o p c ar e • Im p ro ve d p at ie n t ex p er ienc e • B et te r m at chi n g o f re so u rc es t o p at ie n t r is k

Annex 5: Capital Classification

For the purpose of this programme, capital is classified as work that generates a physical asset, with an expected life of more than one year. Capital resources may only be used to finance the delivery of what, under International Financial Reporting Standards (IFRS), are regarded as non-current assets (tangible, intangible or investments).

A key requirement of non-current assets is that there is a reasonable probability that they will deliver future economic benefit (i.e. valuable service) over more than one year (in most cases many years). A non-current asset can be bought or enhanced with capital funds. Expenditure to maintain an asset at its current state is not normally regarded as capital expenditure and cannot be funded with DH capital.

A threshold value of £5,000 per item inclusive of VAT must generally be reached before expenditure can be funded with capital. Exceptions may be allowed where the assets form part of a group of assets that aggregates to more than £5,000.

To qualify as a group, the assets must meet all of the following criteria:

•

functionally interdependent (e.g. an equipment network);

•

acquired at the same date and likely to be disposed of at about the same date;

•

under single managerial control; and

•

each component asset of the group must cost £250 or more.

Only costs that are directly attributable to bringing a non-current asset into being and into appropriate condition for their intended use can be capitalised and funded with DH capital.

Annex 6: Technology,

Architecture and Standards

NHS Number

As a patient moves through their journey in the health and social care system, the right information must be available in the right place at the right time, enabling professionals from any discipline to make fully-informed decisions. Using the NHS number doesn’t make this happen on its own, but it is a fundamental part of it making it possible.

Effective record sharing isn’t possible, or is at best difficult and expensive, if individual organisations across primary and secondary health settings, local authorities and social care use different ways to identify the same person. We also recognise the importance that patients and their carers place on the ability of organisations to identify them and communicate with them with continuity, reducing duplication of identification and data capture processes. The statutory sector “failing to remember me” is a cause of confusion and frustration to service users, and often in turn leads to lower data quality and poorer care.

The cost of getting this wrong has been well documented and published, for example in the Caldicott

Review (https://www.gov.uk/government/publications/the-information-governance-review).

This focus on the NHS Number as primary identifier means that organisations should be ensuring they have the right processes, technology and infrastructure to achieve use of the NHS Number as the primary identifier for clinical correspondence, and use of the NHS Number as early as possible within the care process.

Open APIs

A people-powered health and care system requires an ecosystem of applications, data and processes working seamlessly to make the right information available to the right user at the right time. The systems underpinning this must also be affordable and sustainable. Open Application Programming Interfaces (APIs) have an important part to play in achieving this by:

•

making application functionality easily available – this helps organisations ensure their systems are ‘interoperable’, i.e. that important functionality and information held in one system or department is readily available to another without significant and expensive development effort;

•

allowing the best system for the job to be chosen – having key functionality openly available

through an API ensures organisations can integrate systems and deliver the best systems to suit the needs of their different clinical and business functions. Some organisations may already have systems providing ‘end to end’ functionality that do not require additional integration work. This is a perfectly acceptable approach. However, it constrains an organisation’s options and flexibility moving forward. Ensuring systems have open API’s ensures you have the greatest flexibility and control, both technically and commercially; and

•

promoting and accelerating innovation – opening up data within different systems helps to promote and support a culture of innovation. With appropriate controls in place, it makes it easier for technical or clinical staff to use this information to improve patient outcomes or safety. It also allows for the creation of add-on products and services that don’t necessarily need to be built by the vendor of the primary system. This can often be done quicker and at lower cost.