Public Services > Healthcare

NHS Digital outlines enterprise architecture ambition

David Bicknell Published 21 July 2017

Fit for 2020 goal for NHS Digital to modernise its delivery model by implementing an effective enterprise architecture function supported by necessary processes and tooling


NHS Digital was today hosting an internal conference call giving staff the chance to question senior executives on the issues raised for the organisation in its recent capability review, and by the newly published Fit for 2020 report which responds to the review’s conclusions.

In a letter sent out to staff, interim chief executive Rob Shaw – in place ahead of Sarah Wilkinson joining the organisation next month – reiterated that the review had been commissioned to ensure that NHS Digital had the capacity, ability and corporate governance to be able to deliver all the requirements set out in Personalised Health and Care 2020.

Shaw said, “Fit for 2020 highlights areas of excellence alongside elements of our work where we need to do better and the report describes how we are going to continue to improve, meet and exceed the challenges which lie ahead of us in supporting the objectives of the NHS Five Year Forward View.

“Work has already started and a Fit for 2020 team has been established to deliver these commitments - the majority of these will be completed by April 2018.”

The Fit for 2020 report detailed that like all organisations operating in the health and care ecosystem, including local authorities for social care, NHS Digital must support the NHS to address the challenges set out in the Five Year Forward View.

The report added that the way that technology and data are addressing the challenges is described in the National Information Board’s Personalised Health and Care 2020. They aim to reconcile the growing demand for health and care services with reducing resources; focus on prevention, self-management and well-being in addition to treating ill-health; increase the personalisation of care and support services to empower the citizen; and accelerate and extend the integration and devolution of services.

The specific delivery requirements have been translated into a major portfolio of work for NHS Digital, comprising 33 new programmes grouped into 10 domains which will bring in an anticipated additional budget of £4.2bn over the next 5 years. That, said the organisation, is a significant responsibility over and above its existing commitments and statutory duties. It requires NHS Digital to:

• have access to the right skills and expertise, either directly or through partnering, to ensure it has the capacity and capability to fulfil these commitments

• improve its delivery model, by implementing the necessary foundations for a systematic approach to designing, planning, and implementing the commitments

• ensure proper accountability for the delivery and adoption of the services and programmes, and work with national and local partners to ensure that they are used effectively

• have the skills and capacity to manage the increased contractual and commercial requirements that are being put in place to deliver the commitments. This includes around 150 contracts with a value of £200m that have been novated from the Department of Health into NHS Digital

• have effective corporate governance arrangements in place to instil confidence in its ability to manage the resources committed to NHS Digital to enable it to discharge its responsibilities

• operate under agreed system-level governance arrangements that are “robust, transparent and effective for rapid decision-making, approvals and assurance”.

At the same time, it said, there are strategic agendas which will have material implications for NHS Digital, including a major role implementing the recommendations from the National Data Guardian’s review of security and opt outs.

Among the plans NHS Digital has detailed in Fit for 2020, it plans to modernise its delivery model by implementing an effective enterprise architecture function, supported by the necessary processes and tooling for the national health and care system.

It said, “The work being done to design and deliver local sustainability and transformation plans is already addressing ways of improving interoperability within a local health economy, so at a national level we must ensure that interoperability standards are in place and used to ensure that information can flow between organisations, or geographical groupings to provide consistent access to data and services, so that there is no ‘postcode lottery’ of variability in different parts of the country.

“Similarly, we need to ensure that the local services and systems that are being designed have access to the national services, under appropriate governance arrangements, to allow them to work effectively. The interface between national and local services will be critical to properly integrated care models.

“Finally, we must ensure that existing and future national systems work together: that key functionality such as access permissions or personal records are only built once, but used many times by other systems. This means we need to have a more detailed understanding of the architecture – the way technology is used and the way data flows around the health and care system. This is important not only to ensure consistency, completeness and interoperability, but also to ensure that robust investment decisions are made, and that there is no unnecessary duplication.

It added, “This work is underway and we have brought in external consultants to support us in designing a new service that works across the health and care system. This will be an important piece of the system-level governance arrangements, working through the Enterprise Architecture Board.”

In terms of consolidating its service operations, NHS Digital said that while the ‘Personalised Health and Care 2020' portfolio contains many new programmes and developments of existing services, many of the services it delivers today are still managed using ‘programme management’ governance arrangements, although the delivery and implementation work has been largely completed and the services are now being used locally.

It accepts that this is inefficient and distracts it from the true objective for these programmes, which is to encourage wider
adoption in local settings, such as hospitals or pharmacy or other community settings. It said, "The Electronic Prescribing Service, the Summary Care Record and NHSMail2 are good examples of this, although it should be noted that Personalised Health and Care 2020 includes a big programme focus on new referrals capability."

NHS Digital said it plans to establish a true Service Operations capability responsible for maintenance development and the future roadmap for all NHS Digital technology services. It also said it will set out the criteria and due diligence for managing the transfer of programmes into service operations and implement the transfer of programmes into Service Operations during 2017/18.


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