NHS IT ops, orgs and policy

Published on: 27th January 2017 | Updated on: 15th January 2023

Many organisations and policies influence the development of NHS IT within the community pharmacy sector. The following is a high-level summary of some key organisations and aspects involved with the delivery of NHS IT.


National IT

A range of organisations are involved with setting out and implementing IT policies at the national level.

Operations overview

NHS England (NHSE) undertake a range of tasks that support pharmacies and others in accessing and using national NHS IT applications in line with the ‘Securing excellence in IT‘. NHSE, through its local teams may either provide support functions itself or make arrangements for commissioning support units (CSUs) or any other IT provider to deliver them. GP IT services are managed by clinical commissioning groups (CCGs) on behalf of NHSE. A ICB provide support functions to GP practices directly or commission CSUs or another to do so.

Full list of IT policies/organisations (national)

A list of national pharmacy IT-related organisations list is set out below.

National organisation (IT)  Further info
Code4Health pharmacy sub-group Volunteer group of contractors and others which learn about and explore new open source digital solutions.
Community Pharmacy IT Group (CP ITG) Maintains a work programme in relation to English community pharmacy IT. Participating organisations include various pharmacy bodies Community Pharmacy England, AIMp, CCA, NPA, and RPS, as well NHS England pharmacy and IT teams, NHSBSA, and pharmacy system suppliers. If you would like to feed into discussions contact Community Pharmacy England’s IT team.
Data Alliance Partnership Board Oversees the development, and approval of information standards, data collections and data extractions. Formally had been known as Data Coordination Board (DCB) (2017-April 2021) and prior to this it was known as the Standardisation Committee for Care Information (SCCI).
Endeavour Health (charity) Aims to improve healthcare by enabling the design of, and researching the effectiveness of, new forms of healthcare information technology and healthcare provision with particular emphasis on patients as users of IT.
FHIR Foundation Promotes global adoption and implementation of the FHIR® platform standard.
GP system suppliers System suppliers are used GP practices to support their work.
HL7 UK Dedicated to providing a framework and related standards for the exchange, integration, sharing, and retrieval of electronic health information.
Information Governance Alliance (IGA) Previously provided data security guidance from DHSC and NHS bodies. NHSX has taken over from IGA responsibilities.
INTEROPen An action group to accelerate the development of open standards for interoperability in the health and social care sector. Leading organisations and individuals are encouraged to join INTEROPen. Members include NHS England, GP system suppliers, and many of the organisations included within this list.
medConfidential Campaigns for confidentiality and consent in health and social care – seeking to ensure that every flow of data into, across and out of the NHS and care system is consensual, safe and transparent.
National Cyber Security Centre (NCSC) NCSC is the UK’s authority on cyber security. It is a part of Government Communications Headquarters (GCHQ).
National Data Guardian (NDG) The National Data Guardian (NDG) advises and challenges the health and care system to help ensure that citizens’ confidential information is safeguarded securely and used properly.
National Information Board (NIB) Previously helped to set digital priorities in health and care (2014-2017). Others such as NHSX have taken on this role.
NHS England’s Transformation Directorate The joint organisation for digital, data and technology. It brought teams from the Department of Health and Social Care (DHSC), NHS England and NHS Improvement together into one unit to drive digital change and lead related policy. NHSX is soon to incorporated into NHS England and NHS Improvement.
NHS England’s digital directorate Supports the NHS and social care services. Formerly had been named HSCIC and before that Connecting for Health. NHS Digital IT teams and responsibilities were incorporated into NHS England on 1st February 2023.
NHS Cybersecurity and IG team Conducts work relating to the IG toolkit, the IG training tool, and cyber and data security.
NHS HSCN team Is overseeing the transition and then maintenance of the HSCN network (N3 replacement).
NHS England IT National Service Desk (NSD). Pharmacy system suppliers may escalate EPS issues to the NSD on behalf of contractors where needed.
NHS Smartcard central team Sets Smartcard and access control policy for use by local Smartcard Registration Authorities.
NHS programme team: Digitising Community Pharmacy (incl EPS) Manage aspects of EPS, whilst also exploring development of EPS enhancements, real time exemption, promoting digital literacy and more.
NHS programme team: Pharmacy Supply Chain and Secondary Uses Projects include the implementation of a single identifier for prescribers working within the NHS.
openEHR This not-for-profit company has a vision of life-long interoperable electronic health records (EHRs); and computing on EHRs to improve the quality of health care and research. Its mission is to promote and support implementation.
Pharmacy system suppliers Systems are business-critical so it is essential to give careful consideration to selecting a system supplier, or working with your supplier.
Professional Record Standards Body (PRSB) Works with the public and healthcare professionals to define the standards needed for good care records.
System suppliers Systems are business-critical so it is essential to give careful consideration to selecting a system supplier, or working with your supplier.

Other national bodies may be involved with use of IT, even if that is not the primary focus of the organisation. A list of such organisations are set out below.

National organisation(s) (remit beyond IT) Further info
Department of Health and Social Care (DHSC) DHSC help to set out pharmacy related policy including in regards to data sharing and security.
Health Education England Health Education England’s remit includes an objective to improve the digital capabilities of health and care staff.
NHS Business Services Authority (NHSBSA) NHSBSA are involved in working with a number of IT projects which impact pharmacy. For example they:

NHS England

NHS England leads the National Health Service (NHS) in England. Working with the Department of Health and Social Care (DHSC), it sets the priorities and direction of the NHS to improve health and care. NHS Digital and NHSX were incorporated into NHS England.

NHSE local teams: May be involved with some local IT matters e.g. the completion of the Data Security and Protection Toolkit by pharmacy contractors. NHSE have published a list of local NHSE teams with contact details.

Primary Care Support England (PCSE) PCSE (formerly Primary Care Support Service – PCSS) provides administrative and support services to community pharmacies and other primary care providers on behalf of NHS England and NHS Improvement. This includes in regards to EPS token supplies.
Community Pharmacy England Community Pharmacy England’s IT team works to support community pharmacy contractors and LPCs on NHS IT matters. Community Pharmacy England works with relevant parties including the Community Pharmacy IT Group (CP ITG).

Policies (national)

A list of key national policies are set out below.

Policy (IT) Author(s) Categories Date Summary of policy

Integrating care (Nov 2020).

NHS Long Term Plan (2019).

Five-Year Forward View (5YFV).

 

NHS England & NHS Improvement IT and wider policy 2014-2020 Integrating care (“Next steps to building strong and effective integrated care systems across England”): The document contains plans to further increase the importance of Integrated Care Systems (ICS). From April 2021, all parts of the health and care system will need to work together as ICS, involving:

  • Using digital systems and data to drive system working, connect health and care providers, improve outcomes and put the public at the heart of their own care;
  • Stronger partnerships in local places and a more central role for primary care in providing joined-up care;
  • Provider organisations (NHS Trusts) being asked to step forward in formal collaborative arrangements that allow them to operate at scale; and
  • Developing strategic commissioning with a focus on population health outcomes.

NHS Long Term Plan: Setting out NHS intended priorities for healthcare for 2019-2029 including anticipated digital developments.

5YFV: The NHS needs to adapt to take advantage of the opportunities that science and technology offer patients, carers and those who serve them. But it also needs to evolve to meet new challenges: longer life expectancy, with complex health issues. The document proposes measures to help deliver a more responsive NHS in England.

Data saves lives (2021)

Integration and Innovation (2021).

The future of healthcare (2018).

Power of information (2012).

 

DHSC IT policy incl. data sharing and security 2012-2021

Data saves lives (“reshaping health and social care with data”): These policy proposals set out how to better use data across the health and care system. Community Pharmacy England has summarised the propoals into a one-page briefing factsheet.

Integration and Innovation (“working together to improve health and social care for all”): This included DHSC’s legislative proposals for a Health and Care Bill. This recognised the value with broad “duty to collaborate” across the health and care system and ICSs” and a plan to “legislate to ensure more effective data sharing across the health and care system, which is critical to effective integration, and will enable the digital transformation of care pathways”

The future of healthcare (“our vision for digital, data and technology in health and care”) This set out the Government’s ambitions for the use of technology, digital and data within health and care. This approach includes setting clear standards for the use of technology in health and care.

Power of information (“giving people control of the health and care information they need”): A strategy that set out plans for using information and technology to improve health, care and support – to improve the experience, quality and outcomes of health and care services, intending to put people at the heart of care.

 

Digital priorities (pharmacy) and related papers. Community Pharmacy IT Group (CP ITG)  IT policy 2020-2021

Digital priorities: CP ITG published its Digital priorities list (two pages) summary version (one-page) or  infographic version.

CPCF IT: CPCF grid, infographic and IT Reproductions of the grid and infographic to support IT relating to the Five-Year Community Pharmacy Contractual Framework (CPCF).

EPS future list: Collated views about the key EPS priority items

 

Everyday Interactions. Public Health England Interoperability & standards 2017 Everyday Interactions: Outlines public health impact ‘pathways’ to support pharmacy teams and others to record what they ‘do’ in their interactions with patients, what data can be collated and also the possible impacts from these interactions. These pathways could be of interest to pharmacy contractors and their system suppliers. The pathway templates include: Obesity, alocohol, dementia, and smoking.
A Digital NHS? Kings Fund IT policy 2016 A Digital NHS? Looks at the key commitments made and what was known about progress up to 2016, grouped under three broad themes: interoperable electronic health records, patient-focused digital technology, and secondary use of data, transparency and consent. The report identifies barriers to further progress and opportunities for delivering on the digital agenda.

Topol Review.

Topol Review 2 years on.

Health Education England Digital capabilities 2019-2021

Topol Review (“Preparing the healthcare workforce to deliver the digital future”): It makes recommendations to enable NHS staff to make the most of innovative technologies such as genomics, digital medicine, artificial intelligence and robotics to improve services. These recommendations were intended to support the aims of the NHS Long-Term Plan, and the workforce implementation plan.

Topol Review 2 years on (roundtable discussions): Some of the original authors of the ‘Topal Review’ dicussed progress on the findings two years after the original review was published.

Personalised health and care; and related

NIB reports.

NIB including DHSC IT and wider policy 2014-2017

Personalised health and care 2020 (published 2014): A framework for action that intends to support frontline staff, patients and citizens to take better advantage of the digital opportunity. The intention is that better use of data and technology has the power to improve health, transform the quality and reduce the cost of health and care services via four key ways: (1) give patients and citizens more control over their health and wellbeing; (2) empower carers; (3) reduce the administrative burden for care professionals; and (4) support the development of new medicines and treatments. It also said clinicians should be more paperless; and patients should expect that those caring for them have efficient access to relevant information.

NIB reports (2016-2017): The role of the NIB was to put data and technology safely to work for patients, service users, citizens and the professionals who serve them. It brought together national health and care organisations from the NHS, public health, clinical science, social care and local government, along with appointed independent representatives to develop the strategic priorities for data and technology. It sets data and technology work-stream priorities in health and care and advised DHSC.

Wachter review.

Making IT Work.

DHSC & IT advisory body IT policy 2016-2017

Wachter review: This review on use of IT when improving the NHS, suggested technical changes tend to succeed where carried out alongside workforce transformation and workflow amendment / training. The review suggested recommendations to inform the English health and care system’s approach to the further implementation of IT in healthcare, especially the use of electronic health records and other digital tools to achieve a paper free system. Recommendations included: (1) strengthen and grow the pool of healthcare staff that will have trained both clinically and within digital fields; (2) Allocate the funding to help Trusts go digital – mostly for those needing help, and for rewards for those exemplars; (3) Link national funding for digital to viable local implementation plans; and (3) Ensure interoperability as a core characteristic of the NHS digital ecosystem.

Making IT Work (“Harnessing the Power of Health Information Technology to Improve Care in England”): Wachter working with an IT advisory body to NHSE and DHSC set out recommendations as to how to best implement digitl technology policy.

Caldicott2 (2013).

Caldicott3 (2016).

National Data Guardian (NDG) Data sharing and security 2013-2016

Caldicott2 (“Information Governance Review”): Review of information-sharing to ensure that there is an appropriate balance between the protection of patient information and the use and sharing of information to improve patient care.

Caldicott3 (“Review of data security, consent and opt-outs”): Recommendations aimed at strengthening the safeguards for keeping health and care information secure and ensuring the public can make informed choices about how their data is used. A recommendation was made in some scenarios that the duty to share information for a patient benefit could be as important as the duty to protect confidentiality.

Older policies which influenced current arrangements Various Various Various

Informatics (“The future, an organisational summary”): (DHSC 2012)

Securing excellence in IT Services (“Operating model for community pharmacies and others”) (NHS England 2012)

 

Local policies are set out within the section below.

CP ITG papers (national)

Community Pharmacy IT Group (CP ITG) has worked on several paper to help set out national pharmacy IT priorities:


Local IT

A range of organisations are involved with setting out and implementing IT policies at the local level.

As a principle, Community Pharmacy England and Community Pharmacy IT Group pharmacy representatives have supported the principle of LPCs, Integrated Care Systems, Local Authorities and local commissioners supporting local IT projects consider:

“To foster a robust and competitive environment, local standards, frameworks, and tenders should be designed to accommodate a wide range of IT system suppliers. Doing so creates a healthier marketplace that is more appealing to vendors. These vibrant marketplaces promote competition across various dimensions, including features, innovation, service levels, data provision, interoperability (alignment to NHS IT and other standards), pricing  and overall value to healthcare teams (such as pharmacy and GP practice teams) and taxpayers.

Rather than fixating on a single solution within a larger IT ecosystem, localities (as well as national policy teams) are encouraged to embrace a diverse array of suppliers or look towards lists with a multitude of assured suppliers that meet relevant criteria. This approach benefits healthcare teams (such as pharmacy teams), and their patients across the longer term and contributes towards a more dynamic IT landscape.”

CP ITG papers (local)

Community Pharmacy IT Group (CP ITG) has worked on template papers that can be used by LPCs or contractors to set out local priorities which align to the CP ITG’s national vision.

Further comments about the templates can be sent to it@cpe.org.uk.

Local digital roadmaps

Clinical Commissioning Groups (CCGs) published Local digital roadmaps (LDRs) from 2017 to set out how the local health system would use ‘digital’ to provide improved and more efficient healthcare. LDRs were intended to support: a more interoperable approach; procurement of the software and hardware technologies to support appropriate information sharing across systems; providing business change and training support regarding new technologies that help clinicians move towards paperless workflows; and the use of a robust delivery plan.

Previously LDRs were published (at: London; South of England; North of EnglandMidlands and East of England) but many have not been recently updated and instead ICS are likely to consider local digital  priorities. Some of the LDRs were influenced by Guidance for LDR creation and NHE&I’s 2017 “Universal Capabilities Information and Resources“. NHSE can be contacted about past LDR work at england.digitalroadmap@nhs.net.

Digital maturity

The 2022 Plan for digital health and social care set out that all integrated care systems (ICSs) and their NHS trusts are aiming to have core digital capabilities. This set out intentions of the government:

  • Electronic health records, in place by March 2025. This set out a need to recalculate digital maturity amongst the ICSs
  • All ICSs towards required levels of digital maturity by 2025 and help them go further, digital transformation needs to be embedded in oversight arrangements
  • Changes in the regulations will aim to signal to the health and social care sectors that digitisation is a priority
  • Clarifying which technical and data standards are ‘musts’ technology product suppliers, how the NHS will plan to support organisations to achieve standards and how the NHS will plan to enforce them

Digital maturity for ICSs was defined in What good looks like (NHS England’s Transformation Directorate (NHSE’s TD). The integration of primary care was reviewed through the Fuller stocktake report.

  • 90% of NHS trusts with electronic health records by December 2023, and 100% by March 2025
  • increased cyber security capabilities, resilience, clinical safety and accessibility
  • established digital, data and technology talent pipelines, and improved digital literacy among leaders and the workforce
  • ensured all health and social care settings have the right infrastructure and connectivity to work digitally

Digital maturity is also to be determined by for example:

The government determined that as of 2022 no ICS was yet making full use of the transformational potential of digital technologies.

Annual digital maturity assessments will allow health and care organisations to measure their progress towards the core capabilities set out in What good looks like and identify the areas they need to prioritise. Organisations will be able to access the What good looks like hub, which brings together:

  • information;
  • good practice examples;
  • standards;
  • guides and policies;
  • useful tools and templates; and
  • networking information.

Much of the scope of local digital maturity of the ICS is currently separate from pharmacy digital maturity.

Full list of IT policies/organisations (local)

A list of local organisations is set out below where the organisations may have some impact on IT.

Local organisation(s) Further info (incl lists where available)

Clinical Commissioning Groups (CCGs); and

Commissioning Support Units (CSUs)

CCGs: Services CCGs commission include: urgent and emergency care (including out-of-hours); most community health services; and more. For community pharmacy, CCGs may wish to commission services such as palliative care schemes, MUR+ and other medicines optimisation services.

CSUs: CSUs provide CCGs with external support,  skills and knowledge to support them in their role as commissioners. CSUs do not have formally defined boundaries and may serve any CCG. CSU specialist support services include IT support. CCGs/CSUs may be involved with or act as the Smartcard Registration Authority within some localities.

CSU list: CSUs may include: NHS North of England CSU; NHS Arden and Greater East Midlands CSU; NHS Midlands and Lancashire CSU; NEL CSU; NHS South, Central and West CSU; Capita; Optum; and eMBED.

List of CCGs.

List of CSUs.

Directory of Services (DoS) local teams and leads.

A list of local contact details is available to users of NHS Service Finder (available for health care staff such as pharmacy teams members and LPC members):

List of local DoS team contact info (login required).

Health and Wellbeing Board (HWB) See the ‘Local Authorities’ row of this table.
Integrated Care Systems (ICS)

Around 40 Sustainability and Transformation Partnerships (STPs) were formed from 2016 and were intended to evolve into Integrated Care Systems (ICSs) and many have done so. ICSs are intended to run services in a more coordinated way, to agree system-wide priorities, and to plan collectively how to improve peoples’ day-to-day health. They service populations of between 300,000 and 3 million.

List of ICSs list (maintained by NHSE).

Local Authorities (LAs, local government)

LAs are involved with commissioning the majority of public health services. Each LA has a Health and Wellbeing Board (HWB) which has a wide remit across the new health and care system, providing strategic oversight and bringing together all the local commissioners. HWBs do not commission services; that is undertaken by the LA.

Each council also has a health Overview and Scrutiny Committee (OSC) dedicated to scrutinising local NHS policy, planning, and impact against local needs and inequalities. The health OSC also must be consulted on any proposed substantial service changes.

Local health and shared care record project teams (re LHCR / ShCR)

Contractors and LPCs may identify their local record project team via the list below.

List of local records projects/teams.

Local Pharmaceutical Committees (LPCs)

LPCs work with local partners – potentially to help set out local IT priorities.

List of LPCs.

NHS England IT local  implementation or local user research staff

NHS England is a body made up of thousands of staff, some of whom may work locally on user research or IT implementation (e.g. use of EPS and health records).

 

NHSE local teams

May be involved with some local IT matters e.g. the completion of the Data Security and Protection Toolkit by pharmacy contractors.

List of local NHSE teams with contact details.

NHSE Digital First programme team: local projects The Digital First Primary Care programme team support the NHS Long Term goal of making a digital route available where appropriate for patient pathways.
Primary Care Networks (PCNs)

PCNs are a key part of the NHS Long Term Plan, with general practices being a part of a network, typically covering 30,000-50,000 patients. The networks provide the structure and funding for services to be developed locally, in response to the needs of the patients they serve. It is important that community pharmacy teams and LPCs are fully involved in the work of their PCN and this is continuing to be encouraged.

Lists of primary care networks (published monthly by NHS England’s digital directorate in a zipped spreadsheet file called ‘epcn‘).

Regional Medicines Optimisation Committees

The four Regional Medicines Optimisation Committees for England make recommendations, pursue actions, and co-ordinate activities related to any aspect of Medicines Optimisation.

The Specialist Pharmacy Service website contains a page through which patients, practitioners and teams can submit ideas for RMOCs to consider. The website also contains RMOC membership lists, agendas, meeting dates and minutes.

Shared care record project teams See the row above related to: ‘Local health and shared care record project teams’.
Sustainability and Transformation Partnerships (STPs)

STPs were formed back in 2016. These were intended to evolve Integrated Care Systems (ICSs) and most have done so. These service populations of between 300,000 and 3 million. The intention of STP/ICS is that they will run services in a more coordinated way, agree system-wide priorities, and plan collectively how to improve patients’ day-to-day health. There are around 40 STP/ICS areas within England.

For list see row related to ‘ICS’.

Smartcard Registration Authorities (local) Oversees local Smartcard-related issues. See: Contact RA info.

Policies (local)

A list of key local policies are set out below.

Local polic(ies) (IT) Summary of policy and relation to IT policy
Local digital priorities templates (CP ITG)

Community Pharmacy IT Group (CP ITG) has worked on template papers that can be used by LPCs or contractors to set out local priorities which align to the CP ITG’s national vision.

Further comments about the templates can be sent to it@cpe.org.uk.

ICS/STP digital priorities Various
Local Digital Roadmaps Local Digital Roadmaps were published in 2017 for around 60 areas of England. Some of these included targets to boost: paperlessness; EPS/eRD; online ordering of repeat prescriptions; NHSmail; e-discharge; and records use. Previously LDRs were published (at: London; South of England; North of EnglandMidlands and East of England) but many have not been recently updated and instead ICS are likely to consider local digital  priorities sometimes building on the past LDRs. Many of the LDRs were influenced by Guidance for LDR creation and NHE&I’s 2017 “Universal Capabilities Information and Resources“.

Deployment support

In some areas, local NHSE teams previously supported deployment by organising beneficial local awareness raising events or facilitating bringing together GPs and pharmacies to discuss IT business change (e.g.  EPS / eRD business change. In many areas, this type of support will continue to be available, but in other areas, it may not. Support is available if LPCs want to independently organise events to provide support for contractors.


Related pages

EPS nomination and queries about it

EPS Tokens arrangements

Report/escalate IT issues

Smartcards and Registration Authorities

NHS IT systems list

System suppliers list

IT requirements and standards A-Z

Pharmacy services IT requirements


Further info

If you have queries on this webpage, or you would like to make a request for an addition to one of the lists, or you require more information please contact it@cpe.org.uk. To share and hear views about digital developments with like-minded pharmacy team members, join the CP Digital email group today.

 

 

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