The digital workstream sits across the urgent and emergency care programme and the wider NHS England digital programme. The focus is on digital first and within that is included the GPFV online consultation programme.

NHS England (London region) has launched the ambitious Digital First programme to support the delivery of digital access to NHS services and help patients and their carers manage their health. One component of this programme is the integration of elements into the NHS App to increase its functionality. This is currently being conducted across 5 ‘Accelerator’ sites, one in each sustainability and transformation partnership (STP) in London. The overall aim of the programme is to review local health economies across London, identify challenges in the patient journey, and to mitigate these through the redesign of pathways, using technical solutions. The implementation of these elements, listed below, will help to ensure that the NHS App provides a single “front-door” access and a seamless patient journey.

Core capabilities being explored for the NHS App:

• Ability to offer video consultations
• Ability for patients to consult with their GP Online service
• Seamless ability for patients to book into Extended Access Hubs
• Full clinical records captured by local/regional record sharing solutions
• Triaging/assessment of patients before enabling them to book at their registered practice

Digital First Accelerator sites are local areas selected by STPs using set criteria to act as leaders to support the design and implementation of a digital ‘front door’ into NHS services. Each STP receives additional funding to support change management and to ensure delivery. A ‘Discover, design, deliver and adopt methodology’ has been implemented at the accelerator sites as this suits the dynamic environment within which the programme sits. Each respective Digital First accelerator will report through local governance channels and to Primary and Care Urgent and Emergency boards. They will be supported by the Digital Transformation team which has been set up to provide centralised project management in collaboration with local areas.

The focus of work is currently:

• Supporting the continued role out of online consultation offers across London and monitoring achievements against national targets to ensure that by March 2020, 75% of practices are offering online consultations to their patients
• Helping the system to ensure that all GP practices are technically enabled to provide all the functionality that will be offered through the NHS App, as part of the Digital Primary Care transformation plan to ensure it is available to 100% of the population by 31 July 2019
• Integrating extended access with other services at scale to deliver value for money and efficiencies and support compliance with national core requirements to maximise capacity, availability and utilisation of appointments for 100% of the population. This includes the delivery of 100% NHS 111 direct booking system into extended access services for the whole population by 31 March 2020
• Supporting the increase the percentage of people triaged by NHS 111 that are booked into a face-to-face appointment, where this is needed.This will be done through building on direct booking and should include supporting the rollout of GP Connect technology to directly book into GP surgeries, with 1 practice appointment per day, per 3,000 patients, with a minimum of 1 appointment per practice per day (the number of appointments required will rise in increments of 3,000 patients)
• Shaping and driving the digital first offer though learning from accelerator sites. This will support the requirement that all patients will have the right to digital-first primary care, including web and video consultations offered by all London GP surgeries, by April 2021
• Undertaking work to ensure all practices offer and promote electronic ordering of repeat prescriptions and using electronic repeat dispensing for all patients for whom it is clinically appropriate, as a default from April 2019
• Continued work to ensure all practices will need by April 2020 to have an up-to-date and informative online presence, with key information being available as metadata for other platforms to use

Estates and Technology Transformation Funding

Having the correct estates and digital infrastructure is key to delivering primary care transformation. It is a key enabler and a foundation to this work. The focus of the work includes:

• Implementing the 2019/20 London STP’s Improvement Grant Programme, using available BAU capital.  The 2019/20 programme consists of a maximum of 100 schemes assessed as being fully or partially supportable for funding from the region’s capital programme in 2019/20, to enable infrastructure improvements across London’s general practice premises, in line with CCG Local Estates Strategies, and prioritised by London’s 5 STPs. (Target date 03-20)
• Recommend either approval of 18 new builds and 13 improvement grants currently in due diligence, or that they should be removed from the ETTF pipeline, if there is evidence that these are not deliverable within the ETTF timeline
• Ensuring delivery of 27 schemes (4 new build; 4 IGs and 19 technology schemes) no later than 31^st March 2021
• Bringing forward prioritised estates schemes from the ETTF dormant pipeline that remain strategic priorities, subject to funding becoming available and their completion by 31^st March 2021
• Seeking to maximise London’s access to ETTF funds, over and above its annual allocation
• Continuing to work with the London Estates Board, via the Programme Director for the London Estates Delivery Unit, to ensure a smooth transition (in terms of knowledge, transference of viable and funded schemes, and good governance arrangements)

GP Online Services

GP online services is an NHS England initiative that supports GP practices to offer and promote online services to patients, including access to appointment booking, ordering of repeat prescriptions and access to coded information in records. Transformation Partners in Health and Care works closely with STPs, CCGs and GP practices across London.

Background

• Strong evidence from the London Estates Technology Transformation Fund Project (ETTF) and national team accelerator sites indicates that practices that actively promote these services and register patients benefit from reduced administrative workload and increased patient satisfaction.
• London has set out an ambitious and attractive vision of primary care that works more easily and effectively together (general practices with each other and other primary care providers), operates without borders, and in partnership with the wider health and care system. This vision is outlined in the Transforming Primary Care in London: A Strategic Commissioning Framework building on NHS England London’s Transforming Primary Care in London: General Practice A Call to Action. It addresses the need to provide a more consistent service for all Londoners through improving coordination of care, access to services and taking a more proactive approach to our patients’ health and wellbeing.
• What you can do to encourage uptake for online services:
• Provide patients with an online services registration form and patient information leaflet
• Promote online services to your patients via your website, telephone answering service, text messaging campaigns, email campaigns, posters/TV screens in your waiting room and practice leaflets
• Ensure practice staff knows how to register patients with online services and be aware of any safeguarding risks
• Use the new animated video produced by Transformation Partners in Health and Care at GP practices to increase awareness to patients

We have implemented

• Transformation Partners in Health and Care conducted a pan-London project led by our GP online services team (previously known as Patient Online team) to improve the provision of online services in primary care. It involved overseeing local GP online facilitators in each CCG area that worked directly with all London practices delivering:
• Technical support to Practice Managers and administrative staff in ensuring availability of services to their patients
• Engaging with GPs and practice team staff, raising awareness, delivering presentations and webinars for all practice staff
• Empowering patient participation groups and local voluntary sector organisations to champion GP online services to raise awareness in their local community
• Raise awareness around GP online services
• Utilised a wide range of communications tools for practices that included leaflets, posters and on-line toolkits and more
• Results of this project have shown an increase in the utilisation of online services for registering patients and appointment availability across the London region.
• London has demonstrated very encouraging progress throughout the length of the ETTF project. Over 500,000 patients have created themselves a new online account in this period meaning there are currently over 1.7 million Londoners with an online account. These patients will be utilising the online services of the 99.5% of London GP Practices that have them enabled.
• With over 1.7 million patients using online services we can expect to see non cash releasing savings of £4.2 million to the NHS, per year, just through online appointment booking alone. This level of utilisation will also provide time savings of over 400,000 working days per year!

Looking ahead

• Transformation Partners in Health and Care and NHS England London region will continue to support the GP online services initiative ensuring delivery for 20% of patients registered as per the aim for 2017 PMS contract

Local resources available

• GP online services animated videos: 30 seconds and 60 seconds that can be used for social media and GP practice screens.
• Tools to promote GP online services in your area: Patient Online Services  communications toolkit created for London CCGs and boroughs3

For additional support, please e-mail London region ENGLAND.POLLondon@nhs.net