Paul Rice, Head of Technology Strategy, NHS England

2. THE FORWARD VIEW INTO ACTION:
Paper-free at the Point of Care –
Developing Local Digital Roadmaps
Five Year Forward View April 2016

4. Transfers of Care
Use technology to seamlessly transfer patient
information at discharge, admission or referral
“Having the ability to quickly access an individual’s
medical history will enable me as a paramedic
attending a call to make informed decisions when
responding to an emergency.” Paramedic
Records, Assessments and Plans
Capture information electronically for use
by me and share it with other professionals
through the Integrated Digital Care Record
Medicines Management and Optimisation
Ensure people receive the right combination of
medicines every time
Decision Support
Receive automatic alerts and notifications to
help me make the right decisions
Remote Care
Use remote, mobile and assistive technologies
to help me provide care
Asset & resource optimisation
Increase efficiency to significantly
improve the quality and safety of care
Orders & Results Management
Use technology to support the ordering of
diagnostics and sharing of test results

5. Baseline and benchmark
(NHS providers) progress towards
being paper-free at the point of
care using a new Digital Maturity
Self-Assessment Tool
Create a Digital Roadmap
outlining the steps (operational
and strategic) to be taken
towards becoming paper-free at
the point of care
Confirm a Footprint detailing the
partners and the governance
arrangements to drive the local
health and care system to become
paper-free at the point of care
1. 2. 3.

7. 85 Footprints
48 single CGG Footprints
37 multiple CCG Footprints –
ranging up to 12 CCGs
Region North
Midlands
& East
London South
Total Number 32 23 7 23
Single 22 9 2 15
With partners 10 14 5 8

8. 24
6
7
2
4
1
Number of LDRs in each STP
1
2
3
4
5
6
44 STPs with between 1 and 6 LDRs in each

9. 0 2 4 6 8 10 12
1
2
3
4
5
6
7
8
9
10
11
12
Number of STPs
NumberofCCGs
Number of CCGs Per STP
Number of STPs
Number of CCGs per STP

10. READINESS
Are providers set up effectively to deliver paper-free at the
point of care?
CAPABILITIES
Do providers have the digital capabilities they need to
deliver paper-free at the point of care?
INFRASTRUCTURE
Are the underpinning technical enablers in place to deliver
paper-free at the point of care?

11. Red = Infrastructure score <40%
Amber = Infrastructure score 41 – 75%
Green = Infrastructure score 76 – 100%
Blue lines reflect the bandings applied in MyNHS
National Scores for Readiness, Capabilities
& Infrastructure themes (all services).

12. National Scores for Readiness, Capabilities & Infrastructure themes (all services).
0
10
20
30
40
50
60
70
80
90
100
Readiness Capabilities Infrastructure
Readiness Sections scored
higher than capabilities
Medicines Management, Remote & Assistive
Care and Decision Support have lowest
results across the self-assessment

13. What percentage of respondents stated positively* that…
Healthcare professionals rely on digital records for the information they need at the point of care… 32%
Professionals have digital access to the information they need from other healthcare providers… 21%
Professionals have access to a consolidated view of their patients health & care records… 14%
More than 60% of care summaries are shared digitally with GPs… 64%
More than 60% of lab tests are ordered digitally… 52%
More than 60% of radiology tests are ordered digitally… 49%
More than 60% of inpatient medications are prescribed digitally... 19%
Healthcare professionals receive digital alerts to patient preferences... 23%
Digital systems alert professionals to patients whose observations or EWS are deteriorating… 28%
Remote/virtual clinical consultations and clinical advice are available to patients… 11%
Staff rostering is managed digitally throughout the organisation… 74%
Healthcare professionals have access to Wi-Fi throughout the organisation… 82%
Wi-Fi is available in public areas throughout the organisation… 50%
*Answered ‘Mostly Agree or Completely Agree’ or >60% for quantitative responses

14. 1. Users can view a dedicated page for
each section of the assessment as well
as an overall summary.
3. A selection of charts allow users to
display the raw data in an
accessible/informative way.
5. Users can apply different filters to the data
more relevant. E.g. average of acute only,
data from the South only.
2. A trend line allows users to make a
visual comparison of their own
scores/answers against the
national/regional/ service average.
4. Each page shows the national scores &
answer breakdown for the questions in the
different sections of the DMA.

15. In their LDRs, commissioners and providers should describe
how, working collaboratively, they will underpin and transform
service models and key clinical priorities with the necessary
digital technology and capability, and in so doing, help to close
the gaps in health and wellbeing, care and quality and finance
and efficiency.
In their LDRs, commissioners and providers should plot their
route to the delivery of ‘paper-free at the point of care’ within
and between care settings, and outline how they will exploit
digital technology and data to support transformation and secure
sustainability more widely.
THE FORWARD VIEW INTO ACTION:
Paper-free at the Point of Care –
Developing Local Digital Roadmaps
Five Year Forward View April 2016

16. A vision for digitally-enabled
transformation
Information sharing
• Approach
• Information sharing agreement
• Adoption of NHS number and
standards
Readiness
• Leadership, clinical
engagement and governance
• Change management
approach
• Benefits management and
measurement
• Investment approach
• Programme structure
• Resources for change
Capability deployment
• Schedule
• Trajectory
System-wide Infrastructure
• Mobile working
• Unified communications
• Shared infrastructure initiatives
Where are we now
• Overview of current maturity
• Key recent achievements
• Key current initiatives
• Rate limiting factors
Universal capabilities delivery
plan
• Baseline
• Ambition
• Activities
• National services /
infrastructure / standards
• Evidencing progress

17. The Thinking
• Every local health and care system will be expected to
make progress against a set of 10 universal capabilities,
demonstrating clear momentum between now and end-
March 2017 and substantive delivery by end-March 2018.
• In many systems, the capability will already have been
deployed to some degree and the main challenge going
forward is achieving more comprehensive take-up and
optimisation.
• The potential of these capabilities has already been clearly
demonstrated in some localities. They represent the
minimum evidence that local footprints are making clear
progress towards operating
paper-free at the point of care.
• The priorities require only marginal financial investment.
Many are (or will be) supported by national services,
standards or infrastructure. In some systems, alternative
local solutions will be available –if used, a rationale should
be provided.
• The list of universal capabilities may evolve in due course.
The List of Universal Capabilities
• Professionals across care settings can access GP-held information on
GP-prescribed medications, patient allergies and adverse reactions
• Clinicians in urgent and emergency care settings can access key
GP-held information for those patients previously identified by GPs as
most likely to present (in U&EC)
• Patients can access their GP record
• GPs can refer electronically to secondary care
• GPs receive timely electronic discharge summaries from secondary care
• Social care receive timely electronic Assessment, Discharge and
Withdrawal Notices from acute care
• Clinicians in unscheduled care settings can access child protection
information with social care professionals notified accordingly
• Professionals across care settings made aware of end-of-life preference
information
• GPs and community pharmacists can utilise electronic prescriptions
• Patients can book appointments and order repeat prescriptions from
their GP practice

18. Alignment
Governance
Resourcing
The Driving Digital Maturity Programme