Guest Blog: Balancing interoperability and freedom across Integrated Care Systems
NHS England’s 42 Integrated Care Systems (ICSs) were created to help achieve some of the most ambitious and critical goals set out in the NHS Long Term Plan.
The ICS model has the potential to improve communication and collaboration between primary and secondary care providers, support a shift towards population health management, and help the NHS better meet the diverse needs of local populations across England.
But, there’s an important goal that the ICS model isn’t fully aligned with: increasing the interoperability of NHS data and systems across England.
Balancing local and national demands
The ICS model helps care teams and organisations make precise decisions at a local level. But that level of local flexibility and freedom can create new national challenges – especially when technology is involved.
With every ICS responsible for its own technology decisions and investments, prioritising its investments to meet local needs, there’s a risk that the model moves NHS England further away from its goal of interoperability and connected data across the country.
Success starts with the right standards
So, what can NHS England do to help them ensure that their local-level decisions don’t lead to national-level data and service interoperability issues?
The solution starts with stronger, better-supported and more relevant standards. With the right standards and guardrails in place, NHS England can take a light-touch approach to guiding the digital decisions that ICSs make, in ways that promote interoperability without restricting their ability to acutely tackle their local challenges.
ICSs themselves have a role to play in enabling interoperability too. As they start to make their own plans for future data and digital investments, it’s in their interest to collaborate with other ICSs and make tech decisions that will help them work together in the future.
NHS England, ICSs, practitioners, patients – a standardised, interoperable data and system foundation is in everyone’s best interests. Supported by a consistent digital foundation, teams and organisations across NHS England can collaborate more easily, build wider and more robust digital strategies, improve patient experiences, and deliver leading services like patient-driven care.
Total interoperability is a lofty goal, but the benefits are closer than they may appear
Getting to a point where every ICS across England has 100% interoperable systems, software and digital tooling would require significant effort and change. But even if just a small number of ICSs started collaborating more closely to make joint digital decisions, they could realise a lot of the benefits very quickly.
It’s a journey that needs to be tackled incrementally, but one that NHS England and England’s 42 ICSs should start in earnest soon. Without it, the ICS model opens the door further to regional digital divides, potentially reducing the accessibility and equality of care.
Balancing freedom and control is hard. But it’s getting easier.
There’s no single ‘right’ way to balance local empowerment with centralised governance and a standardised way of working. Every organisation must find its own ideal balance between the two – which is why many are increasingly exploring modern architectural paradigms like Data Mesh.
Data Mesh is a decentralised architectural approach that puts domains in control of their data, enabling them to create their own data products. But the foundation of the mesh also ensures interoperability, supporting the wide reuse of domain-oriented data products across an organisation.
For organisations like NHS England, that balance of domain empowerment, central standardisation and built-in governance may be exactly what they need. But, until that can be accomplished, small steps towards better cross-ICS collaboration and more consistent decision-making can move them in the right direction.
To find out more, and learn how our team can help you, talk to Thoughtworks today.
Authors
Scott Davies
Scott is a Technical Director at Thoughtworks with over 20 years of experience in software delivery and distributed delivery, and is the technology lead for Public Sector in the UK.