Arvind Madan - Director of Primary Care, NHS England

1. Dr Arvind Madan
Director of Primary Care, NHS England

2. Primary Care
Ageing population
Increasingly complex patient diagnoses
Slower than required growth in numbers of
healthcare professionals
Changing user expectations
Variations in outcomes

3. 1 in 20 of 1.2 trillion Google
searches are health-related
~ 50 million visits per month to
NHS Choices
Go online for
health information

5. 6% of appointments could have
been dealt with by practice staff
other than the GP
4% of patients could have
avoided contact with the practice
if self-care support had been
available
120
80

6. 92% of practices offer patients
online access to their Detailed
Care Record
Online Appointment Booking
98.7% of practices offering
8.4 million patients signed up
12% of all appointments are
available online
Online Repeat Prescriptions
97.4% of practices offering
8.2 million patients signed up
4% of all repeat prescriptions
requested online
Online Access to Records

7. Access to patient data at the point of care
Interoperability to allow data sharing between health and care professionals
Patient empowerment through the use of endorsed apps and other digital tools

8. Enable patients through signposting and remote management to help them prevent
ill-health through self care
Increased practice efficiencies through a wide choice of innovative technology that
supports new ways of working
Access to data and tools that enable providers to evaluate, measure and improve
episodes of care and services
Support and guidance for professionals to help them make best use of technology
and connect with each other

9. Better use of technology for practices
• Increase in revenue funding to CCGs
• Data Quality Training
• Information Governance and cyber security
• Increased uptake of Patients Online
• Increasing online self-care and tackling digital exclusion
• Development of 111 Online
• Wi-Fi in GP practices for staff and patients
• Mobile access to records
• Apps library on nhs.uk to support clinicians and patients
• Telephone and e-consultation tools
• Remote care of long-term conditions and Telehealth
• Paperless 2020 e.g. EPR, EPS, GP2GP, e-discharges
• Summary Care Record and record sharing across
practices and services
• Advice and Guidance support services
• Improved data extraction and payment system
• Digital Maturity Index and buying framework for CCGs

10. “I can choose from a wide
range of innovative systems
and solutions that can
improve the way I work”
“My working hours are
flexible, as I can manage
my patients remotely”
“I’ve been supported to
use new technology
confidently to deliver
better care”
Enabling you to offer digital services
to your patients which allow them to
take ownership of their own care
Enable patients with long-term
conditions to be remotely managed
through sharing of personal health
care data
Supporting new ways of working
through online access and reducing
bureaucracy through linking digital
workflow and task management
Making real-time digital records
available inside and outside the
practice
Educating and supporting you to
make the best use of technology
Seamlessly linking health
professionals and digital records
Providing access to the
right data and tools to
enable you to capacity
plan and measure the
service demands based
on patient need
Analyse data and
intelligence to allow you
to make service
improvements and
modifications
I can signpost and remotely manage
my patients and help them prevent
ill-health through self care
I can evaluate the quality of
service that I provide to my
patients
I can work efficiently and make
sure my patients are seen by the
right professional
Technology that builds confidence
to support empowering your
patients to take advantage of the
digital tools and apps on offer and
sign post to the right services
“I’ve have been given the
right business tools to
understand my patients
health needs”
I can access support
to improve my digital
skills and services
Support services
available to
accelerate and adopt
new ways of working
Online clinical
communication
network available to
provide practical
advice and guidance
Simple payment
systems

11. Back Office Systems
Staying Well
Self-help content
e.g. NHS Choices
Risk Assessment
Tools e.g. One You
Well-being tools e.g.
Apple Healthkit and
wearables
Feeling Unwell
Transactional tools
e.g. Patient Online
Sign posting e.g.
pharmacy, mental
health services
Symptom checking
e.g. 111 Online
Remote Care
Email Consults
(minor illnesses
and requests)
Long-term
Condition Apps
(Reactive and
proactive care)
Telehealth for
ongoing
monitoring e.g.
virtual wards
Data based
population
management e.g.
risk stratification
• Human Resources
• Finance
• Practice management
• Rota management
• Secondary data use
• Quality metrics
• Data extraction/Payments
• Commissioning intelligence
• Patient Record
• Electronic Prescribing
• Electronic Record Transfer
• E-referral and E-discharge
Patients use practice
website as a resource to:
• stay well
• source credible advice
• remotely manage
clinical interactions

12. Patient
empowerment, self
care and prevention
New ways of working
and reduced
bureaucracy
Providing access to
data and tools to
measure quality and
efficiency
Supporting
hard to reach
groups
Order and attach
test results
electronically
Patients able to
provide pre-
referral info
Book all primary
care appointments
online
Free patient
and
professional
WiFi
NHS endorsed
library of apps
24hr digital urgent
& emergency care
via 111
Repeat
prescriptions
Click and
Collect
Digital GP
consultations via
phone, email,
webcam, messenger
where appropriate
Telecare apps
widely
available
Telehealth
devices used
by patients for
diagnostics
Remote
monitoring of long
term conditions
Online patient
consent
options
Electronic
engagement with
health professionals
E-discharge
summaries
received in
GP Record
Transfer e-records
between practices
Remote access to real-
time digital records
Approved apps
on nhs.uk that
signpost and
share information
with GP
Shared records
across federations
Ability to deliver
virtual GP services
Wider choice of
systems and
infrastructure
Full read/write
access for urgent
& emergency care
Single GP
payment system
Electronic receipt
of all clinical info
Real-time info
sharing using
NHS SPINE
Interoperability standards
included in provider
contracts
Morbidity and activity data
analysis across federations
Local automated
extract services
Standards and
system accreditation
Digital maturity and
assurance tool for
commissioners
Trial local
extract services
Purchasing by local
commissioners
Patients have
digital access
to practice
DRAFT - not for wide circulation