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NHS England – Global Digital Exemplars

By Tom Foley.

Ann Slee, ePrescribing Lead, Strategic Systems & Technology, Patients &
Information, NHS England

As well as her work with NHS England, Ann has recently been involved in Tech Fund and NIHR funded programmes, loosely based on a Learning Health System philosophy, that have been aimed at achieving improved digital maturity.

NHS England have committed to funding a number of Trusts to become Global Digital Exemplars (GDEs). A GDE will be an internationally recognised NHS care provider delivering exceptional care, efficiently, through the world-class use of digital technology and information flows, both within and beyond their organisation boundary. It will also provide a reference site for other care providers. 12 Acute providers have so far been chosen:


  • Salford Royal Hospitals NHS Trust
  • Wirral University Teaching Hospital NHS Foundation Trust
  • City Hospitals Sunderland NHS Foundation Trust
  • Royal Liverpool and Broadgreen University Hospitals NHS Trust

Midlands and East

  • West Suffolk NHS Foundation Trust
  • University Hospitals Birmingham NHS Foundation Trust
  • Luton & Dunstable University Hospital NHS Trust


  • Royal Free London NHS Foundation Trust


  • Oxford University Hospitals NHS Foundation Trust
  • Taunton and Somerset NHS Foundation Trust
  • University Hospitals Bristol NHS Foundation Trust
  • University Hospitals Southampton NHS Foundation Trust

Information Technology is increasingly recognised as a key enabler of change and transformation. In secondary care in particular, we are not yet realising the benefits of investing in digital technology to deliver the triple aim as outlined in the Five Year Forward View.

So far, there has been a focus, within providers, on getting digital infrastructure in place, in areas such as ePrescribing. There has not yet been enough work on using the data collected to optimise and transform care. It is not clear why this has been, but possible reasons include, day to day pressures, funding challenges and the need for more imaginative approaches.

Some providers are beginning to make real progress by combining improvement research (e.g. from IHI) with technical infrastructure and by learning from other countries. Other providers will require some more encouragement. As well
as providing funding to the GDEs, NHS England is taking a two pronged approach to sharing and spreading innovation:

1.    Establishing a Learning Network: to encourage GDEs to share learning but also to collaborate on developing common solutions, so that they do not each have to reinvent wheels unnecessarily. Initially,
learning will be shared between GDEs, but the expectation is to then share work with other Trusts so that they can leapfrog the original exemplars.

2.    Independent Evaluation: of the GDEs will be a central part of their development. This was recommended by the Wachter Review and will measure progress again qualitative and quantitative measures, including digital maturity. It will provide important learning for future work. Evaluation of digital interventions is critical, but it can be challenging to evaluate underlying standards, technical infrastructure and
outcome measures. This requires ongoing work.

There are great opportunities to use data to help redesign healthcare. NHS England are aiming to offer a vision of how this can be achieved and incentives to make it a reality. The hope is that it will become core business.

The Model Hospital Project is a good example of how quantitative data can be used to benchmark hospitals, providing an incentive and a tool for improvement. This sort of data will also be very important to the Vanguards.

There is significant opportunity for partnership between the NHS and academic teams:

      In evaluation

      In analytics/research

      In developing spin-off projects

NHS England has been looking at what it can learn from other industries and has identified examples that might be applicable. The next stage will be to investigate these in detail.

NHS England have used research from The Health Foundation, particularly to inform the development of their Learning Networks They also see significant potential to learn how to disseminate learning, from work that The Health Foundation is doing around Q Community. We need more effective and creative methods of dissemination than publishing on our website or in academic papers.