Annual State of the NHSScotland Assets and Facilities Report for 2012

Annex I

eHealth Strategy 2011-2017

The eHealth Strategy 2011-2017 provides NHS Boards with the opportunity to drive eHealth enabled improvements closer to the front line of service delivery and to align eHealth more closely with the NHSScotland Quality Strategy. Five new strategic eHealth aims have been developed and these will be the focus of activity over the next six years. They are: supporting people to communicate with NHSScotland; contributing to care integration; improving medicines safety; enhancing the availability of information for staff; and maximising efficient working practices. The eHealth Strategy aims to leverage the IM&T assets to support the quality improvements that NHSScotland has committed itself to through the Quality Strategy.

The potential of information technology to support and transform healthcare services is universally recognised. In Scotland, eHealth has a pivotal role in enabling a radical e-transformation in the way in which high quality integrated healthcare services are delivered efficiently and effectively to people of all ages across the country.

The focus on five strategic eHealth aims as an enabler of quality improvements in healthcare services across Scotland will have considerable implications for the way in which asset will be used to support service delivery in the future. Increasingly, patients and staff will focus on the use of IM&T assets rather than property assets to receive and delivery care. It also changes the way in which performance is measured. Boards' eHealth Plans will be aligned to LDPs and will include:

• benefits being maximised from IM&T assets that have been acquired during the previous strategy (2008-11);
• information and evidence on eHealth's contribution towards achieving the five strategic eHealth aims;
• promotion and implementation of good practice and successful local initiatives more widely;
• convergence of approaches to delivery in order to reduce duplication of effort and reduce cost;
• collaborative working between Boards and cross-border eHealth developments

Society is increasingly comfortable with self-service models of interaction and although face-to-face services have not disappeared, their dominance has been replaced by a much more diverse mix. Although NHS24 delivers telephone based and online services, NHSScotland relies heavily on face-to-face consultations and the way people receive healthcare remains largely unchanged despite the radical transformation in the way in which other public services are delivered. eHealth can enable NHSScotland to take advantage of the everyday technologies already used by most people in their daily lives. eHealth could contribute to a radical transformation in the delivery of health and social care services in Scotland over the next decade through enabling people to access and interact with their health records electronically, and through a greater emphasis on the delivery of services through different communication channels, e.g. online by patient portals or electronic windows to information, via email, websites, digital channels and social media.

Section 5.7 of this 2012 State of the NHSScotland Assets and Facilities Report begins to explore the potential and implications of shifting the balance of future capital and revenue investment between assets groups i.e. from property to IM&T infrastructure and equipment. This initial work has shown that a relatively small shift in investment between asset groups has the potential for transformational change in the magnitude of investment in other asset groups. Further work is needed to model this type of change in investment and the implications for services and existing assets. In particular, it raises a number of questions that need to be addressed:

1. At what point in the future can we expect the eHealth Strategy to have a material impact on the need for property assets and how can we plan for this change?
2. What impact is the eHealth Strategy likely to have on organisational structures, staff numbers and the way in which people work? Will these new ways of working impact on the need for physical assets such as staff bases, offices, meeting rooms as well as clinical spaces?
3. What risks are involved in changing the balance of investment from property to IM&T assets and how can we manage and mitigate these risks?
4. What are the implications for the estate of re-balancing investment and is there sufficient flexibility in estate assets to respond to this change?
5. How can we unlock existing investment in property to support increased investment in IM&T?
6. How will we measure and monitor the pace of change towards a more IT enabled healthcare environment?
7. Can we identify the sustainable benefits from embracing and integrating new technology into the healthcare delivery models?
8. What information (staff numbers, costs, benefits etc) do we need to be able to properly model alternative investment choices and make the case for change towards an IT enabled future?
9. What funding vehicles are most appropriate for investing in IM&T infrastructure and can we demonstrate value for money from these investments?