Care in the Digital Age: Delivery Plan 2023-24

Annex – Summary of key work programmes under the Delivery Plan

We have summarised key programmes and projects to illustrate our priorities, and progress to date. Further information on each is available at digihealthcare.scot.

Digital Front Door – citizen access to personal health and care information

The 'Digital Front Door' for health and social care will include a range of features allowing people to access, self-manage, and contribute to their own health and social care information online, or through an app, as well as providing information on local health and social care services. The Digital Front Door's development will build upon the NHS24 app released last year; we expect this to be delivered by the end of the current Parliamentary term.

Near Me – remote access to appointments and consultations

Near Me provides video-based access to appointments across Scotland. Originally NHS-only, it is now available across a range of public services offering convenience and flexibility, and reducing the need for travel. A total of 440,000 Near Me consultations were held in the last year from over 2,200 clinics. More recently, the service has been expanded into local community hubs, providing additional accessibility for those who may not have online facilities or a private space at home. Use of group consultations has also grown in the past year, with 8,000 group sessions involving 35,000 participants. Activity to support the use of Near Me within Duty Social work has also been completed this year.

Digital Mental Health

There are now 26 digital therapy options available for conditions including depression, anxiety and insomnia. Over 200,000 people have been referred to date, with over 70,000 in 2022 alone. Around 85% of referrals are from GPs with the remainder largely self-referrals. The digital option allows access to support for people round the clock, reducing waiting times – with people typically waiting no more than 5 days to commence their therapy. It also offers an alternative route for those who do not feel comfortable with a face-to-face session, or who may need support out of hours.

Microsoft 365 Roll Out – support for multi-disciplinary team working

This major infrastructure project supports the integration of the health and social care workforce by enabling greater communication, collaboration and sharing of information locally, including shared calendars between staff from different employers. Working with the Local Government Digital Office, federated access to Microsoft 365 between the NHS and local authorities is now live in 6 council areas with associated training resources on the NHS Education for Scotland Turas platform.

Workforce Digital Skills

The Digital Leadership Programme previously open to Nursing, Midwifery and Allied Health Professionals has been expanded and is open to other professions across health and social care. A strong focus on digital leadership has been realised this year with the creation of the Leading Digital Transformation in Health and Care MSc in partnership with the University of Edinburgh, recruiting 60 participants in the first cohort.

Integrated Health and Social Care Record

We continue to plan for the digital and data requirements of the National Care Service, including consideration of what is required to deliver a nationally consistent integrated record across Scotland's health and social care sector, providing professional access to personal health and social care information for the improved delivery of care. This work is being developed jointly between COSLA, and the Scottish Government's Directorates for Digital Health and Care and Social Care and National Care Service Development.

Robotic Surgery

We have contributed over £20 million to a national framework for surgical robots to be purchased for the NHS in Scotland. The Robotic-Assisted Surgery systems provide a less invasive treatment option for cancer patients and will primarily be used for urological, colorectal and gynaecological operations. Procedures are delivered by robotic ports and tools, operated by the surgeon who sits at a console in the same theatre. In the longer term, remote digital surgery will be available. Evidence shows that the use of surgical robots can halve the hospital stay of patients and reduce re-admission rates. There are now 16 active surgical robots with all but three NHS Health Boards currently using Robotic Assisted Surgery systems.

Long-Term Conditions Management and Hospital at Home (Connect Me)

Digital services offer nationally consistent pathways for treatment and digital remote monitoring to treat a greater range of long-term conditions without the need for hospital visits. Connect Me and Hospital at Home support local services with the ability to provide these pathways for conditions such as hypertension, COPD (Chronic Obstructive Pulmonary Disease), heart conditions, asthma, and diabetes. Some 5,000 people already are using the service for hypertension monitoring – the number is increasing month on month with over 1,600 people joining in March 2023 alone.

Digital Social Care and Telecare

In addition to the remote monitoring highlighted above, the Scottish Government and COSLA are working together to explore how technology can support people in their care at home, prevent hospital admissions and enhance the hospital discharge process. This includes proactive outbound calls via telecare services to support waiting well (and general wellbeing), and the management of the migration from analogue to digital telecare for an estimated 170,000 people in response to UK-wide changes to the telephony network.

Enhanced GP IT systems

All GP practices in Scotland will move to the same GP IT system, enhancing the delivery of multi-disciplinary community-based primary care services, and allowing remote access for staff and enhanced patient services. There are currently 110 GP practices that are live with new GP IT system, and this will be rolled out in the next few years.

Picture Archiving Communications System (PACS)

PACS supports the seamless acquisition, storage, retrieval, and display of digital patient images within and between clinical sites across Scotland. Clinicians will be able to access images taken at stages along pathways and readily access relevant patient records. This will streamline care and speed up diagnosis and treatment, and make it easier to adopt advances in Artificial Intelligence.

Digital Lifelines Scotland

Digital Lifelines seeks to improve digital inclusion and to design digital solutions that better meet people's needs, to improve the health outcomes for people who use drugs, reducing the risk of harm and death.

Digital Inclusion Programme

We continue to demonstrate our commitment to digital inclusion with the commencement of the first phase of a new £2 million programme aimed at exploring and addressing barriers to digital access, initially in mental health and housing. Announced in July 2023, the Digital Pioneers are 13 voluntary organisations and charities receiving £600,000 of Scottish Government funding administered by Scottish Council for Voluntary Organisations (SCVO) that will deliver a range of initiatives and support projects over the next two years.

Cyber Security Centre of Excellence (CCoE)

The Cyber Security Centre of Excellence opened in December 2022 within the Abertay cyberQuarter, Dundee. The Abertay cyberQuarter aims to create new solutions to cybersecurity challenges, bring inclusive economic growth to the region, and retain graduate talent by creating skilled jobs in this field.

Theatre Scheduling

We are trialling a new, national approach to theatre scheduling, using digital technology to achieve an estimated 15 to 30 per cent increase in theatre availability, and a reduction in surgery waiting times year on year. The initiative is currently live in three Health Boards and is being assessed through the Accelerated Innovation and Adoption Pathway (ANIA).

Digital Dermatology – with the Centre for Sustainable Delivery

A potential beneficiary of the ANIA pathway, digitising dermatology referral not only reduces the need for unnecessary referrals and lengthy waits to see specialist – over 12 weeks in 50% of cases – but also allows GPs and secondary care to share images and identify urgent cases that can be expedited to surgery. Evidence suggests a potential for a 50% reduction in outpatient appointments through this initiative, directly contributing to the reduction of NHS waiting times.

NHS Scotland's Laboratory Information Management System (LIMS)

LIMS is crucial to the function of Laboratory Medicine as it is used to result and report all primary, secondary, and tertiary laboratory requests received by Laboratory Medicine. It also provides capability to create automation of workflows, integration of instruments, and management of samples and their associated information. The implementation of a common, modern LIMS is a key enabler for a truly distributed service delivery model that will better fulfil on-demand requirements.

Master Patient Index – the replacement of the Community Health Index (CHI) system

All patients in Scotland have a unique CHI number that identifies them and ensures continuity of care. The system that powers this is foundational to all patient care – and operates on a platform developed in the 1970s. The current system will be replaced from August 2023, opening opportunities for enhanced data integration and improved service delivery and removing the dependency on legacy technology.