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PAPER: NIB 0420-001 AGENDA ITEM 2: Minutes of Leadership meeting held on 8 December 2015 and

matters arising PURPOSE: For approval

National Information Board

Leadership Summit

13:00 – 16:20, Tuesday 8 December 2015

Royal College of General Practitioners, London

Notes and Actions

Attendees Chair Tim Kelsey – National Information Director The Academic Health Science Networks Tara Donnelly – Managing Director, Health Innovation Network, attending on behalf of Mike Burrows Association of Directors of Adult Social Services Terry Dafter – Associate Director of Adult Social Services, Stockport Department of Health Dame Una O’Brien – Permanent Secretary Dr Will Cavendish – Director General of Innovation Growth & Technology and Informatics Accountable Officer Andrew Baigent – Director of Group Financial Management Tim Donohoe – Director of Informatics Delivery Management Peter Knight – Deputy Director of Research Information & Intelligence Alison Smith – Deputy Director of Data and Information Strategy Vicky Cave – Acting Deputy Director of Data and Information Strategy Health Education England Prof Nicki Latham – Executive Director of Performance and Development Health Research Authority Stephen Robinson – Corporate Secretary Health & Social Care Information Centre Andy Williams – Chief Executive Kingsley Manning – Chair

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Healthwatch England Neil Tester – Director of Policy & Communications Human Fertilisation & Embryology Authority Peter Thompson – Chief Executive Independent Cancer Taskforce Harpal S Kumar – Chair Independent NIB Members Alex Kafetz Dr Jo Bibby Dr Justin Whatling Mat Campbell-Hill Sam Smith Local CIO Council Dylan Roberts – Chair Macmillan – representing Richmond Group of Charities Lynda Thomas – Chief Executive Amanda Neylon – Head of Digital, attending on behalf of Julie Flynn Medicines and Healthcare products Regulatory Agency Dr Janet Valentine – Director of Clinical Practice Research Datalink Monitor Peter Sinden – Chief Information Officer Neil Stutchbury – Director of Business Engagement National Institute for Health & Care Excellence Alexia Tonnel – Director of Evidence Resources National Maternity Review Baroness Julia Cumberlege – Chair NHS Blood and Transplant Ian Trenholm – Chief Executive NHS Business Services Authority Nina Monckton – Head of Information Services NHS England Dr Paul Rice – Head of Technology Strategy NHS Litigation Authority Helen Vernon – Chief Executive Public Health England Prof John Newton – Chief Knowledge Officer

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Additional Attendees Care Quality Commission Dr Paul Bate – Executive Director of Strategy & Intelligence Department of Health Cameron Robson – Deputy Director of Information Policy & Strategy Tessa Ing – NHS Transparency Amy Clark – Policy Advisor and Engagement Lead, National Data Guardian Review Team Dot Everyone Baroness Martha Lane Fox – Executive Chair Graham Walker – Head of Policy, accompanying Martha Lane Fox Claire Morris – Health Project Lead, accompanying Martha Lane Fox Health and Social Care Information Centre Sir Nick Partridge – Non-Executive Director James Hawkins – Director of Programmes Delivery Rachael Allsop – Director of HR and Transformation Dermot Kehoe – Assistant Director Communications and External Relations Paul Baverstock – Head of Marketing Communications Health Education England Prof David Croisdale-Appleby – Non-Executive Director Health Research Authority Prof Deirdre Kelly – Non-Executive Director Independent NIB Members Tanuj Aggarawaz – Intern, The Health Foundation Local Government Association Mark Golledge – Programme Manager – Health and Care Informatics Monitor Adrian Masters – Managing Director of Sector Development National Institute for Health & Care Excellence Prof Finbarr Martin – Non-Executive Director Mark Salmon – Programme Director, Information Resources NHS England Dame Moira Gibb – Non-Executive Director Ronan O’Connor – Director of Information and Transparency, Patients and Information Deborah El-Sayed – Director of Digital and Multi-Channel Development Helen Rowntree – Head of Digital Services Richard Jefferson – Senior Responsible Officer (SRO) for Summary Care Record, Electronic Prescription Service and Code4Health Bob Gann – Programme Director – Widening Digital Participation Dr Masood Nazir – National Clinical Lead – Patient Online Programme Jana Dale – Stakeholder Engagement, Patient Participation and Communications Lead – Patient Online Dr Jason Broch – Chair, NHS Leeds North Clinical Commissioning Group

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Susannah McIntyre – Media Relations Officer Viki Smith – Programme Manager NHS Litigation Authority Denise Chaffer – Director of Safety and Learning, accompanying Helen Vernon NIB Secretariat Jane Pawson – (NIB Secretariat) NIB Secretariat Lead Tracy Dibdin – (NIB Secretariat) Secretariat Project Officer Gemma Riley – (NIB Secretariat) Public Health England Diarmaid Crean – Deputy Director for Digital

Apologies The Academic Health Science Networks Mike Burrows – Managing Director, Greater Manchester Academic Health Science Network Care Quality Commission David Behan – Chief Executive Emma Rourke – Director of Intelligence Department of Health Rt Hon Jeremy Hunt MP – Secretary of State George Freeman MP – Minister for Life Sciences Dame Sally Davies – Chief Medical Officer and Chief Scientific Advisor David Williams – Director General of Finance, Commercial & NHS Jon Rouse – Director General of Social Care, Local Government & Care Partnerships0 Andy McKinlay – Deputy Director of Group Financial Management Charlotte Buckley – Deputy Director of Local Insight & Resilience Government Office for Science Prof Sir Mark Walport – Chief Scientific Advisor to HM Government and Head of the Government Office for Science Health Education England Prof Ian Cumming – Chief Executive James Freed – Chief Information Officer Health Research Authority Dr Janet Wisely – Chief Executive Health & Social Care Information Centre Linda Whalley – Director of Strategy & Policy Healthwatch England Dr Katherine Rake – Chief Executive Human Fertilisation & Embryology Authority Nick Jones – Director of Compliance & Information

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Human Tissue Authority Allan Marriott-Smith – Chief Executive Jamie Munro – Head of Business Technology Independent NIB Members Annie Whelan Local Council Representative Rob Tinlin – Chief Executive, Southend-on-Sea Borough Council Medicines and Healthcare products Regulatory Agency Dr Ian Hudson – Chief Executive Monitor Jim Mackey – Chief Executive National Data Guardian’s Panel Dame Fiona Caldicott – National Data Guardian National Institute for Health & Care Excellence Sir Andrew Dillon – Chief Executive NHS Blood and Transplant Aaron Powell – Chief Digital Officer NHS Business Services Authority Nick Scholte – Chief Executive NHS England Simon Stevens – Chief Executive Karen Wheeler – National Director: Transformation & Corporate Operations Prof Sir Bruce Keogh – National Medical Director Beverley Bryant – Director of Digital Technology, Patients & Information Michael Macdonnell – Director of Strategy Group Noel Gordon – Non-Executive Director Dr Julia Maier-McAlpine – Strategic Programme Manager, Five Year Forward View NHS Litigation Authority Tom Fothergill – Director of Finance & Corporate Planning NHS Trust Development Authority Bob Alexander – Chief Executive Iain Wallen – Director of Information & Analytics Public Health England Duncan Selbie – Chief Executive Macmillan – representing Richmond Group of Charities Julie Flynn – Strategic Data and Influencing Lead Strategic Clinical Reference Group Clare Marx – Chair

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Prof Martin Severs – Interim Director of Information & Analytics and Lead Clinician (Caldicott Guardian), HSCIC UK Statistics Authority John Pullinger – National Statistician

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Item

1. Welcome and

introductions

The Chair welcomed members to the meeting, which was being

livestreamed with a speech-to-text facility.

The Chair explained that in compliance with the need to be

transparent, the Board meeting would take place as usual with

National Information Board (NIB) members followed by an open

question and answer session with members of the public. Many had

already offered their thoughts via social media. Jo Bibby, NIB

Independent Member, kindly agreed to facilitate the question and

answer session.

The Chair added that all Board papers for the meeting were public

and would be available on the NIB GOV.UK website after the

meeting:

https://www.gov.uk/government/organisations/national-information-

board

The Permanent Secretary also welcomed members to the meeting

and to those observers following the Board meeting in the room and

also on the livestream.

The Permanent Secretary explained that the agenda would cover

the outcome of the Spending Review (SR) and the resources

available to implement Personalised Health and Care 2020

(PHC2020).

The Board would also hear updates on progress delivering

PHC2020 and have an opportunity to reflect on the achievements

since PHC2020 was published in November 2014.

The Permanent Secretary welcomed and introduced the Chief

Knowledge Officer at Public Health England (PHE), who would take

over as Chair of the NIB from January until the summer. She

thanked him for agreeing to take on the role of Interim Chair and

recognised that he was already fully engaged with the development

of the PHC2020 strategy and the work of the NIB.

The Permanent Secretary announced that Baroness Martha Lane

Fox would be joining the meeting to announce her four

recommendations to the NIB on widening digital participation.

Unfortunately the Secretary of State and Minister for Life Sciences

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were unable to make the Board due to a crucial vote in the House of

Commons. All ministers were under a three-line whip this afternoon.

Both sent their sincere apologies.

The Permanent Secretary wanted to remind the Board that this

would be the Chair’s last NIB meeting, at least in person, as he was

moving on to undertake a new challenge in Australia in January.

She thanked the Chair and acknowledged the huge contribution and

leadership he had brought to this agenda.

The Chair thanked the Permanent Secretary for her kind remarks

and for welcoming the Interim Chair.

The Chair introduced the following new members:

• Harpal Kumar, Chair of the Independent Cancer Taskforce

and Chief Executive of Cancer Research UK, who was

attending for the first time.

• Baroness Julia Cumberlege, Chair of the National Maternity

Review, who is also attending for the first time.

• Tara Donnelly, Managing Director of the Health Innovation

Network, who is representing the Academic Health Science

Networks (AHSNs) on this occasion.

The Chair welcomed the Chief Executive of Healthwatch England.

Healthwatch England had been members for a while, but today was

her first meeting.

The Chair also welcomed the National Statistician, UK Statistics

Authority, who was not here today but would join the Board in future.

The Chair welcomed Alison Smith who had taken over running the

NIB Secretariat from Rebecca Chaloner. The Chair acknowledged

the fantastic job Rebecca did for the NIB.

2. Minutes of Leadership

meeting held on 3 September 2015 and matters arising

Paper Ref: NIB 1208-001

The minutes of the last meeting were agreed.

3. Chair’s Overview

The Chair reiterated that today’s meeting was a key point for

PHC2020. Baroness Martha Lane Fox would put forward her

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recommendations aimed at making a step change in digital

inclusion, not just for the health service, but more widely.

The Chair said the Board must not lose sight of the fact that more

than 10 million people in the UK do not have access to broadband,

largely because they can’t afford it. 50% of that number were

people of working age. This was a really important social issue.

NHS England and the NIB had been in close partnership with the

Tinder Foundation for the last three years, supporting people in the

most disadvantaged circumstances to learn how to use the internet.

Baroness Martha Lane Fox’s recommendations would mark a step

change in our commitment to that agenda.

The Board would have an opportunity to reflect on the progress in

delivering the priorities set out in PHC2020. Several important

milestones had been passed since the publication of the strategic

framework in November 2014.

The Board would hear an update on the outcome of the SR and the

settlement received for ensuring that the data and technology

enablers we have in our health and care system are put best to work

for patients and the professional who serve them. The £1 billion

investment of new capital in technology is an important validation

and endorsement for all the work the NIB have achieved to date.

The Chair announced that the Board would hear an update on the

digital roadmaps for the NHS and Summary Care Record. We now

have around 75% of Ambulance Services speaking in real time to

out of hours GP services and to A&E departments using the

Summary Care Record. No other health and care system in the

world has achieved this.

The Chair reiterated that this was his last NIB meeting and was

proud at what had been achieved over the last 18 months. The

degree of consensus and collaboration in really difficult times had

been incredible.

The Chair thanked the Chief Knowledge Officer at PHE for taking on

the role of Interim Chair until the permanent appointment was made.

4. Informatics Accountable

Officer – summary/overview update

The Chair introduced the Informatics Accountable Officer (IAO) who,

in the absence of Minsters, would provide an update on progress.

The IAO thanked the Chair on behalf of himself and Ministers for the

enormous contribution he had personally made to the NIB and in

delivering the PHC2020 agenda. He welcomed John Newton as

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interim chair.

The IAO highlighted the achievements of the last 3–4 years:

• Over 318,000 hits on MyNHS.

• 10 million GP appointments will have been booked online by

April 2016.

• GP practices will have delivered 15 million online

prescriptions by April 2016.

• 97% of patients now able to access online services across a

range of different services.

• First nation to offer universal access to people’s electronic

health record.

• 70% of the NHS 111 services have the ability to access a

summary care record.

• Community pharmacy access to the summary care record.

• NHS Choices is visited by thousands every week for a

trusted source of guidance to understand what services exist

locally.

• Creation of Care Cert, the designated centre of excellence in

understanding cyber security risks and supporting the health

and care service in effectively tackling cyber security risks.

• In October 2015, the first 3,000 matched records were made

available from genomics.

• In 2015, healthcare IT delivered around £150 million worth of

savings.

The IAO said these achievements were due to the work of the NIB

and everyone in the room and in the health and social care system.

Now the SR had reached a settlement, the focus would move

another significant set of ambitions, for example:

• By 2018, all patients to be able to access the health record

and record their comments and preferences in the health

record.

• By March 2018, an ambition for 20% of patients to be using

online services.

• Through the Test Beds Programme, treatment of those

people with chronic conditions improving

• More endorsed health apps.

• By September 2018, an integrated electronic care record in

primary and urgent and emergency care.

• By 2020, an integrated electronic care record for all care

settings.

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The IAO said these were a significant set of ambitions which would

empower patients, better use data and technology to support

clinicians and use data to achieve a safer, more efficient and more

cost effective health and care service.

On behalf of Ministers, the IAO wanted to endorse the work of the

NIB and to celebrate its achievements over the past year as well as

looking forward to collaborating on the challenges over the next few

years.

The Chair thanked the IAO for his speech.

5. Personalised Health and Care 2020 Delivery Update

Paper Ref: NIB 1208-002 Paper Ref: NIB 1208-003 Paper Ref: NIB 1208-004 Paper Ref: NIB 1208-005 Paper Ref: NIB 1208-006 Paper Ref: NIB 1208-007

The Chair explained that the Board would receive a delivery update

and introduced the Deputy Director of Data and Information Strategy

at the Department of Health (DH). Questions and comments would

be taken at the end of the delivery update.

Introduction/Update

Alison Smith introduced herself as the new Deputy Director of the

Data and Information Strategy Branch within DH, which included

heading up the secretariat for the NIB. She briefly recapped on

progress since the launch of PHC2020 which was launched in

November 2014. Many organisations had been involved in

producing PHC2020 and had worked collaboratively since it was

published to take forward the work streams to implement the

strategy. The specific programmes of work that came out of the

workstreams fit within six domains which focus on patients and

citizens, transforming general practice, out of hospital care, hospital

services, paper-free healthcare and data.

The Board would hear updates on delivery since the September

Leadership Summit in a number of different areas:

The Director of Digital and Multi-Channel Development at NHS

England gave an update on the new NHS.UK service.

The National Clinical Lead for the Patient Online Programme at NHS

England gave an update on ‘Patients online: supporting citizens to

access digital services’.

The Deputy Director of Information Policy and Strategy at DH gave

an update on ‘Data for outcomes and intelligent transparency:

MyNHS’.

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The Head of Technology Strategy at NHS England gave an update

on the launch of the Digital Roadmaps Programme.

The SRO for the Summary Care Record, Electronic Prescription

Service and Code4Health at NHS England gave an update on ‘Real

time information exchange in the NHS with summary care records’.

The Chief Executive of the Health and Social Care Information

Centre (HSCIC) and the Executive Director of Performance and

Development at Health Education England (HEE) gave an update on

the ‘Leadership and Workforce Capability Programme’.

All Board papers for the meeting are public and will be available on

the NIB GOV.UK website after the meeting:

https://www.gov.uk/government/organisations/national-information-

board

6. Keynote address –

Widening digital participation: recommendations for action

The Chair brought forward the widening digital participation agenda

item.

The Chair introduced Baroness Martha Lane Fox, who had been

commissioned by Secretary of State for Health to look at how the

NIB could move faster and be bolder on digital inclusion. She would

update the Board on her recommendations.

Baroness Lane Fox said she was delighted to be attending the NIB

Leadership Summit and thanked the Chair for inviting her. She also

thanked Secretary of State for Health for asking her to take forward

the work on digital inclusions and thanked NHS England and its

Chief Executive for their help and support. She also thanked her

own personal team for its support.

Baroness Lane Fox explained that her own personal health

challenges and experiences had led to her giving more thought

about the different ways that people became isolated as patients

and how the internet could transform that experience. As an internet

entrepreneur, she had never thought about digital inclusion and

assumed that everyone had internet access. In 2009 there were

around 16 million adults who were not able to access the internet to

fulfil even basic needs. Now, in 2015, the figure is around 12 million,

with about six million who had never been on the internet. Research

had shown that the demographics that supported those figures leant

heavily towards the most disadvantaged people and communities.

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Baroness Lane Fox presented her four recommendations, set out

below:

1. Reaching the ‘furthest first’ – making sure those with the

most health and social care needs who are often the least

likely to be online, are considered first in the design and roll

out of new digital tools being used across the NHS.

2. Free Wi-Fi in every NHS building. Patients should not be cut

off because they are in hospital. Health professionals need

this too.

3. Building the basic digital skills of the NHS workforce to

ensure that everyone has the digital skills needed to support

people’s health needs and to proactively introduce people to

new digital health apps and tools.

4. A target that at least 10% of registered patients in each GP

practice should be using a digital service such as online

appointment booking, repeat prescriptions and access to

records by 2017, ultimately changing the way that GPs and

patients interact

Baroness Lane Fox explained these were the building blocks which

would enable a change in the relationship between health

professionals.

Baroness Lane Fox added that in addition to the four areas above

she would also be working with the NHS on a project looking at end

of life care. This was also a complex and difficult area for clinicians

and patients and by putting the internet at the heart of this we could

create a beneficial service transformation.

Baroness Lane Fox advised that making small and slow digital

changes would not be enough. Organisations such as the NHS

need to drive this forward and make real changes.

Baroness Lane Fox thanked the NIB for listening to her

recommendations and deferred the expertise of the Board in driving

these forward.

The Chair thanked Baroness Lane Fox for her inspiring presentation

and invited the Director of Digital and Multi-Channel Development at

NHS England to provide an update on the initial thinking that had

been done in response to Baroness Lane Fox’s recommendations:

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1. A timeline has been established for setting up discovery

work. Consideration needed to be given to whether there are

other areas that could be explored, for example

Code4Health. We have been carrying out work around

urgent care which highlights the criticality of this. Some of

the pilots we sponsored in London have looked at inclusion

of access to digital care plans around end of life and this has

changed the way in which people receive the care that they

want and how their wishes for dying are respected.

2. In terms of Wi-Fi across the NHS estate, 36% of

organisations said they were providing public Wi-Fi in 2013.

Organisations allowing people to access it in public areas will

be encouraged.

Moving forward into 2017, we hope people include free Wi-Fi

in their considerations about which organisation they receive

their care from.

3. In terms of building digital skills for the workforce and the

importance of leadership we aim to build on the work that the

Chief Executive of HSCIC and the Executive Director of

Performance and Development at HEE have already done.

We aim to build on the work Bob Wachter and the Tinder

Foundation have been doing around building digital

participation.

4. To be able to use online services such as online appointment

booking, repeat prescriptions and access to records there

must be a deeper understanding of the barriers and drivers

for people. 51% of people do not know these services are

available, which shows there is significant work to do. The

presentations you heard earlier today have set out what our

plans are.

The Chair thanked the Director of Digital and Multi-Channel

Development for helpfully setting out these initial plans and opened

the floor up to questions from NIB members.

Sam Smith, NIB Independent Member, asked in relation to the

recommendations from Baroness Lane Fox and the initial plans from

NHS England, what is going to change and what are the leaders of

the NIB going to commit to differently as a result. What follow-up

and accountability will there be?

The Chair responded to confirm that the recommendations would be

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reviewed by the NIB in detail over the next few months and a set of

proposals would then be put forward, hopefully at the NIB

Leadership Summit in March, around how we plan to take forward

these recommendations. There was some dependency on the

outcome of the SR which would be fully settled shortly.

The Chief Executive of Macmillan welcomed the recommendations,

especially around universal free Wi-Fi on the NHS Estate. She

would also like to hear more about the work around end of life care.

Also, if 51% of people use the internet for banking and three out of

four people use it for shopping, she asked whether 10% was a high

enough target for GPs by 2017?

Baroness Lane Fox responded to say she would be happy to join up

the Dot Everyone team with MacMillan. In relation to the 10%

target, she acknowledged it did not sound ambitious but it was a

target that was achievable and realistic and covers every GP

practice.

The Chair of the National Maternity Review asked where maternity

services would be prioritised in the recommendations.

Baroness Lane Fox explained that no service had been prioritised

within any of the recommendations. The recommendations were

building blocks that she hoped would impact all health and care

services.

In relation to reaching the furthest first, Jo Bibby from the Health

Foundation, NIB Independent Member, thought it was not just the

NHS that had a challenge of getting its digitally enabled services out

to those people who were the most excluded. Many other public

services and community organisations had exactly the same issue.

Working with and partnering with other sectors could get us further

faster in reaching these people.

Baroness Lane Fox agreed and said it had to be not just about

touching people and customers in different places but also through

different media messages and through different access

infrastructure points. She would be happy for Jo Bibby to join up to

the work her charity Go ON UK were doing to encourage digital

inclusion, particularly in Croydon where they were trying to make the

entire borough digitally enabled and were partnered with the Post

Office, the NHS and the Library to see what could be created in the

local area.

The Chair made an observation on behalf of Annie Whelan, NIB

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Independent Member, who was not present at the meeting. Current

cuts to social care and housing means more people were sleeping

rough which made access to computers and the internet difficult.

She hoped review would consider this.

Baroness Lane Fox thought it was interesting that 25% of homeless

people had a smartphone and many saved their money to ensure it

was topped up with credit. This provided opportunities to reach out

to these people. The Chair added that he would put Annie Whelan

in touch with the implementation team working on the

recommendations so she could feed in.

Action: NIB Secretariat to ensure Annie Whelan would be put in

touch with Baroness Lane Fox’s implementation team

regarding the recommendations and homelessness.

The Chair of the Local CIO Council said that to reach those who

were hardest to reach then thought should be given to extending the

scope outside of the NHS. In the health and care system there were

six million carers who were not in the NHS who spend the most time

with those who are most digitally and socially excluded.

Baroness Lane Fox pointed him towards Go ON UK and the work

they were doing locally and the toolkits they were providing which

would help empower those people who were the most

disadvantaged.

Justin Whatling, NIB Independent Member, explained he had been

involved in some of the test bed applications. He wondered whether

it would be family networks and others looking after elderly relatives

that were tapping into those services because they want to keep an

eye on those they were caring for. Some of the devices were simple

and users did not need to be internet savvy to make use of them.

He thought there needed to be some lateral thinking about how to

solve the challenge of reaching the furthest first.

Baroness Lane Fox said she was aware of two examples, one was a

community in Aberdeen where a group of care homes connected

people by sharing information in different ways and one was from a

community in Japan that helped people connect using an app which

people could use to say they were lonely and people could locate

them to visit using the app. It was these kinds of models she wanted

to trial and create prototypes for, and bring into the health and care

system.

The Chair thanked the Board for their questions and observations.

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7. How NIB Framework will

support Five Year Forward View implementation and delivery of Efficiency Challenge

The Chair introduced the Director of Informatics Delivery

Management at DH to describe the process of moving from creating

the vision and framework to implementation.

The Director of Informatics Delivery Management said the outcome

of the SR had been a culmination of the work which started twelve

months ago when the NIB work streams began to look at how the

proposals set out in PHC2020 could be taken forward and

implemented. Those working on the work streams did a fantastic job

identifying around 80 separate suggestions. Over the summer,

those suggestions were costed, scoped and grouped into a series of

programmes for delivery. That work formed the basis of the SR bid.

A figure of £1 billion for technology had been announced. The

existing funding that enables the delivery of the current portfolio was

in addition to this £1 billion. The next steps are to look at the most

efficient route to delivering each of those programmes and how they

will be sequenced over the five year period.

The Director of Informatics Delivery Management wanted to clarify

the fundamental point that this was not about delivering the

technology but about the technology enabling the transformational

outcomes that the system needs and what the Five Year Forward

View (FYFV) pointed to.

In terms of next steps, the Director of Information Delivery

Management confirmed that the governance and leadership of the

six domains (under which the programmes for delivery sit) was being

considered. It was likely that there would be a senior responsible

owner for each of the six domains. There would be clear lines of

accountability and delegated authority for spending where required.

Senior responsible owners would lead the delivery and provide

challenge on how programmes are delivered.

Work would continue to look at the new programmes to ensure

robust justification of the benefits and cost savings they would

deliver into the system. Legacy programmes would be looked at in

detail to ensure that they were still required. It would be ensured

that all programmes continue to be strategically aligned to

outcomes.

In terms of reporting back on progress, there would be an update at

the NIB Leadership Summit in March.

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The Chair thanked the Director of Informatics Delivery Management

and added that the excellence of the work that underpinned the SR

should be celebrated. It was a fantastic achievement.

The Chair invited the Director of Group Financial Management to

provide his observations.

The Director of Group Financial Management echoed the Chair’s

comments that this had been a great success and a reflection of the

hard work done by all involved. An important consensus had been

achieved around the digital agenda.

The Director of Group Financial Management set out what he

thought the next four challenges were:

• Clarity around the 25 projects is needed. It must be clear to

everyone, not just NIB members, why these are the right

projects.

• All programmes must be linked to the FYFV. The right

governance is required to ensure this link.

• Ensuring the programmes we deliver are relevant, fit for

purpose and make a difference – within the funding

envelope.

• We must link with the clinical community and ensure that

what we are intending to delivery works for them we need to

approach them.

The Chair thanked the Director of Group Financial Management for

his observations and for setting out the upcoming challenges.

8. National Data Guardian

review update

The Chair explained that unfortunately the National Data Guardian

(NDG) had been unable to attend the meeting and this item would

be presented by the Policy Advisor and Engagement Lead on the

NDG Review Team.

The Policy Advisor and Engagement Lead gave a presentation

which updated NIB members on the NDG review. The slides are

available as part of the main deck published on

https://www.gov.uk/government/organisations/national-information-

board

The Chair thanked the Policy Advisor and Engagement Lead for her

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update.

9. Questions, Comments

and Observations from NIB members

The Chair invited NIB members to ask questions or make

observations on the updates they had heard.

In terms of the programmes for delivery, Alex Kafetz, NIB

Independent Member, thought the Board could provide oversight

and advice on where data collections could stop and in identifying

where there are duplicate initiatives being developed.

The Director of Informatics Delivery Management responded to say

that decisions around what programmes need to stop should be

clear and made with a detailed understanding of why they are being

stopped.

Tara Donnelly, Managing Director of the Health Innovation Network,

said a number of the AHSNs had a focus on diabetes as they

believed that if a different approach was not taken to tackling this

disease then the problem would become much bigger. She was

impressed by the idea of the diabetes planner and would like to link

up to it. Would there be any prototyping before 2018?

The Head of Digital Services at NHS England responded to say that

in terms of the full NHS.UK proposition, including transactions

high-quality information, access to apps would not be available until

2018. The diabetes planner was one element of that service. She

thought there would be some elements that could be ready before

2018 but they would be others that would take more time. She

accepted the Managing Director’s offer of working with the AHSNs

and carrying out more testing with their users and networks.

Jo Bibby, NIB Independent Member, thought the diabetes planner

was a great product. The health of the public and patients was not

just a product of the NHS and the services they used it was a

product of all sorts of services and activities that they utilise in the

community along with other public services. Apps, such as the

diabetes planner, need to ensure they enable people to actually

manage their health not just manage healthcare interactions. Apps

also need to be useful in enabling people to access and manage

wider information that would be useful in improving all aspects of

their condition.

The Head of Digital Services confirmed that their approach to

developing a solution had been to involve the user right at the start

and involve them in the development process so they had a better

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understanding about their lives and not just their health experience.

There was a fundamental opportunity that needed to be addressed

to stop thinking about health as something special and think about

the way in which people were living their lives more broadly.

The Chair thanked the Board for their questions and observations

and welcomed any further questions to be taken outside of the

meeting.

10. Annual Report and NIB

work plan Paper Ref: NIB 1208-008

The Chair introduced the Chief Knowledge Officer at PHE, who

would provide an update on the Annual Report and NIB work plan.

The Chief Knowledge Officer thanked the Permanent Secretary, the

IAO and the NIB Chair for allowing him to chair the NIB for the next

few months. He would take on the challenge of maintaining the

pace of delivery of the programmes and ensuring momentum was

not lost.

The Chief Knowledge Officer recognised one of the greatest

successes of the NIB was the level of collaboration and

engagement. The videos shown today highlighted that continued

engagement with clinicians and patients who were using the

technology would be key to determining success.

The NIB Annual Report would inform people about the NIB and

detail the programmes identified to deliver the commitments in

PHC2020.

The Chief Knowledge Officer confirmed that an editorial group had

been established to work on the Annual Report and thanked those

who had volunteered. The Annual Report would be published in

March.

The Chief Knowledge Officer explained he would, before the

January Working Group, consult with Board members to obtain

views on the future work plan for the NIB. There were several big

challenges that the NIB would need to consider such as consent and

opt-out, big data, consumer devices and wearables, building

incentives into the system to drive forward technology programmes,

transparency. The Board would also need to think about how they

support and act on the four recommendations put forward by

Baroness Lane Fox.

11. Concluding remarks

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The Chair invited the Permanent Secretary to give her reflections on

the Board meeting.

The Permanent Secretary said it had been a very stimulating,

energising and motivating meeting and it was clear how much

progress had been made over the past twelve months.

The Permanent Secretary listed several behaviours she thought

were important for continued success in the future.

The first was being connected to a purpose. The purpose of the

PHC2020 agenda was to improve health and care for people and to

making the NHS better, safer and more efficient. The purpose

should not be lost sight of, especially during difficult times.

The second is that we have pooled sovereignty. It is fundamental

that leaders and senior leadership teams, both nationally and locally,

have this behaviour.

The third is that we have been open and honest about the progress

and successes and failures we have experienced. We have been

prepared to challenge each other on how things get done.

The Permanent Secretary thought these behaviours were those of

system leadership whether at a national or local level and were key

to success.

The Permanent Secretary thought all the updates received today

had been fantastic and had created a level of excitement about

where each programme was heading. The talk from Baroness Lane

Fox had been inspiring and had set a challenge for the NIB.

The Permanent Secretary thanked everyone for their participation

the Board meeting.

The Chair thanked the Permanent Secretary for her reflections.

12. Any other business

No other business was discussed.

The Chair ended the Board meeting.

13. Dates of next meetings

Date of next Working Group meeting: 19 January 2016

Date of next Leadership Summit: 15 March 2016

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