Alexis Farrow, Programme Director, Digital Notts
Over the past year, Digital Notts has continued to play a central role in enabling digital transformation across Nottingham and Nottinghamshire, working in partnership to support a more connected, efficient and sustainable health and care system.
In this short video, Alexis Farrow, Programme Director at Digital Notts, discusses the impact of this year’s work and how digital innovation continues to support better outcomes for our citizens and communities.
Nottingham and Nottinghamshire ICS has an innovative system-wide approach to digital collaboration and funding digital transformation activity.
Groups such as the Notts Digital Collaborative and the Digital Strategy Oversight Group meet on a regular basis, bringing together senior digital leaders from across our system. These forums are key for bringing partners together to coordinate activity, share learning and collectively address shared challenges. This collaborative approach has helped reduce duplication, increase consistency and maintain momentum across a broad portfolio of digital work.
Our work is underpinned by the Local Digital Charter, which was significantly refreshed and updated in December 2025. The charter sets out shared principles for joint working and aligns governance and ways of working across the system. It introduces a stronger focus on sustainability, digital inclusion and data-driven outcomes and helps decision making across the system.
The charter was developed with input from Lincolnshire and Derbyshire colleagues with the intention that it will provide a good foundation to developing a cluster wide charter.
As well as the specific programmes led by the Digital Notts team, we enable a variety of other projects across the ICS. Last year, these projects included:
Last year, our system saw significant progress in several key digital transformation programmes to improve frontline productivity across primary, secondary, mental health and community care settings.
Most significantly, both acute Trusts within Nottingham and Nottinghamshire had full or partial rollout of their electronic patient records (EPRs). EPR deployment is one of the biggest transformation changes within an organisation but one that is crucial as the NHS continues its move from analogue to digital.
For both Trusts, the move to an EPR brings benefit for both staff and patients thanks to:
Sherwood Forest Hospitals (SFH) also deployed Cancer 360 across all cancer specialities. Working as a live Patient Tracking List (PTL), which pulls information from various systems every 90 minutes, a single patient view is created for all cancer patients. This enables all teams to easily view the whole diagnosis and treatment journey, speeding up reviews, chasing of results and reducing waiting times.
Nottinghamshire Healthcare NHS Foundation Trust (NHT) progressed with the optimisation of their EPR as well as a range of significant digital transformation projects. These included migration of their Access Rio EPR system to a cloud-based solution and the rollout of electronic prescribing and medicines administration (EPMA) to streamline and improve the process and safety of prescribing and medications.
Colleagues in primary care also saw significant investment and focus on digital transformation activity. This included hardware upgrades, the introduction of new software and patient-friendly websites, as well as the digitising of 56,000 Lloyd George records, freeing up significant clinical space and enabling easier access to patient records.
GP Practices also benefitted from the use of AI and other automation tools (including Microsoft Copilot) test projects throughout last year. Workflow Automation which automates routine tasks, was piloted in four GP Practices. This early pilot is estimated to save between 15 – 30 minutes per day. Other GP Practices piloted SystmOne Auto-review rules, which reduces the administrative burden within Practices, freeing up more time for patient-focused tasks.
Given the success of both pilots, workflow automation will continue to be rolled out across our locality, meaning that more patients and GP Practices will benefit from the impact of frontline digitisation work.
Within Digital Notts, the voice of citizens continues to be a vital part of how we shape, deliver and improve digital services across Nottingham and Nottinghamshire.
Throughout 2025–2026, our Citizens’ Digital Forum (CDF) has played a central role in providing insight, feedback and challenge across a wide range of local and national digital programmes. At a local level, this has included feedback on the new Digital Inclusion Delivery Framework, Primary Care Digital Strategy and digital planning to support the new Integrated Neighbourhood Teams (INTs). At the same time, members have contributed to national discussions on the new 10-year NHS plan for change and research to support NHS App development.
The CDF has championed patient engagement by highlighting variations in digital approaches between providers, exploring differences in NHS App usage within primary care, and supporting targeted engagement with patient groups such as young people and those navigating new total triage models. This valuable insight has helped partners identify opportunities to improve consistency, accessibility and improve patient experience.
Feedback from members also highlighted the barriers some residents faced when trying to register for the NHS App, but who did not have valid photo ID. Backed up with insights from our Digital Inclusion Coordinators and with analysis of population data, a campaign was developed to raise awareness that registration was possible. The ‘No ID No Problem’ campaign was launched in early September within one PCN and laid the blueprint for wider rollout across Nottingham and Nottinghamshire.
CDF members continue to share learning across the system, supporting peer‑to‑peer discussion, and promoting digital tools such as the NHS App through community engagement activities. Membership continues to grow, extending links to extending links to Healthwatch Nottingham and Nottinghamshire, strengthening our collective citizen voice.
Last year was a landmark year for the Notts Care Record. Following its official go-live in July 2025, the Notts Care Record moved quickly from rollout into full day-to-day use across the system. By the end of October 2025, the legacy shared care record was fully decommissioned which completed the first phase of the system-wide transition to the new Notts Care Record.
Increasing use across the system
The Notts Care Record continues to develop, with new features supporting more personalised care. A dedicated frailty view now brings together key information on mobility, nutrition and other needs, alongside important end-of-life preferences.
For clinicians, this provides a clearer, more complete picture to support timely and informed decision-making. For patients and their families, it means care is more aligned to what matters most. This helps deliver more coordinated, compassionate care.
Realising the impact and benefits
Early feedback and evidence from local organisations show that the Notts Care Record is already making a difference with users. In November 2025, we interviewed Dr Colin Dunkley, Paediatric Consultant and Children’s Epilepsy lead at SFH to discuss his experience of using the Notts Care Record for his patients.
During the interview, Colin highlighted the benefit for both clinicians and patients.
“Because we can see the information directly, there is less reliance on the patient to recall very detailed treatment information. Instead of taking weeks to chase information from other providers, the Notts Care Record enables immediate access which saves time for all involved.”
Initial analysis from NUH also suggests that using the record saves around one minute per patient in the Emergency Department, one of the busiest EDs within England. This time saving helps to release valuable clinical time where information is required in a fast-paced environment.
As well as starting to capture local impact, the Notts Care Record team has drawn on findings from external academic studies to estimate the wider benefits in terms of staff time released to care.
Applying this modelling locally, we estimate that current use of the Notts Care Record frees up more than 38,000 hours of frontline health and care staff time each year. This represents around 29 whole-time equivalent roles’ worth of additional capacity, or approximately £1.1m in value, supporting more time with patients and improved delivery of health and care services across the system.
Launching and embedding the Notts Care Record has been a significant milestone for Digital Notts and our partners. From our analysis, we know it is already enabling better care, and it will continue to play a key role in transforming how our system works together.
health and care professionals used the Notts Care Record
patient records viewed through the Notts Care Record
of frontline staff time saved this year
Last year, the Public Facing Digital Services Programme (PFDS) continued to expand and strengthen the digital services available to our citizens. Our PFDS priorities support the ongoing delivery of the NHS 10-year plan and the move from analogue to digital.
The NHS App
Use of the NHS App goes from strength to strength, with registered users increasing by +9% during the past year. Around 68% of Nottingham and Nottinghamshire citizens are now registered for the NHS App and are actively using it to support management of their own health and care.
More than 1.7 million repeat prescriptions were ordered via the NHS App, averaging around 141,000 requests per month. This equates to approximately 20% of all repeat prescriptions requested. This frees up significant administrative time for primary care teams to focus on other patient-facing activities and priority tasks.
Over 23,500 administrative hours were released through NHS App repeat prescription ordering across Nottingham and Nottinghamshire in 2025 – 2026. *
* This represents non-cash releasing capacity, equivalent to approximately 18 WTE Band 3 roles (c£600,000 including on-costs).
Improving patient-facing digital communications
The ICS saw a significant shift in the use of digital letters and other forms of patient-facing digital communications within primary and secondary care. This shift generated cost savings and supported sustainability targets through reductions in paper use and carbon emissions in all areas.
Within primary care, reliance on SMS usage was reduced by 30% during 2025–2026. Colleagues in the ICB worked closely with GP Practices to support moves towards other accessible and modern communication channels where appropriate, such as email and the NHS App. These channels provide more timely and inclusive access to information for patients, improve the reliability and speed of communications, and make better use of more cost–effective digital options.
Sherwood Forest Hospitals (SFH) Digital letters are sent via the NHS App and PKB for outpatients, radiology and clinical letters. This enables cost savings of more than £241,000 per annum through reduced postage and printing costs.
In addition, Did Not Attend (DNA) rates for patients registered with PKB were approximately 1.72% lower than for unregistered patients. In 2025-2026, this equated to around 1,072 fewer missed appointments. As well as helping to reduce waiting lists and using clinical time more efficiently, this represents an estimated £139,510 of avoided cost per annum.
The use of patient engagement platforms
Significant progress was made in the use of patient engagement platforms (PEPs). Across the ICS, all acute and community organisations now have a PEP or funding available to progress with a PEP. This will help to deliver a consistent approach for patients when they engage with healthcare services via the NHS App.
CityCare secured over £350,000 in national funding to invest in a new PEP, becoming one of the first community interest companies in England to receive this support. The secure online system integrates directly with the NHS App, allowing patients to view, cancel and re-book appointments digitally. This helps to reduce the administrative burden while improving flexibility and choice for patients.
Nottinghamshire Healthcare Trust (NHT) also saw major benefits from the rollout of Patient Knows Best (PKB) as a core patient engagement platform. Moving away from paper-based approaches resulted in +34% increase in patient Outcome Measures response rates (PROMS), enabling services to capture outcomes more consistently throughout a patient’s care journey. Further developments enabled patient digital responses to be integrated directly into patient records, saving clinical and administrative time and supporting more timely decision-making.
Digital tools became increasingly important in supporting people to manage long-term conditions and recovery outside of traditional appointments. The mid-Notts MSK Together Partnership continued the expansion of digital MSK care plans. Accessed via the NHS App and using PKB, the digital care plans supported their patients between physiotherapy sessions. The number of active digital care plans is increasing, with work underway to develop digital waiting-well support at the point of referral as well continuing to embed a digital-first approach for staff and patients.
Nottingham University Hospitals (NUH) also saw a significant shift to digital letters. Following the implementation of Nervecentre EPR in November 2025, NUH saw a 53% increase in the number of letters sent digitally.
Analysis shows that increased use of digital appointment correspondence is associated with lower DNA rates. As uptake grows, this leads to improved utilisation of outpatient capacity and a proportionate increase in the value of avoided costs. This is expected to increase throughout 2026 and into 2027 as more departments in both Trusts move to digital communications.
Read more about how SFH uses the NHS App and PKB to engage with patients.
Digital transformation and Integrated Neighbourhood Teams
Digital transformation played an important role in the evolving and expanding work of our local Integrated Neighbourhood Teams (INTs). In partnership with stakeholders, we created our first INT digital plan and priority actions list to support this new way of working within the community.
Other work included increasing the use of the Notts Care Record to better support multi-disciplinary teams (MDT) working to improve patient outcomes. At the same time, we helped identify place-based digital inclusion priorities which recognised the different needs of local communities. Working with the Good Things Foundation, we promoted local digital support hubs to mitigate against digital exclusion for our most vulnerable residents.
Ensuring that everyone can access and benefit from digital health and care remains a core priority for Digital Notts. During the past year, our Digital Inclusion programme continued to focus on tackling the practical, skills-based and systemic barriers that prevent some citizens and workforce groups from engaging confidently with digital services.
Most significant was the development and delivery of the new Digital Inclusion Delivery Framework for Nottingham and Nottinghamshire. Shaped through three months of engagement with partners across health, local authorities, voluntary and community organisations, and public representatives, the Delivery Framework sets out five clear priority themes to guide coordinated action across the system. The Framework was published at the end of March 2026, providing a shared foundation for future delivery.
Across these priority themes, strong progress continued to be made throughout the year. Digital Inclusion Coordinators played a pivotal role, supporting 2,939 citizens across 415 support sessions throughout the year.
The Digital Inclusion Coordinator embedded at Sherwood Forest Hospitals ensured that secondary care patients, hospital colleagues and the wider community had access to digital support – for the NHS App and the patient engagement portal provided by Patient Knows Best (PKB). Citizen feedback highlighted the value of this local, personalised approach, particularly for those unsure where to begin.
Other targeted Digital Support Hub events were delivered in GP practices within some of our most digitally excluded and deprived communities. Through 11 GP-based Digital Hubs, more than 120 people received hands-on support, resulting in 55 new NHS App registrations.
We also continued to increase access to digital devices for all residents. Positive steps were taken to map device and databank provision across the Integrated Care System, identifying 43 registered hubs, including 29 databanks and 11 digital skills hubs, and supporting more informed neighbourhood-level digital planning.
Alongside this, workforce digital capability was increased through consistent uptake of established training offers, with 185 staff receiving direct digital skills support and more than 200 staff completing structured learning via the Skills Development Network, including specialist digital health literacy training developed with the Patient Information Forum.
Partnership working remained central. Four community and voluntary sector organisations were supported to embed digital inclusion into their services, collectively helping 440 people and delivering 52 skills sessions, with seven case studies captured to share learning. Nationally, Nottingham and Nottinghamshire organisations also secured over £322,000 in external Digital Inclusion Innovation Fund investment, reinforcing the strength of our collaborative, system-based approach.
In September 2025, Digital Notts successfully concluded the nationally funded Digitising Social Care (DSCR) 3-year programme. This marked a major milestone in the digital transformation of adult social care providers across Nottingham and Nottinghamshire. The programme has played a vital role in enabling safer, more connected and person-centred care for some of our most vulnerable residents.
Working closely with Nottinghamshire County Council, Nottingham City Council and partners across the Integrated Care System (ICS), Digital Notts led the local coordination of the programme, ensuring national funding was targeted where it could have the biggest impact. Between July 2023 and September 2025, more than £700,000 was distributed to support adult social care providers to move from paper-based systems to assured digital social care record solutions.
By the end of the programme, 86% of local adult social care providers were using a digital social care record. This exceeded the national target of 80% and positioned Nottingham and Nottinghamshire as one of the strongest performing systems in England. This achievement reflects Digital Notts’ strategic commitment to people-centred digital transformation.
Equipping the care workforce with digital tools reduced administrative burden, enabling more time for care colleagues to focus on supporting their service users. It strengthened digital confidence across care home teams and supported the expansion of sensor-based falls monitoring. The move away from paper-based processes also delivered system-wide efficiencies, with over £370,000 saved in printing and paper costs across providers over 12 months.
Although national DSCR funding has now ended, its legacy will endure. The Digital social care programme has provided a foundation for transforming information sharing across health and social care. It established strong digital foundations within the local care sector and demonstrated how collaborative, system-led delivery can create sustainable change.
Building on this success, Digital Notts will continue to support further digital integration, helping to create a more efficient, joined up and resilient health and care system for Nottingham and Nottinghamshire.
of adult social care providers using a digital social care record
the national target
national funding distributed locally
estimated annual savings from reduced printing and paper
adult social care providers supported since programme launch
The Digital Notts Digital Business Management Unit (DBMU) provides governance, financial and administration support for the team and across the wider ICS. To make digital transformation more meaningful and sustainable, last year DBMU developed a number of tools and techniques to support our system-wide approach to benefits. They included:
Building on the EPR benefits framework from NUH, a generic system-wide digital benefits framework was developed and implemented across the ICS. This established a consistent and robust approach to identifying, tracking, and evidencing impact of digital transformation activity. The framework was also shared across the DLN cluster, which will become even more important as we progress throughout 2026 and into 2027.
At the same time, the team established a benefits network; a virtual learning lab and support network bringing together benefits leads across the Derbyshire, Lincolnshire and Nottinghamshire (DLN) Cluster. It provides a safe space to share tools, techniques, templates and practical experience, and to collaboratively develop consistent approaches to benefits identification, measurement, realisation and reporting.
Working with colleagues from across the system as well as the cluster benefits group, benefits dependency mapping tool was designed and developed. It offers a simple, structured way to translate outputs and outcomes into clear, measurable benefits. The framework also captures the key change management dependencies required to realise the benefits. First used in autumn 2025, it has already proved vital in delivering several successful benefits workshops.
The team also designed and agreed an approach to capturing benefits across our interoperability programme. This included high-level metrics along with detailed, more clinically focused case studies and bottom-up benefits modelling. The high-level metrics, which are based on academic studies, enable us to estimate the hours and value of staff time released as part of our monthly usage report for the Notts Care Record. Early reporting already indicates this is estimated to be more than £1.1m annually.
The 10-year plan sets out clear expectations regarding the need to demonstrate the benefit of digital transformation. Digital Notts will continue to develop our KPIs to make full use of data to help capture benefits. We will continue to work with partners across the cluster and NHSE to build on our progress to date and help to ensure that benefits are core to everything we do.
Alongside delivering key digital transformation programmes, Digital Notts added value in other ways. Over the past year, the team supported the coordination of business cases, approvals, bids and investment planning. This played a key role in securing funding and enabled more collaborative procurement and efficiency opportunities across system partners.
Key successes from the past year included:
In the year ahead, Digital Notts will build on strong existing foundations to deliver more joined-up, efficient and citizen-focused digital health and care.
Working across Nottingham and Nottinghamshire and the wider Derbyshire, Lincolnshire and Nottinghamshire (DLN) cluster, Digital Notts will strengthen collaboration at scale to maximise value for money, share learning, and deliver a more consistent and sustainable approach to digital transformation across the system.
This includes supporting the development of a shared DLN digital strategy, creating a clear and aligned vision for how digital innovation will be delivered across the wider footprint. Through this approach, opportunities such as innovation hubs, test beds and shared learning will help accelerate progress, spread best practice and enable more effective use of resources.
Key priorities include expanding the use of shared care records, improving digital inclusion, and strengthening partnerships with voluntary and community organisations to support neighbourhood delivery. Core programmes will continue, including optimising and levelling up electronic patient records, and increasing the use of the NHS App and personal health records. Alongside this, Digital Notts will explore how data, automation, artificial intelligence and emerging technologies, including Ambient Voice Technology, can improve productivity and access to care.
Aligned to the NHS 10 Year Plan, this work will help ensure people can access services more easily, experience more coordinated care, and benefit from faster, more personalised support – where and when they need it.
Together, this positions Digital Notts to deliver more connected, responsive and citizen-centred services for the years ahead.
Please get in touch if you’d like more information or want to discuss how digital transformation could help you, your workforce and your patients. Simply email nnicb-nn.digital.notts@nhs.net.