Annex 2 - sustainable technology case studies

EPS allows prescribers to send prescriptions electronically to a dispenser (such as a pharmacy) of the patient's choice. This makes the prescribing and dispensing process more efficient and convenient for patients and staff. EPS reduces travel to GP clinics and postage, providing £1.2 million worth of carbon emissions savings per year and saving £7 million in return visits to the pharmacy due to out of stock medicines. It also cuts the need for printing and therefore reduces paper and electricity use.

The NHS e-Referral Service (e-RS) is a national digital platform used to refer patients from primary care into elective care services in England. It allows patients to choose their first outpatient hospital or clinic appointment and book it in the GP surgery, online or on the phone. Over several years, the use of e-RS between primary and secondary care in England had maintained a steady position at approximately 50% of such referrals. However, this has more recently increased significantly to close to 100%.

We have used sustainable technical architecture principles to enable e-RS to be more efficient. We have minimised runtime, moved to virtualisation by being hosted on the Cloud, optimised databases to run the system with less energy and enabled a paperless system, especially after integrating e-RS with NHS Login in February 2020, which replaced patient letters with emails.

Digital health and care services should reduce the burden on front line services and enable people to manage their care in their own homes. In order to do so, people need to prove who they are and be safely linked to their records. NHS Login is a service that provides a re-usable way for patients to access multiple digital health and social care services with a single login.

NHS Login helps sustainability because:

• identity can be proven digitally, eliminating journeys to GP clinics to verify patient identity, as well as saving frontline resources
• it is re-usable and interoperable and can be consumed by many integrated services, preventing duplication, reducing the numbers of bespoke and dedicated computer resources and minimizing wasted resources in development and management

• it is web-based and supports increased integration capacity and sustainability at scale; and

• it empowers people by helping them to manage their own health and care – a key sustainability well-being benefit

The NHS App is significant because it provides access to high quality health and care information to enable people to manage their care.

This service was commissioned by NHS Digital’s Social Care Programme (SCP). Its general aim is to work with the adult social care sector to better understand their requirements through direct engagement.

The service enables care homes to take up NHSmail so they can share residents’ health information securely with NHS professionals. For example, we plan that 4,000 out of the total 4,800 nursing homes will have NHSmail mailboxes by the end of 2020-21, and therefore support more effective care. A case study into a similar health information project found that up to four episodes per year could be avoided for every 100 care home residents, saving NHS resources and avoidable journey miles.