Where to turn for digital support over winter

Alex Chaplin profile picture

09 January 2019

Alex Chaplin
Provider support director
NHS Digital


The cold weather is already here and winter is upon us; bringing with it a whole host of challenges for staff across the NHS.

Here at NHS Digital, we have been working closely with clinicians and system leaders to understand the priority areas where we can support trusts and their staff during these busy times.

We know that technological solutions can't put more boots on the ground, but what they can do over time is free up existing capacity, enabling doctors and nurses to spend more time with their patients.

We know that technological solutions can't put more boots on the ground, but what they can do over time is free up existing capacity, enabling doctors and nurses to spend more time with their patients.

Alex Chaplin    Provider support director

But unfortunately, even the smallest of interruptions in these services can have a significant impact on patients and staff, so it's vital that first-class support is there if the worst happens.

A great example of how we're providing this support is through our Trust System Support Model (TSSM), which was launched in April 2018, and is a service we've been working on with help from NHS England and NHS Improvement.

TSSM has been set up to act as a trusted partner to support NHS trusts who are planning or have undertaken significant digital activity – by offering specialist advice and guidance in areas that can be difficult for trusts to source for themselves.

TSSM has been set up to act as a trusted partner to support NHS trusts who are planning or have undertaken significant digital activity – by offering specialist advice and guidance in areas that can be difficult for trusts to source for themselves.

Alex Chaplin    Provider support director

Our subject matter experts are here to offer guidance on a whole range of areas from infrastructure, application and performance testing through to business change, service management and clinical engagement. They can also help to identify emerging risks and provide jointly-authored supporting materials.

Now of course, we wouldn't advise trusts implement any major tech deployments during the winter period. Our deputy chief executive Rob Shaw had in fact written to chief executives implementing a change freeze for national systems from Wednesday 19 December 2018 to Wednesday 2 January 2019.

We are however keen to ensure trusts are aware of TSSM, which could prove to be a lifeline this winter when it comes to resolving issues caused by recent deployments or indeed planning for future ones.

We are however keen to ensure trusts are aware of TSSM, which could prove to be a lifeline this winter when it comes to resolving issues caused by recent deployments or indeed planning for future ones.

Alex Chaplin    Provider support director

We can all relate to feeling frustrated by our home computer when it freezes or when it won't connect to the printer. That feeling must be 100 times worse if you're a nurse or a doctor who is trying your very best to care for patients. Technology is here to make clinicians' lives easier, so it can be incredibly frustrating if something goes wrong and it actually ends up making things harder.

TSSM's ultimate aim is to take away that frustration and to build on lessons learned from previous deployments to ensure that suppliers can deliver a solution that reduces the risk of downtime and impact to frontline services.

TSSM's ultimate aim is to take away that frustration and to build on lessons learned from previous deployments to ensure that suppliers can deliver a solution that reduces the risk of downtime and impact to frontline services.

Alex Chaplin    Provider support director

Patients don't tend to notice the technology used by the NHS unless it goes wrong, so the real beauty of TSSM is the way it works quietly in the background, benefiting patients everyday without them even realising.

Up to now, TSSM has worked in partnership with around 25 trusts, but we expect this number to rise significantly as more trusts become aware of the service.

Broadly speaking, TSSM provides three different levels of assistance:

  • Business case review: This is where TSSM team members get involved at the earliest possible point in the lifecycle to help trusts to mitigate against avoidable issues. Some examples of this include reviews and guidance at all levels from strategy development through strategic outline case, outline business case, up to full business case
  • Pre-deployment assurance: This is where a trust seeks support prior to an implementation project; exploring and applying lessons learned from previous projects. Examples so far have included assessments of readiness to go-live and assistance in resolving commercial challenges with suppliers
  • Post-deployment intervention: This is where a trust is experiencing delivery challenges and TSSM provides "boots on the ground" to help with analysis and resolution. Examples to date have included technical challenges such as electronic patient record (EPR) performance and stability and operational challenges such as difficulty in embedding new ways of working associated with a new EPR into the trust's operations.


Perhaps one of the most important points about TSSM is the fact that it recognises that the future is digital and that NHS trusts are the ones who are truly leading the way in deploying new technology to support patient care. Above all else though, it is completely driven by patient safety. TSSM seeks to help you on these endeavours and support to improve the likelihood of success.

Perhaps one of the most important points about TSSM is the fact that it recognises that the future is digital and that NHS trusts are the ones who are truly leading the way in deploying new technology to support patient care. Above all else though, it is completely driven by patient safety.

Alex Chaplin    Provider support director

For example, one trust came to us after they experienced performance and stability issues following the deployment of their new EPR service.

Actions taken by the trust and the supplier had failed to resolve these problems, so the trust sought input from NHS Digital.

TSSM quickly mobilised a "red team" of on-site support and, by liaising with the trust and the supplier, we were quickly able to restore a stable service.

It is important to note that TSSM does not act in a regulatory or commissioning capacity, and we will always respect a trust's confidentiality in accordance with the terms of reference agreed with each trust that we are supporting.

TSSM acts as a trusted partner, seeking to gain early sight and engagement in order to promote a 'prevention rather than cure' approach for the benefit of all.

TSSM acts as a trusted partner, seeking to gain early sight and engagement in order to promote a 'prevention rather than cure' approach for the benefit of all.

Alex Chaplin    Provider support director

We absolutely recognise the challenges that providers are under, which is why Rob Shaw recently wrote to chief executives to provide guidance and offer support.

Winter is a challenging time for everyone associated with the NHS and stable technology is crucial when it comes to supporting frontline staff. NHS Digital and our system partners are doing all we can to stand by them during difficult times to deliver the very best for their patients. If you need advice, or assistance, please get in contact.

About the author

Alex Chaplin profile picture

Alex Chaplin
Provider support director

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