A new report from Public Policy Projects (PPP) urges a rethink of patient flow management across the NHS, advocating for whole-system approaches that leverage digital intelligence to tackle persistent bottlenecks and deliver better care outcomes.
Beyond Bed Management: Enabling Whole-System Patient Flow Through Digital Intelligence details a transformative approach to patient flow management across the NHS. The report, based on a high-level roundtable with senior NHS, local government, academic, and industry stakeholders, and chaired by Dr Victoria Betton, highlights the pressing need to move beyond traditional bed management strategies to operationalise whole-system flow through digital intelligence.
This latest report from PPP’s Digital and Data Transformation series – convening leaders from health and care to produce actionable insights for digital transformation – underscores how governance reform, cultural change, and user-centric digital tools can enable the NHS to deliver on the 10-Year Health Plan’s three major shifts: hospital to community, analogue to digital, and sickness to prevention.
Key recommendations include:
- NHS organisations should ensure that flexible governance structures empower local integrated neighbourhood teams with decision-making authority, clarifying accountability for cohorts at every step of their care journey.
- Commissioners and procurement teams must ensure that tenders for any electronic patient record or other digital tool include explicit, testable interoperability use cases, aligned to national standards (e.g. UK Core FHIR), with pre-defined acceptance criteria, open APIs, and financial/contractual penalties for failure to deliver functional interoperability in real-world workflows.
- Ensure that NHS England funding earmarked for digital transformation in community settings is properly allocated to equip neighbourhoods with digital tools that support cohort segmentation, risk stratification, and preventative management, enabling healthcare teams to anticipate demand and proactively advance population health improvements.
- Any NHS digital transformation project must be overseen by a multidisciplinary change management team. This team must ensure that tool implementation is driven by continuous engagement with clinicians, technical staff, and patients to align digital solutions with real-world workflows, localised workforce strategies, and targeted training through a sustained user-feedback loop.
Patient flow: A governance challenge, not just a logistical problem
The report identifies governance failures as a key barrier to effective patient flow, with misaligned decision rights and accountability creating bottlenecks across acute and community settings. Roundtable participants called for governance structures that clarify who holds responsibility at each stage of the patient pathway and empower integrated neighbourhood teams (INTs) to act on real-time insights.
Governance reform must be accompanied by cultural change, training, and leadership buy-in to overcome psychological barriers and ensure digital tools are embraced as enablers of better care.
Digital tools must empower, not just observe
The report also highlights the transformative potential of digital intelligence tools, which can provide real-time visibility of patient cohorts, enabling INTs to anticipate demand, coordinate care, and address delays at transition points. However, these tools must move beyond visibility to confer actionable patient-level insights, enabling neighbourhood teams – empowered with decision-making authority from intelligence – to act rather than passively observe data.
Interoperability is foundational to achieving this vision. NHS organisations must ensure that all digital tools deliver interoperability in real-world settings, enabling seamless data sharing across acute, primary, community, and social care settings. Without interoperability, insights generated by digital tools will remain siloed and underutilised.
