Meet NHS Surrey and Sussex ICB
NHS Surrey and Sussex Integrated Care Board (ICB) is responsible for planning and funding health and care services for populations across Surrey and Sussex. With around 800 corporate staff and oversight of approximately 400 GP surgeries, the ICB sits at the heart of a complex, multi-team system where slow processes have a direct, human cost.
When patients need funding for nursing home placements, end-of-life care or specialist equipment, time matters. When pregnant women need physiotherapy referrals, delays affect outcomes. And when staff are buried in paperwork, they have less capacity to focus on the work that actually makes a difference.
The challenge
NHS Integrated Care Boards are required to deliver 2% productivity gains annually - exhausting every efficiency opportunity before reducing services. For NHS Surrey and Sussex ICB, monday has become a core part of how they deliver on that.
Prior to monday, across NHS Surrey and Sussex ICB, critical processes were running on a mix of paper forms, Word documents, Excel spreadsheets, and manual emails. The results were predictable: delays, errors, and staff stretched too thin.
The most pressing example was the All-Age Continuing Care (AACC) funding process. When a patient, often elderly, often in their final weeks, needed funding approved for nursing home care or specialist equipment, a clinician or case worker would fill out a multi-stage Word document. That document would travel from inbox to inbox, gathering signatures and it would often corrupt mid-process. It would miss panel deadlines and sit in a queue for another two weeks. In some cases, funding hadn't been approved before the patient passed away.
Meanwhile, the team managing maternity physiotherapy referrals was spending an hour each day manually downloading data from an external website, copying it into emails and forwarding each one to the relevant local hospital. This process was managed by one person, and if they were off work for whatever reason, nothing went out.
The same story played out across the organisation: HR tracking in spreadsheets, health and safety assessments taking 45 minutes per form, ID badge requests requiring 54-minute manual chains of emails. The admin burden was enormous and it was falling hardest on the people who could least afford it.
The solution
Building processes that run themselves
The Digital Team's role is to automate, innovate and turn paper-based or Excel-based mundane tasks into end-to-end online processes using monday. They came to monday four years ago, initially using monday as a project management tool for the team. What they discovered was a platform they could push far beyond its original brief - building end-to-end automated workflows that removed the need for manual intervention at almost every step.
Today, they have built approximately 170 processes across the ICB, each one replacing a manual, paper-based or email-driven workflow with something that simply runs.
"With the support from monday, you can pretty much manipulate it to do what you want it to do. We bought it as a project management tool. Now around 90% of what we use it for is automated processes of some kind." - Caz Evans, Technology Lead Manager, NHS Surrey and Sussex ICB
Transforming patient funding decisions
The AACC funding process was the first major rebuild. The Digital team replaced the error-prone Word document with an online monday form connected to an extensive network of other boards. Each stage of the approval chain is automated: the right person receives the right notification at the right time and the form moves itself forward.
The results are stark. They reduced the number of stages from 8 to 4 and what used to take up to two weeks now takes as little as 24 hours for straightforward cases. Panel reviews, previously hampered by missed deadlines and incomplete paperwork, now happen with every eligible case visible and ready, cutting review time from 14 days to under 7.
For patients approaching end of life, this operational shift makes all the difference in receiving the care they need whilst there's still time.
Getting maternity referrals to hospitals instantly
NHS Surrey and Sussex ICB coordinates physiotherapy referrals for pregnant women across the region. The process used to require a staff member to log into a third-party website daily, download a spreadsheet and manually send emails to the correct hospital - a task that consumed an hour every day, and only happened once a day.
Now, the referral form is embedded directly on the external website, powered by monday. When a patient submits their details, the platform identifies the correct hospital based on their GP surgery, sends a secure NHS email to that hospital instantly, notifies the patient, and then deletes all patient data from monday within seconds - leaving only a date, reference number and delivery status for audit purposes.
Since September 2024, 4,692 referrals have been processed this way, with zero manual effort from the team. Nobody now needs to take care of this administrative task, it simply runs itself.
Clearing a 90-person backlog with connected workflows
The Occupational Therapy team manages requests for specialist equipment - referrals that pass between internal staff and two external provider organisations. Previously, this was done by manual email and tracked in separate spreadsheets. At one point there was a backlog of over 90 patients waiting for their equipment, and sometimes even requests got lost.
The team built a connected workflow on monday that routes each request from the ICB's board to the relevant external provider's own monday workspace automatically, based on the patient's location. Providers who use monday via a guest account receive a notification, process the request, and close it out - triggering an automatic update back to the ICB. The backlog is now down to 4.
Giving staff their time back
Beyond patient-facing outcomes, monday has had a profound impact on the staff who use it every day.
The health and safety team's Display Screen Equipment (DSE) assessments are mandatory annual reviews for all staff. They used to land in the health and safety officer's inbox as lengthy paper forms, each taking 45 minutes to read in full before they could determine whether any action was needed. Now, the monday form's automation routes only the cases that require action. The result: 80% time reduction per assessment, and nearly 10 weeks of working time returned to one staff member since the process launched.
The same member of staff also managed ID badge requests - a 54-minute process involving multiple buildings, multiple emails and multiple manual steps. That process now takes only 11 minutes using monday. Combined, these two processes alone freed up close to 20 weeks of working time for a single person, for them to put into more valuable tasks.
And the impact isn't just measured in hours.
"A lot of our staff have come back and said this has taken a huge weight off their minds. They're finishing their work within their working hours, going home at the end of the week without stress, and coming back on Monday ready to start again. Staff wellbeing is a big part of this - and that matters for the patients they're looking after too." - Caz Evans
Scaling across the organisation
The demand for the Digital team's work hasn't slowed down. They currently have 7 processes in active development, 10 in testing, 12 in pilot, and a waiting list of 14 more teams - all of which have come to the team organically, upon hearing the impact monday is having on other parts of the organisation.
Other NHS organisations have also noticed. They have advised teams at Portsmouth, Hampshire, Isle of Wight, and Kent and Medway - several of whom have since purchased monday licences of their own.
The impact
NHS Surrey and Sussex ICB's success with monday has removed the friction that stops people from doing meaningful work, and making sure that when a patient needs a decision, a referral, or a piece of equipment, they get it as fast as possible.
“This is more than process improvement. Digital automation has fundamentally changed how we deliver our work. We have replaced slow, fragile paper processes with secure workflows that act in minutes, not weeks, giving thousands of hours back to our staff and accelerating decisions that directly affect patient care. By removing repetitive administration, we are enabling our people to focus their expertise where it creates the greatest value: solving problems, supporting colleagues and improving outcomes for the communities we serve.” - Tim Moore, Deputy Director of Digital Infrastructure, NHS Surrey and Sussex ICB
Across 170 automated workflows, the ICB has cut weeks off critical approval timelines, cleared backlogs that had been building for years, freed up thousands of hours of staff time, and built processes that keep running in the background, without the need for human intervention.
"The processes run themselves. They don't break, they don't need managing, and the teams don't need to worry about them. That's the goal: build it once, and let it do its job." - Caz Evans, Technology Lead Manager, NHS Surrey and Sussex ICB
When NHS staff finish work on time, rest properly, and come back each day without a backlog hanging over them, they're better clinicians and operators - and patients get better care.
And the innovation doesn't stop. Looking ahead, the Digital Team is preparing to build AI agents to prepare panel summaries before funding review meetings - turning hours of preparation into minutes and enabling faster decisions for the patients who need them most.
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