Digital Healthcare Revolution and Building Blocks
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Digital healthcare revolution by Helen Rowntree, Head of Digital Services, NHS England
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Digital Healthcare Revolution and Building Blocks
- 1. www.england.nhs.uk Digital healthcare revolution Helen Rowntree Head of Digital Services NHS England #DigiOFE | 25 February 2016#Health2020
- 2. www.england.nhs.uk What digital is about, what the internet allows, is a radical redesign of services. Cheaper, better, faster. This frees up money, resources and attention to put into the really important work, the work on the frontline. Martha Lane Fox, Dimbleby Lecture, March 2015
- 3. www.england.nhs.uk 1. Health and wellbeing 2. Care and quality 3. Funding and efficiency Three widening gaps NHS. (2014). Five Year Forward View. Retrieved 6 December 2015 https://www.england.nhs.uk/wp- content/uploads/2014/10/5yfv-web.pdf
- 4. www.england.nhs.uk Digital has the power to be non-judgemental, non-discriminatory and epitomises the founding principles of the NHS
- 6. www.england.nhs.uk What are the building blocks to achieving this ambition?
- 7. www.england.nhs.uk Digital skills of patients and staff
- 8. www.england.nhs.uk What are the building blocks to achieving this ambition?
- 9. www.england.nhs.uk Design services which meet the needs of users
- 10. www.england.nhs.uk Design council. (2013). Design for Public Good. Retrieved 6 December, 2015 https://www.designcouncil.org.uk/sites/default/files/asset/document/Design%20for%20Public%20Good.pdf
- 11. www.england.nhs.uk Create the right conditions to support this ambition
- 14. www.england.nhs.uk Addressing the digital skills divide
- 15. www.england.nhs.uk Developing a new, national digital service – NHS.UK National Information Board, (2014). Personalised health and care 2020: a framework for action.
- 16. www.england.nhs.uk What next? #Health2020 @rowntron Head of Digital Services @NHSEngland
Editor's Notes
- I am going to start by telling you a story Last year, I took my son for an outpatient appointment. At the end the consultant suggested we would need a follow up appointment. He said: ‘I would usually book you straight in, here and now, but we are changing IT systems next week, so there’s no point. You’ll have to call us in a few weeks time. I’m sorry, but it’s just the way it is in the NHS’ What struck me about this, was the grudging acceptance (on both our parts) that ‘it’s just the way it is in the NHS’ – that the NHS lags behind in its use of technology. I think that picture is actually changing pretty rapidly – there are some brilliant examples of digital technology being used to deliver world class services. Today I am going to talk to you about some of the building blocks that we need to put in place to be able to do this across the board, and also some of the national programmes that we’re leading from NHS England It’s probably worth mentioning that I’m coming at this from a citizen perspective – that is, citizens using technology – as that’s the focus of my work in NHS England.
- As you are an audience that has come to a conference about digital technology, you probably all have a good understanding of what this means. But I really like this quote from Martha Lane Fox, in her excellent Dimbleby lecture last year, which focuses on digital technology and public services. It’s not about new websites, or putting existing services online, or channel shift. Its about rethinking how we design and deliver services so that they are cheaper, better and faster. That’s better for us as taxpayers, better for us as patients and better for us as people working in the NHS.
- The Five Year forward view set out the scale of the change that’s required to ensure the NHS is sustainable. For the first time, we have truly embedded digital and technology into the guiding operating principles of the NHS. A digital can clearly play a role in relation to all of the three widening gaps described in the Five Year Forward View: Health and wellbeing – need to get serious about prevention, narrow health inequalities and ensure we put measures in place to tackle avoidable illness Care and quality – reshape the delivery of health and care services and decrease variations in quality and safety Funding and efficiency – a combination of growing demand, and flat real terms funding would produce a £30bn funding/year shortfall by 2020/21 The Five Year Forward view recognises that digital is a key enabler of the New Models of Care that we are now starting to see.
- Its particularly exciting that the power of digital not to discriminate, and to be open to all, is absolutely in line with the founding principles and the constitution of the NHS. We’ve seen this in other spheres, for example, in academia with open online courses. Digital can also transcend organisation and structural boundaries – it can be, in the words of the five year forward view, the ‘electronic glue’ that joins up health and social care, primary and secondary care, the voluntary sector and the NHS. The public/users/citizens shouldn’t need to understand the NHS and digital means they shouldn’t have to
- There’s huge consumer demand for health online. 1 in 20 searches on google is health related. NHS Choices, which we launched in 2007, is a fantastically successful service. It has around 27m visitors each month. Its not just information, where there is a demand for health services online: In primary care, there are a number of online, largely paid for, digital primary care services allowing subscribers to consult a GP via email or skype and be treated for minor ailments – for example, Babylon and DrNow In sexual health, services like SH24 in Lambeth and Southwark, allow users to order a test kit and receive their results without needing to go into a clinic And in mental health, there are a services providing online psychological therapy, either as part of a Psychological Therapy pathway or as a standalone service – including Big White Wall and psychologies online
- So the potential of digital is hugely exciting. In order for us to deliver on this, we will need to make sure we get a few fundamentals right, across the system. So these are things that we should all challenge ourselves on
- In the UK, 6m people are not online These groups are more likely to be older, or socially excluded (for example) out of work. Therefore they are also more likely to suffer from poor health. The digital skills of NHS and social care staff are just as important. Think about the diversity of the health and social care workforce. We don’t have robust data on this, but we do know that many staff don’t feel confident in their own use of digital technology.
- Go:On UK, the national digital skills champion, publishes a ‘heat map’ of digital skills and inclusion. We need to be using resources like this as we are planning and designing services. There are real opportunities for health and care organisations to address digital skills, through for example, models such as social prescribing, or even looking at digital skills in inpatient settings. We’ve seen great examples of this locally, for example in Tower Hamlets and Edlington Hilltop Centre, near Donacaster
- Secondly, it’s critical that we design our services to meet the needs of users. If we’re really going to deliver the benefits we know that digital has the potential to deliver, around efficiencies and better outcomes, we need services that meet the needs of the people using them – whether that’s patients or staff. This should be second nature to the NHS. User participation and involvement have been central to how we approach service redesign for many years.
- So this is how the experts at the design council break it down, very simply. You need to research user needs, try some things out, test them and then improve them. It’s not about focus groups and market research – its about getting people to try things out in as close to a real environment as possible and seeing whether they work.
- The third building block for success is ensuring we have the right conditions for digital technology to succeed. We need the right processes (around how we buy and build technology), we need a technical infrastructure that is interoperable and open – so that we are not locked into specific technologies. And we also need the right kit and environment
- This is really set out best in Personalised Health and Care 2020 Nationally, we’re now working up our delivery plans for the programmes we’ve committed to, now we have funding from Treasury
- I also wanted to mention the review of take up of digital technology that Martha Lane Fox did late last year. She outlined 4 key priorities for the NHS – some of which I have already talked about but I think are worth repeating here. They are also informing our plans for the next 4 to 5 years.
- So what are we doing nationally? I am going to talk about just a couple of our areas of work For the last three years we’ve been working with the Tinder Foundation to address the digital skills gap. We’ve supported 350,000 people to get online and take control of their health. UK online centres The benefits of this don’t just relate to digital skills – we’ve shown that getting online increases confidence, saves time & cost, & improves self care & lifestyles Lack of skills is just one barrier – we need to look more widely at infrastructure and motivation to use digital services. That, and working to address the digital skills of NHS staff themselves will be areas of focus for the next phase.
- The National Information Board commits to a new digital channel for citizens – NHS.UK. This will build on the success of NHS Choices but critically, will connect users to the health and care that they need. It will bring together information and transactions, and offer a personalised experience, as well as access to online services such as apps provided by third parties. We’re currently prototyping elements of NHS.UK and developing a plan for a next phase which will take us to a public beta in 2017. If you want to read more about what we have been doing – have a look at our blog at alpha.nhs.uk As part of developing this we’ll need to realise the opportunity for our national channel to deliver for local organisations – that might be about providing local organisations with a local view of the data we have, or it might be about taking local innovations and scaling them nationally. We’ll be exploring this with the vanguards and test beds.
- We want the NHS to be world class for digital technology, not a poor excuse We’re keen to hear your views on what we have planned