Digital is wonderful – it brings the world into your front room, it enables people to communicate across time zones, save money and find out more about the things that interest them. Digital is convenient, flexible, it can give you the information you need when you need it, and you can use it at a time that suits you.
But digital isn’t always wonderful at everything.
Human beings are (usually) better than technology at being patient, being empathetic, listening to what people really mean rather than what they say. Humans are good at encouraging others, inspiring others, and empowering others to do things they didn’t think they could do.
(And digital has other issues too – just like the real world – to do with crime, security, consent, and other things … but more about that another day.)
The NHS is a wonderful institution and I was delighted to congratulate Matt Hancock as soon as he was appointed as the new Secretary of State for Health. He’s a good man and he understands both the power of technology and how many people still don’t know how to use the internet in a way that benefits their lives.
Matt Hancock gave his first oral Health Parliamentary Questions in the House of Commons yesterday, as well as making his first appearance at the Commons Health Select Committee. He’s been clear that he has three priorities:
- Valuing the NHS and social care workforce
- Transforming tech (starting with a new £487 million fund)
- Prevention being better than cure.
They seem like three pretty good things to start with – assuming that a relentless focus on patients underpins all three.
At the Health Select Committee, Matt Hancock said “Technology in healthcare is coming. What we need to do is to make sure the NHS is able to utilise this in a way that achieves the holy trinity of allowing better care for patients, easier service provision for clinicians, and saves the NHS money.”
Although I’m passionate about tech, I am more passionate about people using technology, and not tech for its own sake. For over four years now, we’ve been working with partners to engage people who are more likely to experience poor health and lower life expectancy due to the wider social disadvantages they experience. In our first three years, we helped over 220,000 people who showed us that with the right support and encouragement they could change behaviours, and lift barriers to exclusion. Part of that behaviour change was helping them to use the best channel for them – such as the online NHS health information instead of a GP, or a Pharmacist instead of A&E. Our research showed that the group of people we supported in one year had the potential to save the NHS over £6 million in those 12 months alone.
Ron Dale, 61, was living in a tent on the A63 and through a series of interventions, including digital upskilling, he was able to re-engage with the health system, move GP practices and book his appointments online. “We helped Ron get familiar with the NHS Choices website and use the ‘Services Near You’ section, to find nearby GPs. He had a look at the reviews, opening times, picked a surgery and he was registered in less than a week,” said Dave Edeson from Inspire Communities in Hull, the Online Centre who supported him. “Ron suffers from particularly severe anxiety issues and he was really happy that the surgery lets him book appointments and order repeat prescriptions online. These services went a long way to alleviate his anxiety, especially once the Inspire Communities showed him how the system worked and how easy it was to make an appointment.”
Dave continues: “Ron is much happier with his new GP too. Not only is it closer but he says the conversations he’s having with the doctor are making him feel much more included in decisions about his healthcare.”
In phase 2 of our NHS Widening Digital Participation, we are working with some of the most excluded groups in the country to investigate ways that digital can make a difference.
This ranges from working with homeless people in Hastings, people with sensory impairments in West Yorkshire, and those with long-term conditions in Stoke. By co-designing pathways for people with complex lives we are able to find out how digital can improve their lives – and ultimately the way in which they interact with the NHS. This includes:
- By targeting local Facebook groups in Stoke, we’ve have been able to increase the uptake of Breast Cancer Screening by 6% (13% in the most deprived wards) against a national drop of 4%.
- By providing access to trusted information through NHS Choices, the homeless community in Hastings have been taking medication at the right times, re-integrating with their GPs and even attending A&E when they have serious injuries – all of which wasn’t happening before due to a variety of mental health issues.
- By partnering GP practices with community partners in the Online Centres Network in Sheffield we’ve been able to show how patient engagement, activation and health transactions can all be improved through social prescribing and digital (as long as you don’t mention the word digital).
We are so proud to be part of the Empower the Person workstream for NHS England. This recognises that designing systems, tools and pathways should leave no one behind. As Juliet Bauer, Chief Digital Officer at NHS England, says, “Technology is here to extend humanity, not replace it”.
We’ve learned some important things on our journey, including
- To start with, and remain focused on, what matters to people – digital is an enabler not the end goal
- To engage people in new innovations including digital tools we need to go to where they are, not expect them to come to us
- People trust peers just as much as they trust clinicians in terms of recommendations around using digital resource
- Digital is really good at prevention, for example supporting people to lose weight to avoid getting type 2 diabetes
- People need relationships of trust, and open door whole person support can help to overcome both social and digital exclusion
- The staff of the NHS are wonderful, but change is hard. Many staff aren’t confident about their digital skills – so they need to build their capability and confidence. But we also need to ensure a fear of change doesn’t block the culture change that will also be needed
- People (patients) are not the problem they are part of the solution – digital services and products should be co-designed in partnership with them
- Social prescribing can be really effective, but it isn’t a silver bullet and needs to be implemented in the right way – it needs to remain informal and based on the needs of the individual, so implemented well it involves local community organisations, and it is a shared decision between both the patient and practitioner.
A digital enabled NHS should offer a better, more inclusive, and 24/7 service, that is free at the point of use, as well as including Matt Hancock’s holy trinity of allowing better care for patients, easier service provision for clinicians, and saving the NHS money.
And, if 90% of the people who are socially excluded are also digitally excluded, it’s critical that all citizens are also, at the same time, enabled and empowered to be able to and benefit from this wonderful digital world and the wonderful digitally-supported NHS that Matt Hancock, his team, and hundreds of thousands of NHS workers all want to see.
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