Hey Matt, Let’s Make Sure the NHS is Wonderful for Everyone

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.”

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Ron and Dave

 

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:

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.

Happy birthday NHS – let’s embrace more digital to evolve and get even better

At Good Things Foundation we’ve been very pleased this week to celebrate the 70th birthday of the NHS. We’ve blogged and published guest blogs, we launched a report (about our pilot project with the Sheffield Perfect Patient Pathway Testbed looking at the digital capabilities of health professionals), and we’ve shared lots of great stories on social media. But as the NHS hits this great milestone, it’s got me thinking, how can we sustain it going forward and can digital play a bigger part?

Innovation isn’t just sexy tech and apps

The first phase of our Widening Digital Participation programme proved that online health information – and importantly, ensuring people having the digital skills to access that information – can have a significant positive impact on people’s lives. We reached hundreds of thousands of people with those digital health skills and found that this behaviour change could save the NHS lots of valuable cash (£6m a year through channel shift eg. using more appropriate and more convenient channels).

The point is, the thing that made the most difference to the learners was the information. There’s so much talk out there about different technologies modernising healthcare but the reality is it isn’t all about sexy tech and apps. People need information to get them started in the world of digital health.

Dr Ollie Hart, a GP based in Sheffield who you may recognise from some of our Widening Digital Participation communications, is working hard to make sure people have the knowledge to use online information to manage their conditions in a safe way. He’s embedded signposting to basic digital information in partnership with a local Online Centre who has been based in the GP’s surgery once a week for the past four years.

One of our first Pathfinders in Phase 2 of the Widening Digital Participation programme is a project in Islington working with young people with mental health needs. The project took the relatively simple step of putting a PDF of young people’s Crisis Care Plans on their mobile phones. It was previously on paper and was often lost or forgotten about.  This solution meant that the Crisis Care Plan was in easy reach whenever the young person needed it. Digital was the solution, but it was very low tech.

As Juliet Bauer, Chief Digital Officer at NHS England, says “Technology is here to extend humanity not replace it.”

Digital can bring so much to the prevention piece

Too often the conversations I’m part of about Health and Digital tend to be almost all about curing people. But for better health for more people and for people to not get sick in the first place then digital has a big role to play in prevention as well as cure.

We have many stories of people who have lost weight by getting support from other dieters online or by using the internet to find easy recipes – and therefore preventing a number of illnesses associated with being overweight or obese.

In June, in Sheffield (where I live), there’s a Move More campaign that got me walking 30 minutes to work and back because of a simple app on my phone and a league table where organisations compete against one another to do the most active minutes per person.

But it is getting the people involved that is crucial. Our Pathfinders show time and again that people need to help design their own solutions – whether this is an old butcher shop turned digital health information centre in Nailsea or better access to healthcare for homeless people in Hastings.

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Digital is a tool that helps to drive behaviour change – and that behaviour change means individual people making better decisions about keeping healthy rather than waiting until poor health strikes.

It’s about making people feel healthier and better

This week has been such a huge milestone and I’ve seen and heard so many great things in the news about our national treasure. It makes me proud.

I’d also like to say a big thank you to the people at the NHS who are working with us to test some new approaches and to see what works (and what doesn’t). Thank you to all of the people in the NHS, in the CCGs, and the GPs involved. Thank you to Nicola Gill (who wrote a great guest blog this week), Juliet Bauer, and Bob Gann, who have helped to drive this initiative forward.

The NHS will hit 80 in ten years, and there’s no doubt that it will be a big decade for digital – in making the NHS even better, more accessible, more convenient and flexible, There will be many more opportunities to create services with people, not just for people.

In the UK there are still over 11 million people who aren’t proficient at filling in an online form or downloading an app – our mission is to help all of them to be confident at using the web for good, and to have better lives, and that’s going to be really important for the NHS in the next decade and beyond. Let’s not forget these millions of people as we design the next tech innovation and as we embrace the next ten years of an even better NHS.

Happy Birthday, NHS. And thank you.

#NHS70

The Digital Health Lab

What does it mean to stay happy and healthy? Some people would say it’s eating well and exercising, others would say it’s being able to stay ‘in the know’ and in control of existing health conditions. What these tasks have in common is that the internet can be used to make them easier. And that’s where our Widening Digital Participation project with NHS Digital comes in.

This week we’re shining a spotlight on this project, not least because the project has been shortlisted at the Digital Leaders 100 Awards for Cross-sector Digital Collaboration of the Year, but also because we’ve engaged 104,300 people through this second phase of the programme so far since April last year.

Building and developing

In the first phase (September 2013 to March 2016) we supported a total of 221,941 people to learn digital health skills. In the third year, through our research, we discovered that the behaviour change of people moving more of their health transactions online would mean potential annual savings of £3.7m in saved GP visits and £2.3m in saved A&E visits. That’s savings of £6 million in just 12 months. These savings alone represent a return on investment of £6.40 for every £1 invested in the programme.

At a time when the NHS is increasingly strapped for cash, we’re happy to help them save a bit of money and alleviate pressure on services by teaching people to use the internet to manage their health. Just to be clear, we’re promoting the use of digital as one channel to help with how people manage their health, and this channel sits alongside the other telephone and face-to-face support people can and should continue to have access to, such as NHS 101, Pharmacists, GPs, Health Clinics and A&E.

Our second phase (that started last April) has identified ‘pathfinder’ partners, that’s CCGs, GPs, Online Centres, third sector organisations, Councils and more with a specific idea to test if (a) it works and (b) if the idea can be replicated and scaled.

What are our pathfinders doing?

There are 13 live pathfinders currently and they’re piloting different ways to embed digital inclusion into healthcare. Here’s a little taster of what they’ve been up to:

  • Digital Health on the High Street, Nailsea: Nailsea Town Council purchased the old butcher shop on the High Street, turning it into a community space that can help Nailsea residents improve their lives through engaging with digital technology and their health. They’ve engaged 870 people, supported 120 people in-depth and recruited 21 Digital Champions.
  • Young Carers, MYMUP, Bradford: We’re working in partnership with MYMUP, local third sector organisations and education establishments in order to support young carers. MYMUP is an online platform that is helping support young carers with their resilience and mental health. We’re working with them to discover the ways that digital support can improve the lives of young carers and also increase access to health information for the people that they care for.

There is so much more to read about what our pathfinders have been up to on our ‘micro-site’, so please do have a look.

It’s not just about digital skills

Good Things Foundation is social change charity. We believe in helping people to improve their social outcomes powered by digital, so through programmes like Widening Digital Participation the health benefits aren’t limited to reading NHS Choices or booking a GP appointment through an online booking system or ordering a repeat prescription for delivery to your home. It’s other things like reducing social isolation – learners who normally live alone and spend most of their time alone can get some company when they go along to their local centre to learn about digital – or improving their mental wellbeing and confidence by interacting with other people.

The benefits to individuals, their communities, and to the NHS of the Widening Digital Participation programme are potentially huge. We’re looking forward to finding out the new and exciting ways that our next 7 pathfinders will help the most vulnerable in our society to become happy and healthy.

And here’s just one story to bring it all to life…