Read about how NHS Digital and NHS England are working together, and with partners, to transform health and care.
Digital transformation blog
Where do you go when you have an urgent medical problem? 111 online began with this basic user need – we wanted to provide a fast, convenient alternative for people who would rather access urgent healthcare advice online.
Since 2017, I’ve had the pleasure of working with the 111 online team. As coverage spreads and the service develops, reiterates and continues to evolve, here’s some of what we’ve learnt along the way.
It is such a straightforward concept that you would have thought we’d already have it: a single way to allow people to use one set of details to log into all their digital health services. We’ve been working over the past few years to develop this simple but powerful capability, which we call the NHS login, and it’s been a fascinating journey into the heart of our users’ experiences and expectations.
I have been Chief Clinical Information Officer (CCIO) for Poole Hospital NHS FT for six years and Chief Scientific Officer (CSO) for eight years. I have been involved in informatics from the outset of my career, initially in the development of our electronic patient record system. I could see significant benefits in clinicians having access to a patients’ data. Patients often arrive expecting me to know their medical history –to have reviewed the letters, notes and blood results beforehand.
I have always had an interest in digital health. Like many colleagues, I have been frustrated by a lack of accessible information to support the care of individuals or the redesign of services. I want clinicians to lead the way in changing this, so, naturally I was excited to apply for the role CCIO when it came up in August 2017!
In his Expo 18 keynote speech Health Secretary Matt Hancock delighted the user research and service design community when he talked about ensuring “an agile, iterative approach focused on the question: what is the user need?”
When we talk about 'empowering the person' what we are really talking about is giving people the things they want, need and have often come to expect. To disempower people leads to frustration, uncertainty, lack of control and a lack of choice for those on the receiving end. The NHS doesn't mean to do this, but it hasn't traditionally empowered people to have control or even sufficient choice over their own care. But it doesn't have to be that way.
Change without continuity and clarity of ambition can result in chaos and disconnection from the shared vision of care that drives successful organisations. With the recent government announcement of additional funding for the NHS, we have a genuine opportunity to plan for the next five years, confident of the level of budget increases we can expect. The NHS has been working at tremendous pace on a plan setting out our ambitions for improvement over the next decade, going beyond the five years of the funding settlement.
When I explain to someone outside of the health and care sector what it is that the National Record Locator Service does, they look at me with a perplexed expression. The public and our expectation is that the NHS is one organisation and that records are shared for direct care to support the delivery of the right care at the right time. They think National Record Locator Service is already what our electronic records do. It must be, surely?
As a community midwife in a remote area of England, working in an area where you would pray for one bar of signal strength to show on your phone, you can imagine my joy to discover that all of the GP sites in Cumbria now have free NHS WiFi connectivity.
At the end of September, the NHS launched a private beta for the hugely exciting NHS App, which is accessed using a new NHS login service. So, we thought this was a useful opportunity to look at the bigger picture and explain why an NHS login is a game-changer in its own right.
Seeing the development of the NHS Digital Academy here in the UK was exciting and having the opportunity to apply was something I did not want to miss, as I believed it would fulfil what I was looking for.
Hello, we’re Louise Mushet (senior service designer) and Victoria Hunt (NHS Apps Library product owner) from the Apps and Wearables programme at NHS Digital. Today is World Mental Health Day, with a focus on young people and mental health in a changing world. We feel privileged to be in one of several teams at NHS England and NHS Digital working in partnership all year round to ensure that those experiencing stress and anxiety can find the right support online when they need it most.
I’m Dean, and I’m the lead designer for the NHS website. I also work with lots of other designers in different parts of the organization. We are pleased to publish a set of design principles, for people making services and tools in the NHS. They will guide designers’ decision making, and help people from other professions understand what design is for, and how it can benefit people.
Working with the voluntary and community sector to empower people to manage their health and care digitally
My team in NHS England is responsible for transforming how people can manage their health and care and access services using digital technology. We believe online health information and services can improve people’s health and wellbeing, patients’ experience, and reduce pressures on frontline services.
How digital apps are helping to realise personalised care for people and deliver real savings for services
My name is Richard Pantlin and I co-ordinate a number of digital initiatives for NHS England’s Personalised Care Group. In addition, I support several STPs/ICSs to implement digital systems (using co-production) for personalised care & support plans and e-marketplaces for care. He led the IT Challenge in 2017 culminating in the report “Harnessing Technology for Personalised Care” and an updated report with more details of IT solutions will be available later this year.
The National Diabetes Audit found that only 30% of people with type 1 diabetes have stable blood sugar, compared to 68% of people with type 2 diabetes. This means a higher risk of things like A&E visits and complications.
A team of us at NHS.UK looked at how we can help people with type 1 diabetes.
I’m a content designer and I’ve been working on the standards team at NHS Digital. Over the last five months we have been working to put together a new NHS digital service manual to help people who build digital services for the NHS save time and work in a consistent, user-centred way. Back in April, I blogged about the beginnings of defining digital standards for the NHS. The first version of the service manual is now ready to be used, so I wanted to provide an update.
Incredibly, we are now a year and half into the delivery of phase two of the Widening Digital Participation (WDP) programme and our partnership with Good Things Foundation. In my last blog we were just getting things started, so it feels like a good time to look back and see if we’ve got to where we wanted to be. The answer is definitely yes.
Having just left the NHS 111 service to join NHS Digital Laura Tweedy reflects on the challenges and the benefits of this essential service.
Getting ready for Expo 2018 is involving a lot of train travel for NHS Digital’s Hadleigh Stollar who’ll be speaking about how the National Record Locator Service will help frontline staff make more informed decisions and provide better care.
I’m a Product Manager at NHS Digital and my role is to look at how we can improve the design of the NHS website (www.nhs.uk). I work with a small team of skilled designers, developers and researchers. Together, we have recently made some important improvements to the site and this blog explains what they are and why we have made them.
Back in December 2017 I was part of a team working to improve access to the Directory of Services.
The Directory of Services identifies where is best to send a patient. It does this by combining symptom information with local service availability. It was originally designed for NHS 111, but has great potential for clinicians and healthcare professionals in other areas of urgent and emergency care.
When I first left home in 1985 to start my nurse training I loaded my stuff into my trusty old Renault and set off north to move to the nursing home never questioning that the aa road map, Northampton A-Z and a reasonable sense of direction would get me to my destination. On arriving I had to locate the payphone and my bag of 2p pieces to call home and let my parents know I was there and safe. That payphone (and essential bag of 2p pieces ) was my only means of contact with home for the next few years and if anyone actually wanted to contact me they had to ring said payphone and hope a kindly passer-by would answer it and then actually come and find me…
Last week, we became one of the latest GP practices to go live with free NHS WiFi, as the national NHS WiFi programme confirmed that it has now rolled out to three quarters of GP practices in England.
I’m told that the remaining 25 per cent are expected to follow soon, giving more than 58 million patients, across 7686 GP practices, access to free NHS WiFi, enabling them to link in with local health clinics and services and paving the way for future developments in digital patient care.
Last Monday, as part of NHS70 Digital Week we launched ourselves into the virtual reality of AltspaceVR for a punchy debate entitled Are the bots taking over? How AI will affect the future of healthcare. And what an amazing experience it was.
NHS Digital Academy: Digital Leaders are an integral part of the uptake of digital services across the system
Four months, two residential sessions down – and now in the midst of the second module, the first 100 candidates are fully immersed as cohort one of the NHS Digital Academy programme. The NHS launched the Digital Academy earlier this year with the main premise of supporting the development of a new generation of digital leaders who can drive the information and technology transformation of the NHS. It was set up in response to Professor Robert Wachter’s Making IT Work report, which observed that the NHS was lacking in leaders who could drive forward the digital transformation required by the service.
It doesn’t get much more real than urgent and emergency care in the NHS.
Every day, our GP surgeries, hospitals and urgent treatment centres help people facing medical challenges from minor through to life threatening. The chances are that person will have used a form of digital technology to get the help they found, whether that be googling their symptoms or contacting any of our telephone and online support services.
Hazel Jones and Jackie Tatterton work in the Apps and Wearables programme and here, they talk about how innovation has touched their field in the past, the present and potentially in the future.
If you’d mentioned cyber security to the first tranche of nurses and doctors joining the NHS in 1948, it’s safe to say you’d have received a few blank looks.
Peter Short is a GP and Clinical Advisor at NHS Digital. He trained at Birmingham Medical School and his driving passion is the use of systems and information that can be made available to support all frontline clinicians. Here he talks of how technology has shaped general practice over the years, and how he sees its future.
Mental health has been transformed over the last seventy years. There have been so many changes: the closure of the old asylums; moving care into the community; the increasing the use of talking therapies. They have all had a hugely positive impact on patients and mental health care.
When it comes to technical innovation in the NHS over the last 70 years, it’s ultrasound that I think has revolutionised the way we deliver care. This one innovation has changed the way we provide safer personalised maternity care for our women and babies.
It’s a sobering thought, but I’ve been working in the NHS for 36 of its 70 years, so I’ve seen a lot of change. Most recently, the change which has excited me most has been the move towards mobile working. For me, it’s a real game changer; enabling nurses and midwives to access all the information they need to care for a patient wherever they are with that patient, whether it’s in a care setting, the patient’s home or a community setting.
When I was asked to take part in the NHS Digital #NHS70innovations campaign I found it tricky to pinpoint one area or a specific innovation that has transformed health care delivery over the last 70 years – there have been so many.
The greatest social innovation by far has been the actual introduction of the NHS itself.
As digital health innovations develop at an increasing pace, it is important that they are safe, effective and offer value. Over the past few years the market has been flooded with some excellent innovations – and some not so good. It has not always been easy to distinguish between them. We have fatigued the system with endless pilots and trials but are seeing little ‘at scale’ adoption.
I’m a physiotherapist by background and I come from a family of NHS workers – my mum was a nurse, my wife is a physio and my sister-in-law is an occupational therapist. Family conversations subsequently often revolve around various aspects of the NHS.
As the NHS celebrates its 70th birthday this year, I think of all the tremendous advancements that have taken place across pharmacy over the past seven decades.
I cannot help but turn to the Hospital Episodes Statistics (HES) when I look at how data played a part in shaping the NHS since it was first founded in 1948. There is no disputing the power of HES as its sheer volume and depth is phenomenal.
When I was asked to contribute to NHS Digital’s #NHS70innovations campaign and choose one technological innovation in health and care that I thought was the greatest in the last 70 years of the National Health Service, I thought where do I start? There’s lots!
We’re currently exploring what people with mild to moderate anxiety and depression need to be able to easily access the Improving access to psychological therapies (IAPT) service on the website www.nhs.uk
We have three goals:
- make it clear you can refer yourself to IAPT
- make it easy to self-refer
- let people know what to expect
We’re currently designing and testing prototype pages with users to help us understand how we can meet these goals. We conducted research with website users as part of a discovery phase and we’re now using this in the alpha phase which includes designing and testing prototypes. Our research focussed on finding out what people with mild to moderate anxiety and depression needed. We tested with website users the existing NHS Choices pages that cover Improving access to psychological therapies (IAPT)
This #MentalHealthAwarenessWeek I was uplifted by the mental health journey NHS Digital is taking, and extremely proud to be able to help transform mental health services through the day to day work I do.
I’m part of a multi-disciplinary NHS funded mental health, learning disabilities, autism and Improving Access to Psychological Therapies (IAPT) services. In doing so we are uncovering new insights that help support the vision set out in the Five Year Forward View for Mental Health. This aims to make it easier for everyone to access high quality services, bringing together mental health and physical health care, and to stop people from having mental health problems through the promotion of good mental health.
Digitising the prescribing and distribution of medicines has an enormous potential to improve patient care, increase safety and make our system in the NHS more efficient. As our world changes at a rate not seen since the industrial revolution, with vast swathes of our lives changing beyond recognition in just the last few years alone, pharmacy has been slow to adjust. We have made great progress, but there remains a reliance on inefficient, paper-based processes which slow us down, increase the potential for errors and cost money. This results in a huge administrative burden, not only on non-clinical support staff, but on pharmacists and primary care prescribers too.
The need for the NHS Digital’s Digital Medicines programmes of work to deliver the tools to change that is bigger now than ever. We spend £17.4 billion a year on medicines, over half of which is in primary care.
By Rosalyn Hewitt. 30 April 2018.
We recently ran a discovery on mental health, focusing on understanding the user needs of people with mild to moderate anxiety and depression, and understanding the role of NHS.UK in supporting these needs.
Approximately 1 in 4 people experience mental health problems.
In my last blog post I talked about Register with a GP going into private beta. Private beta is a working version of a service that’s available to a restricted number of people. It helps us learn about the usability of our service in the real world.
In this post I’ll share what we learned, some of the challenges we faced, and what led to our ultimate decision to stop working on Register with a GP.
Led by our new Head of Product, Marc Heasman, the Product Managers working on NHS.UK recently created a manifesto to describe our commitment to the ways in which we believe we should work.
This is the first version of our product team manifesto, and we’ll continue to work on it.
Let us know if you find this useful, or if you have something similar that you use.
With the particular needs of healthcare users and NHS having a strong, trusted brand, we’re noticing more and more that we need to go beyond the GDS standard and define our own universal method.
My first job in the NHS in 2003 was working on the procurement of the first national electronic referral service for GP to first outpatient appointments (known then as Choose and Book).
I can still remember the jubilation when we got our first ten bookings completed and now, its successor the NHS e-Referral Service (e-RS) handles 50,000 patient referrals a day.
But despite the proven benefits to patients and clinicians, we’ve collectively missed the opportunity to maximise the technology investment with utilisation rates hovering around 52% for several years – until now.
The NHS is for everyone, and those of us designing digital services for the NHS have a responsibility to ensure that everyone can access them.
Accessibility can mean all sorts of things, from ensuring buildings can be used by wheelchair users, to providing printed material in different languages. But there are also lots of things we can do to ensure digital tools and services can be used by people with a range of access needs.
All the way back in September 2017, we were challenged to deliver a single app that would transform digital healthcare delivery. Our vision for this app is that it should provide patients with access to a range of digital tools and services, in a simple, consistent and joined up way.
We’ve wanted to move our content to a new software platform for some time. We believed it was necessary to underpin our ambitions for the development of the service. And we knew it would quickly unlock some important benefits for users.
The NHS Wi-Fi project continues to move at pace. In just 12 months, over 3000 GP practices are now offering free NHS Wi-Fi to over 25 million patients. Most of our 16 ‘high priority’ trusts who received funding in August have now rolled out Wi-Fi across their estates and the remainder are expected to do so before the end of February.
We’ve recently been looking into how we can help manage the impact of urgent prescription requests on the NHS 111 service. By supplying NHS 111 clinicians such as nurses, pharmacists and GPs with additional information about patients’ existing electronic prescriptions, we hope they will be able to make quicker, more informed decisions about whether or not to prescribe urgent medication. In essence, patients who need urgent medication will receive a better service and spend less time on the phone, meaning more time can be given to patients with more complex issues.
Information and technology offers us a chance to not only meet the increased demand set out in the Five Year Forward View, but provide our patients with higher quality care and services which are quicker and more convenient to access
How do you get through to people about eating well when they’re faced with an avalanche of influences every single day, from Instagram fads and slick food ads, to family habits and busy ‘grab and go’ lifestyles?
There are over 26 million people in the UK who live with at least one LTC and 10 million who have two or more. Their ongoing and complex needs are currently met by an already overstretched health and social care system.
One of the challenges facing the NHS is the fact that more people are living longer but not necessarily healthier lives. Advances in healthcare have brought greater life expectancy, and as people age they are more likely to have one or more LTC.
In the second half of 2017 we embarked on a Discovery to understand more about the nation’s current food habits and what the role of NHS.UK is to help people make healthier choices.
The NHS.UK healthy eating discovery explored a range of hypotheses, including:
- establishing a need for trustworthy healthy eating content on NHS.UK
- understanding the tone of voice people responded to the best
- usage of healthy eating apps and tools
- how social media and videos influenced people’s understanding and choices
- how journeys with a health concern differed from those without
- healthcare professionals’ involvement in the healthy eating journey
As part of its Widening Digital Participation programme, NHS Digital and NHS England are now producing a guide to digital inclusion for local health and care organisations. In September we wrote about the discovery phase of this project.