By Tara Donnelly, 17 April 2019
By Tara Donnelly, 17 April 2019
I recently heard an NHS chief information officer (CIO) use the expression ’think big, start small, scale fast’ as the way his trust was seeking to operate in the digital space. He commended it as much more fitting for healthcare than the Silicon Valley start-up mantra of ‘move fast and break things’.
I was instantly reminded of the NHS App. It certainly is a big thing to imagine a digital front door to the NHS. The team started small by beta testing with a defined set of GP practices and learnt from the feedback from the first 3,000 patients and the NHS staff involved, refining as they went. We recently published these findings in the spirit of being as open as possible, sharing as we go, both about what worked well and what did not.
‘Scaling fast’ may not be something we immediately think of when considering innovation or digital products in the NHS. But in this case, it really does apply. Having started just a matter of weeks ago in January, nearly half of all GP practices in England are already connected to the app – astonishingly rapid progress.
It is important to note that there is a difference between practices being technically connected, and practice staff and patients being able to use the app to its full potential. We have a hugely important piece of work to do as the rollout continues to ensure practice staff are aware of the app and able to support their patients. Over the coming months we’re asking practices ‘Are you ready for the NHS App?’ and providing them with concise guidance to help them brief their staff, prepare their systems, and then tell their patients about it.
We can be rightly proud of this huge collective effort across primary care and the digital teams to enable scale at pace.
So how has this progress been achieved at such pace?
It has been due to a really great collective effort and I would like to highlight some of the groups and people involved to give you a flavour of what it takes to get something nationwide in a matter of a few short months.
I will start with practice staff themselves – particularly practice managers who ought to have special mention for leading this revolution on the ground, and GPs and others within the extended primary care team. We’ve had terrific support from influential GP leaders - especially Dr Nikki Kanani, Director of Primary Care for the NHS and Professor Helen Stokes-Lampard, Chair of the Royal College of General Practitioners. The NHS regions, CCGs and the regional digital directors in particular have all done great work to encourage local uptake.
The small but highly dedicated and well-travelled Implementation Team have been supporting practices across the country, as have those leading and supporting primary care digital transformation - Dr Masood Nazir and team. And, of course, there are those directly involved in the development of the NHS App itself, from user-led researchers and the technologists building and refining it, to the analysts creating the tracking dashboards, the communications team providing support tools and webinars, and those leading the programme and ensuring that timely progress is made, working across NHS England, NHS Improvement and NHS Digital.
It has required all these people, often with different employers, to work beyond organisational boundaries for the benefit of empowering our citizens to have the digital tools and services they need to manage their healthcare more effectively. We can be rightly proud of this huge collective effort across primary care and the digital teams to enable scale at pace.
When we began this work, we noted that while there are some great digital tools out there and huge progress has been made, 75 per cent of people in England are unable to book GP appointments digitally. They have to contact their practice by telephone and even, in some circumstances, queue at the practice door before surgery starts – a system that Aneurin Bevan would recognise from when the NHS was founded almost 71 years ago. We are working hard to ensure that everyone who wants to can book appointments digitally, order repeat medication and see their primary care record. Encouragingly, two thirds of patients using the NHS App during the pilot had not been registered for an online GP practice service or app before. So the demand from patients for this is clearly there.
We are now beginning to see some great messages from people using the NHS App, including the following three in the past week on Twitter:
It is also interesting to see when the different functions are most frequently used. For 111 Online it is after 5pm. For booking GP appointments, 8am is by far the most popular time – with 40 per cent more people using it for booking appointments than at 7am or 9am.
We also issued over 800 email notifications in one go last week, letting people know that their GP practice was now live and helping us to check that the surge capacity for NHS login worked well. The messages went out at 3.30pm on a weekday and I was fascinated to learn that instantly more than 300 people registered via NHS login. I would have guessed that registering for the NHS App would be the sort of ‘life admin task’ that got relegated to evenings and weekends, but it is great to see this assumption proved quite wrong and to witness the enthusiasm with people wanting to sign up right away!
So, we are almost halfway there and we continue to work with this great extended team across the country to ensure that the NHS App is widely available across general practice by the summer of 2019 and people can sign up and use the NHS App as their digital front door to the NHS, consigning waiting at the surgery door to history, where it belongs.
Tara Donnelly, Chief Digital Officer at NHS England