Archive for May 19th, 2011|Daily archive page

Servicing the Health Service

Here’s an interesting article from a perspective inside the NHS about my current project ‘Diagnosis Live from the Clinic’ and how it relates to the necessary reform of the NHS and the prerequisite innovation around its service delivery. It is written by Sophia Christie, Chief Executive of NHS Birmingham East and North, who is on assignment to the Department of Health, and was published in the Health Service Journal at

Wired in: digital service delivery can put healthcare into the home

The success of new technologies in major sectors such as retail and travel has put control and convenience in the hands of the consumer. Why then is the health sector not thinking “digital by default”?

Over the last decade, service content and delivery in travel, banking and retail has made a radical shift to the phone and the web, at the greater convenience and control of the consumer.

With this as the context for the rest of our lives, using the health service is becoming an increasingly frustrating experience for many people. In 2009, there were 450 million clinical interactions in the NHS, costing £42bn. Face-to-face interactions made up 84 per cent of the activity and 98 per cent of the cost. Costs and use have continued to rise, but proportions of face-to-face activity have remained steady.

“Digital by default” may have been adopted as a design principle across government, but in the NHS we don’t think to offer contact other than as face to face, even for administrative activity. Much of our contact with services is more transactional.

Recent discussions in response to the white paper and consultation on the information strategy have highlighted three goals, which should underpin the relationship between the NHS and the citizen if we are to sustain our position as dearly beloved British institution with a new generation of users:

  • People should feel in control of their health and care, as citizens and members of communities;
  • Accessible, accurate information should support informed choice and greater safety;
  • Services should be multi-channel to enable convenience, efficiency and effectiveness.

The three are clearly inter-related; we are unlikely to feel “in control” if we cannot routinely access information about our own care, or have to reorganise our working day for the convenience of the outpatients department. The NHS has a track record in the adoption of new clinical technology, but we need to apply this innovation to the process of service delivery.

On 25 May, a new series begins on Channel 4, Diagnosis: Live from the Clinic. Produced by Maverick TV, it builds on the success of the Embarrassing Bodies series and the groundbreaking “NHS Local” digital service they developed with NHS West Midlands. The series will feature live consultations with doctors using Skype to support discussion of a range of minor and common conditions.

Channel 4 is set to expand its audience into a slightly older, more family oriented group than the Embarrassing Bodies viewers. That series was backed up with an increasingly interactive and popular website, where viewers have been able to link into self-tests for a range of conditions, and signposting on to services.

Maverick reports that in two months the My Healthchecker app has been used 650,000 times, and the website recently passed 10 million visits.

Diagnosis: Live from the Clinic proposes to go further, supporting individual consultations on the site after each programme, based on NHS Direct algorithms, with the potential to link to NHS Direct as appropriate. The service has been able to schedule its workload in anticipation of a surge of interest in certain conditions following each broadcast.

The use of Skype will cause us to reflect on why we don’t routinely plan for these types of consultation, or exploit the potential of text and email for queries and routine communications. We need to understand those who are digitally excluded, but in 2009 more than 80 per cent of adults had a mobile phone, and 31 per cent of these had web access. Meanwhile, 73 per cent of homes have internet access. There is a huge opportunity here for technology to support the home as the hub of care.

Some situations will require face to face, but opening up alternative channels for more transactional activity will release time and space for those who really need that. Older people are the lowest users of the internet, but the fastest growing group, and their children and carers are web savvy.

Policy in this area is still developing, and will rightly be subject to lively internal and public debate. But our public are changing, and if we cannot serve them effectively, others will do it instead.

{courtesy of the Health Service Journal  }

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