When people think of NHS Digital, they generally think of IT systems, data and cyber security. What they might not think of is patient care. But making a difference to patients and NHS staff is what gets me and my colleagues at NHS Digital out of bed every morning.
Whilst we might not be by the patient’s bed side, in their GP surgery or in their home when their community care worker visits, the technologies that NHS Digital deliver and the information that we process are with that patient every step of the way.
Imagine an NHS where patients are triaged to the right place for their care; where clinicians have the information at their fingertips to deliver the right treatment; and where information moves smoothly with the patient as they present at different parts of the NHS. Digital can deliver that.
From cradle to grave, the products and services that we deliver touch the lives of everyone who uses the NHS. And a bit like electricity or plumbing, patients and staff might not notice it is there, but they would feel its loss if it wasn’t supporting them every day. We have a role right through the system – from self-care and prevention of illness, right through to patient discharge.
The vital role we play in patient experiences is why we, working with our system partners, established a programme of work to make sure that NHS Digital contributes as much as it can to the smooth running of the NHS during times of peak demand, such as winter.
Working holistically across our whole portfolio, rather than focussing one particular service or function, has been a new approach. It has meant that we have been able to make a number of small changes to several systems that, when added together, will hopefully make a difference to both patients and NHS staff this winter.
We have been working closely with clinicians and system leaders to understand the priority areas where digital can support the NHS during its busiest times.
Obviously, world-class data and intuitive technological solutions can’t create new capacity, but what they can do is free up existing capacity, meaning that doctors and nurses can spend more time on patient care.
We all agree that the time of our doctors, nurses and other health and care professionals is best spent with patients rather than on paperwork, so how can digital support that aim?
Firstly, we focussed on the continued transformation of NHS Choices, which is one of the first places many patients go for information. Choices is one of the most popular health information websites in the world and this trusted service is a key plank of our work during winter. We have used it to signpost patients to the right services, to provide pertinent and timely self-care advice and to encourage responsible and appropriate use of NHS services. Choices has also been the main web and social media channel to support the ‘Stay Well this Winter Campaign’.
Next, we focussed on NHS Pathways, the technology behind 111 services, which handles around 14 million calls each year for advice, guidance and to be triaged to the most appropriate service.
A significant number of 111 calls are about repeat prescriptions, especially at the weekend, so we have been working hard to introduce the ability for 111 clinicians to use the Electronic Prescribing Service to directly issue prescriptions, rather than triaging to the patient’s GP. They will also be able to directly book patient appointments in integrated urgent treatment centres and out of hours GP services, saving time for both patients and doctors.
Another way we are reducing demand on 111 for repeat prescriptions, is to make it easier for GPs to electronically sign a batch of prescriptions in one go. This means that they can sign up to a year’s worth of prescriptions with one electronic signature, making repeat prescribing a smoother process for both GPs and patients.
We have also worked with NHS England to pilot 111 online services where patients use a web site or mobile to follow a guided self-triage receive advice. If they require clinical assessment, they are linked directly through to local clinical assessment or other services (including in some areas dental). NHS Digital has developed a product which was piloted in Leeds and is working with CCGs to choose and deploy the 111 online product that is most suitable for them. We are working with colleagues across the NHS to increase the coverage to a wider population that will be able to use a locally relevant and tailored 111 online triage platforms.
NHS Pathways is also used to triage calls that may require ambulances. The pathways have been amended to reflect the changes to the ambulance standards meaning call handlers have slightly longer to asses each call, but making it faster to identify those calls that are most urgent.
During the winter months NHS Trusts provide a situation report to NHS England, which includes crucial information about service availability. Over 2017 we have worked with NHS England and NHS Improvement to automate and reduce the burden of this daily report. This new system will also allow experts to better understand demand over winter, as real-time data will provide an accurate daily picture, on a national and local scale. Better information means better care.
Another couple of projects which have been running all year but will support this winter, are the campaign to add additional information to the Summary Care Record and support for pharmacies to sign up to NHS Mail.
The additional information on the Summary Care Record (SCR) means that doctors can work with patients to add a range of useful information, such as end of life care wishes or ongoing medical issues on to the SCR. This can provide essential information to care givers, particularly in an emergency. It also supports pharmacists to provide the best levels of care as it enables them to understand more about a patient’s medical background so that they can offer appropriate advice.
This year we have supported 78% of pharmacies to adopt NHS Mail, the secure email platform for health and care. This means that Urgent Care settings can now send secure patient information to pharmacies via e-mail avoiding a previous fax or telephone call.
This is just a taster of the new services we have implemented. Another major job over the next month or two is to work closely with the sector so that health professionals know which services are available to support them and how to access them. We recognise that one size doesn’t fit all and we are committed to continuing to work across the whole system to develop new solutions.
Our work on this topic has also thrown up a raft of other ideas which we will be implementing over the current year, ready for winter 2018. We will be talking and developing ideas with NHS organisations, industry and partners such as NHS Improvement and NHS England. We need to continue to support of health and care staff to make it a reality.