Keeping up with tomorrow’s world

Following new pilots, commercial product launches and many rumours, the Chief Digital Officer unpicks the confusing mix of apps and digital offers currently in the news:

For many of us using digital tools is an everyday occurrence whether that is online banking, booking holidays or posting on social media.

In health, most of us don’t do this but digital apps and products have enormous potential to empower patients to take control of their healthcare and improve the services we can offer.

That’s my aim and the aim of the teams across NHS England and NHS Digital – to provide digital services, alongside and integrated with traditional services, so people can take control of their own health and we can increase access.

Part of this work is basic modernisation, ensuring patients can access free wi-fi from their hospital bed or in the GP waiting room, and part of it is more advanced, developing, commissioning and trialling new apps and online services.

It is when we talk about apps that it can become confusing.

With so much innovation, multiple NHS bodies and a fast-paced commercial market, it can be difficult – for all of us – to understand who is doing what.

The NHS is involved in some, but not all new app innovations. And when I say the NHS, in some cases it is NHS England on a national level, in others it is local NHS bodies innovating and, in some others, it is even individual General Practices.

At a national level we are running two pilot programmes in partnership with local NHS organisations and we have made £45million available to help all GP practices partner with their preferred supplier to offer online consultations – further boosting patient access to GPs.

Our NHS 111 Online pilots went live in four areas earlier this year: in Leeds with Pathways (a solution developed by NHS Digital); in the West Midlands with; in Suffolk with Expert 24; and in North Central London with Babylon.

In these pilots patients can access online triage tools, self-care advice and information on local health care services, or the app/website directs them to seek further urgent care advice via telephone or a face-to-face consultation.

The four pilots demonstrated that transferring NHS 111 services online was safe, and that right from the start about 6% of users would switch from the phone service to the online option. The original pilots have been extended and other areas are now looking at offering an NHS 111 online service too.

With the knowledge that NHS 111 Online is safe, in September Health Secretary Jeremy Hunt set a new challenge for one NHS app by the end of next year to let all patients:

  • access NHS 111; access their healthcare record; book a GP appointment; order repeat prescriptions; express their organ donation preferences; express their data sharing preferences; express their end of life care preferences; and access support for managing a long term condition.

In response we launched our first NHS Online pilot in south east London with NHS Bexley CCG and eConsult; and we are talking to other companies about further NHS Online pilots in different parts of the country.

Through the NHS Online pilot in Bexley patients can: consult with their GP via an online consultation, access NHS Choices self-help advice, book an appointment with their GP, order repeat prescriptions and view their health record.

Whilst our two national programmes are ongoing, various companies – some of whom are involved in our pilots – are working with local NHS organisations on their own projects.

For example, our partner in the Bexley pilot eConsult is working directly with over 350 GP practices to offer online consultations.

Additionally GP at Hand, a General Practice in West London operating under the standard GMS contract, has partnered with software house Babylon to offer online services to patients registered at the practice, such as video calls with a GP. They have also opened a number of sites across London where patients can see a GP face to face, using the GP Choice policy to attract patients from outside the practice boundaries.

We are watching these and other locally led initiatives with interest ensuring, where relevant, they feed into our wider strategy.

Of course there are many more companies working and innovating in this space that my team are continuing to engage with as we endeavour to improve the NHS’ digital offer. In the coming months, as we move from pilots to wider roll out, we will be developing frameworks and guidance to ensure the NHS and its patients can safely benefit from as wide a range of these innovations as possible.

We believe, if we get this right, digital technologies can help us future proof the NHS we are all so proud of for another 70 years.

Juliet Bauer

Juliet was previously NHS England’s Chief Digital Officer. Tara Donnelly is due to take over the role of CDO at the beginning of February. She will oversee a portfolio of digital services including the NHS website, NHS ‘assured’ apps library, and the development of digital services to empower patients to better manage their health and care, including long-term conditions such as diabetes.

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  1. Jaika Witana says:

    Are there any Health care apps currently in use by patients which are commissioned by CCGs?

  2. Kassander says:

    What about the millions who don’t have access to computers?
    Mainly the poor and the oldest will be the neglected ones – as usual.

  3. Kassander says:

    This really is “small beer”. OK, being able to access free WiFi in hospitals is a great move forward from the previous rip-off charges for outsourced access to telecoms & TV.
    Where are the REAL breakthroughs using cutting-edge IT/AI?

    What of the millions who don’t have access to computers and the internet from their homes & those who don’t have the required skills to access even the basic facilities being rolled out? In many cases these will be members of the groups who are already disadvantaged +/ those most needing access to NHS facilities.
    Essays such as the one above give a warm feeling but when examined are little more than froth.

  4. Nora Everitt says:

    This post celebrates four pilots that are being run by NHS Digital to provide advice Apps for the public to use, instead of going to their GP or for when a GP appointment is not available.
    However, three of these pilots are making company profits from being chosen to deliver the piloted App services and one of these pilot providers, Babylon, demands payment from patients for some, if not all, of the services they provide.
    None of this information is made clear to the public.
    I have some questions:
    1.Is NHS Digital a public authority subject to the Freedom of Information Act?
    2.How were the public involved in decisions about the commissioning of the pilot providers?
    3.Is their contract to provide these pilot App services with NHS Digital, or NHS England?
    4.Does their contract include appropriate safeguards regarding the use of patients’ personal information?
    5.Are these pilot providers required to prominently publicise any service costs to people before consultations take place?

    • NHS England says:

      Hi Nora,

      Thank you for your comment.

      I’ve passed the details on to our customer contact centre who will look at the questions and forward to the relevant team for a response. The customer contact centre may contact you to discuss in more detail.

      Kind Regards
      NHS England

      • Kassander says:

        However, because of the Tory Gov’t’s massive underfunding of the NHS you are unlikely to get a reply to your questions before this time next year.

      • Kassander says:

        No Reply?
        Poor Show!

      • Ruth Milsom says:

        To NHS England:
        I am very eager to read your responses to Nora Everitt.
        It’s approaching 3 months since Nora submitted her questions. Her queries relate to very serious matters and warrant your hastened reply.

        • Nicholas C says:

          A citizen, with legitimate concerns about corrupt privatisation of a publiv service, asks a question of a nominally public body and is referred to future contact by a “customer contact centre”. Never mind the fact they still haven’t got back, 9 months later. The above pretty much answers itself!

  5. Chris Frith says:

    I feel NHS Digital has gone beyond the challenge it was asked to do and has threatened general practice by encouraging “pilots” to allowing anxious patients to identify themselves and be tempted to move from their practices without the patients fully understanding and consenting to being part of a pilot. However I suspect these are not pilots which will be scientifically analysed and peer reviewed. In which case it is a new GP model for a subsection of the community which has not been identified as being at risk of poor health and will not necessarily benefit clinically. Mr Hunt asked for an app for every patient with a chronic condition not an app for every patient. There is a significant difference and in my opinion we should not be trying to run before we can walk.
    Dr Chris Frith @NHSaccess
    Former Digital Champion in NHS England’s Patient Online Team

  6. João Bocas says:

    It’s fantastic to see that innovations are finally filtering into the public through delivery healthcare systems.