A few months back, we introduced the NHS.UK alpha, a project to set the vision for NHS.UK and a plan for next steps.

The first 12 weeks of that project are now over (it’s felt a lot longer!) and we’ve spent the last few weeks going around the country presenting what we’ve learned and getting feedback.

We’re really proud of what the team has achieved in such a short time. We saw for ourselves the power of a cross-system team able to leverage both digital and health and care system expertise. We saw the power of deeply understanding user needs and the cutting edge prototypes that flowed from that understanding.  And we got tonnes of value from working in the open, making it much easier to draw on the widest possible expertise and experience.

This blog summarises learnings and next steps, based on our detailed vision and plan.

Read the transcript

What we learned

The opportunity for the health and care system

The last 12 weeks has confirmed to us that the opportunity to improve the public’s experience of health and care digital services is huge. It’s far greater than just buying more technology or putting paper-based services online. Digital will be fundamental to delivering the new models of care and meeting the challenges set by the Five Year Forward View. In the context of our project, we saw opportunities to:

  • reduce pressure on care services – we learned that there are over 30,000 pages on NHS websites advising people to visit their GP. But research suggests 1 in 6 GP appointments would be better served elsewhere – we saw a real opportunity to connect people directly to the help they need, first time;
  • improve the efficiency of care – face-to-face interactions are – and will remain – fundamental to care. But there are many other interactions like booking appointments and picking up prescriptions that could be made cheaper and better. Digital take up of those interactions is less than 10%, presenting a huge opportunity increase take up and efficiency;
  • increase quality for all – we saw that while trust in the NHS is high, the online experience doesn’t always match up to that quality of care.  There are over 3000 websites on the NHS.UK domain but – as we were told by digital teams – no consistent standards or practical support. There are great digital services out there – particularly locally – but often despite, rather than because of us.

The opportunity for patients

Our project was grounded in understanding the needs of patients and front-line staff, because designing services with that understanding is key to making services people will actually want to use. We learned that:

  • Digital is desired people want the NHS to be digital where it can and should be digital
  • Patient experience is a journey around which we can design services – we built up an understanding of how patients themselves experience the journey through health and care for several long-term conditions. That allowed us to identify different opportunities across that journey, for example the real opportunity to help people adjusting to a new long-term condition where there might be shock, denial and an overwhelming volume of new information. We then prototyped and tested possible ways to address that opportunity;
  • People want fast, practical, real-life information and services. People told us that they wanted fast, practical information that fits in with their busy day-to-day lives. They told us they wanted to know about actions and next steps, and we used eye tracking to see for ourselves how people ignored dense content.
  • Personalised information can be motivating. Our diabetes planner prototype taught us how people value personalised information. We saw how they absorbed information better in the context of taking action. Everyone with whom we tested the prototype wanted it – not surprising given people told us they currently have to carry around paper folders to navigate the complexity of their appointments.

What we learned from others

During the project we also talked to patient representatives, clinicians, local government, digital inclusion organisations and the third sector. We heard from over 200 people but know we need to talk to a lot more.

NHS and local colleagues wanted clarity on where NHS.UK is heading, what will be delivered and when. Those delivering digital services wanted it to be easier to do the right thing – rules and standards supporting delivery and more sharing rather than solving the same problem multiple times. Clinicians were positive about the potential for improving online services, but wanted reassurance that these wouldn’t make their lives worse. A key lesson for us was the value of involving clinicians throughout digital projects, not just at the end – continuous clinical involvement allowing us to continually improve our delivery.

NHS.UK will connect people to the care they need

All those learnings have reinforced to us that NHS.UK’s key role should be directly connecting people to the care and information they need. That might sound obvious but all too often we saw people having to understand how the health and care system works to be able to get what they need (and not being able to access certain services online at all). We see NHS.UK working with other services and other teams to ensure that the public’s experience is consistent and high quality, regardless of which organisation is providing it.

We see NHS.UK helping to:

  • bridge the gaps between services, information and organisations
  • work for everyone regardless of their digital skills
  • give people autonomy by providing people with the right tools appropriate to the right phase in their care
  • provide a personalised experience
  • earn trust by signposting people to the best information regardless of who provides it
  • support professionals so that they can serve patients not process

This is a bold ambition. To do it we’ll need help and support from across the health and care system and beyond it. We also know we can’t do this all overnight.

In our next 12 weeks, we’ll be working on the following areas:

  1. Providing people with more relevant, personalised and action-focused information

We’re going to work with NHS Choices as well as other information providers to test what we’ve learned about content with a view to creating a content strategy for NHS.UK.

  1. Connecting people with the services they need, when they need them

We’re going to start by working with a few GP practices and other programmes to improve appointment booking. Appointment booking accounts for 3 out of every 5 transactions that people have with the NHS, so it’s really fundamental to how healthcare is delivered.

  1. Sharing practical guidance and reusable assets that help teams to deliver better digital services

We’ve got an opportunity to dramatically improve the quality and takeup of digital services by giving teams the tools we know that they want. So we’ll start by creating a basic guide that will provide some practical pointers to enable digital teams to provide digital services.

We’ll also be doing two other things. First, extensively engaging across health and care – we know we still have lots to learn and more thinking to develop to create an offer that truly reflects our health and care system. Second, preparing to scale up the work to deliver NHS.UK in practice, supporting and working with talented teams across the health and care system.

Please do give us feedback below, look at our evolving alpha at alpha.nhs.uk or have a look at our prototypes.

You can also see the slides from the show and tell events.

Transcript from the film

Helen Rowntree, Head of Digital Services (NHS England):

The Alpha for NHS.UK is a new way of us designing the strategy for public-facing digital services. We’ve convened a team of experts from across health and care, from digital services, from the existing system to understand forensically what users need and to develop a strategy which is based around those user needs for what we want NHS.UK to deliver in the future.

Adam Bye, Deputy Director Digital (Department of Health):

When we think about users we are thinking about patients, but we are also thinking about clinicians, practice managers and others who are impacted by the online offer that we provide. What we’ve actually been doing is looking at what users need by investigating medical condition areas and those have been type 2 diabetes and mild to moderate anxiety and depression. We’ve been doing prototypes around appointment booking, how you might book a GP appointment. We’ve been doing prototyping around adjusting to a new condition How might digital information better joined up with services help you.

Helen Rowntree:

We’ve learnt a number of things so far. What users want, and actually what clinicians want as well, is practical, action-orientated support and guidance. If you’re diagnosed with diabetes you want to know what check ups, what appointments should you be having with your diabetes specialist nurse, what should you be doing at home through diet, through exercise to help manage your condition. There will be patients… situations where actually you do want a lot more detail and I think there, there’s an opportunity for us to guide people to some of the resources that already exist out there.

Adam Bye:

Working across boundaries, working across the health and care system has allowed us to really utilise the expertise and the experience of people within the health and care system and real digital experts and is allowing us to come up with – I think – a much better outcome.

We have temporarily disabled the comment functionality whilst we make some technical updates. In the meantime, we’d love to hear what you think about our work so tweet us @NHSDigital using the hashtag #NHSTransformationBlog or get in touch at england.digitalhealth@nhs.net.