I’m James, and I’ve been collating data about digital and healthcare services as part of the NHS.UK Alpha project. This post summarises what we’ve been working on and our findings so far.

Why we’re looking at the data

As you’ve seen in previous posts on this blog, we’ve been busy learning about the needs of citizens as well as health and care professionals and building prototypes to understand how to design services and information that meet those needs.

Alongside this work we’ve been trying to understand the size of the opportunity to improve the efficiency of NHS and care services by increasing the take-up and quality of our digital services.

Central government realised savings of £3.56 billion between 2012 and 2015 through digital transformation. During the last parliament, the government pursued a Digital by Default strategy, seeing take-up of digital services increase by a fifth in less than three years, while the average cost per use of a government service fell from £5.00 to £4.30.

The role of digital

Face to face interactions are – and will remain – fundamental to the provision of health and care. However, most people’s current experience of health and care is not just about time spent seeing clinicians.

Much of their time and effort is spent booking appointments, picking up prescriptions, waiting for letters and making phone calls. These interactions are not trivial administration; they are central to the quality and efficiency of the public’s NHS experience.

Making these interactions digital is not a silver bullet to make them better. But we know from our user research that where things can and should be done online, people want this. Therefore, we’ve been collecting data on the usage, quality and digital take-up of common interactions like booking and prescriptions.

We’ve used data from the GDS Transaction Explorer, which contains valuable information about some Department of Health services and combined this with data about services provided by the wider system.

What we found

We began populating key data for each service, including the number of transactions per year, the cost per transaction, and the percentage of these transactions carried out online. After crunching through the data, here’s what we found:

  1. Health and social care is huge

We identified 200 common interactions provided by the Department of Health, NHS or social care organisations and a further 50 services related to health and care provided by organisations in local or central government. From the data we have so far, we’ve found that these services handle at least 1.36 billion transactions/year.

For comparison, there are around 800 services across central Government handling 1.73 billion transactions/year.

  1. The top 5 services make up the majority of transactions

Here are the top five health care services we identified so far:

  • Prescriptions
  • Booking a GP appointment
  • Test results
  • Booking a referral appointment
  • Booking a sight test

These five services alone make up more than 90% of transactions (compared with 72% for central Governmental services).

Services Graph for Blog

3. There is a big opportunity to increase take-up

According to the data we have so far, less than 10% of health care transactions are carried out online (for central Governmental services, this is 78%).

Both these figures are likely to be overestimates as they are averages of the digital take-up data currently available. Those services without digital take-up data were not included in these averages, and we suspect have either no online equivalent or low digital take-up.

What does this mean?

There is massive scope for more health care transactions to be done online. Even though there are a huge number of services, just making a few high volume services better would make a big impact on everyone’s experience of health and care.

And as we’ve found already, booking is fundamental to health care – 3 of the top 5 interactions relate to booking.

Next steps

Building on the data we’ve collected so far, we’d like to be able to measure the impact of changes to services, using data to understand what works and how to improve the public’s experience of NHS.UK. This should be open data.

We’ve been thinking about how we can start to measure the quality, costs, performance and take-up of our digital services. We’ll be blogging over the coming weeks with more details on this.


  1. Comment from Mike Clark

    #nhsalpha blogs do not appear to show great understanding of social care, the wider care sector that impacts on health and wellbeing and also do not appear to relate to the big high cost items in the health and care system. Healthcare is at the most 20% of health and wellbeing. Yes, there is value in increasing healthcare efficiency, but booking an appointment does not necessarily mean improved health outcomes for citizens. (@clarkmike)

  2. Comment from Dan Sheldon

    Hi Mike,

    We’re acutely aware that the two areas we’ve looked at so far (diabetes and depression) as well as the services (appointment booking, GP registration, post-diagnosis support) have majored on health, rather than social care. We’ve got lots more to do to improve our understanding of the social care needs of the public and carers, and that’s on our plan for what we’re doing next.

    In reference to the above post, we’ve identified plenty of social care services but have found it difficult to find reliable data on number of transactions (partly due to them being delivered by 100s of local authorities / providers). Any clues on where to find some of that data would be really useful!

    I’d be interested in hearing what you think the big areas of opportunity for digital transformation are in social care?


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