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NHS England - Transformation Directorate

Supporting people who are vulnerable, isolated or supported by the social care sector

Iain O’Neil, Digital Transformation Director, provides an update on some of the work that is being delivered to support some of our most vulnerable and isolated citizens. This includes work to help care home residents, staff and providers stay connected to loved-ones and health services.

As we are all aware, COVID-19 has placed significant pressures on the NHS and  also on social care and those who are isolated as a result of social distancing. From the outset, NHSX has been supporting society’s most vulnerable groups as part of our core response to the outbreak. Over the past 8 weeks I have been privileged to lead the NHSX Vulnerable, Isolated and Social Care (VISC) Cell, set up to identify and deliver digital solutions to help. 

We have had to find new ways of working that somehow combined the need for speed with the need for good. There have been some lessons which I hope we will learn from for the future and I will write about some of them soon. We have had to adjust our usual delivery timelines and processes - whilst still trying to find or build solutions that meet people’s needs. Needs that are continuously developing. In the early days, supermarkets were empty and videos were shared of people fighting over toilet rolls. We worked to enable health and care staff to access priority shopping at some of the major national supermarkets. Other challenges we have faced are more fundamental, like improving connectivity in care settings - in order to allow digital services to be used. 

To respond to the threat of the pandemic we also had to grow our team significantly and onboard new team members from across Government and industry, to create a collaborative team with everything from user researchers, service designers and delivery managers to policy experts, partners from industry, clinicians and local government experts.  As a team we are focussing on both the immediate problems to hand and embedding long-term positive change for the future. We hope our work here will lay the foundations for improved technology use in the sector. If we ever find ourselves in a similar situation in future we need the sector to be more digitally-enabled. 

We have taken a people-centered approach (with the support of our stakeholders including the LGA, the Care Provider Alliance, CQC and many others) to identify those groups for whom we can have the biggest impact. This has included residents of care homes, recipients of home care, carers, the ‘shielded’, older and vulnerable people who are self-isolating but not shielding, and the NHS and care workforce. In the early days it felt like firefighting as we responded to whatever situation was emerging. In addition to supporting efforts to address immediate workforce challenges, for example, by commissioning an online service that has supported the  recruitment of 750k NHS volunteers and streamlining communications to the frontline, our work is now structured around three identified user needs:

  1. Keeping people connected
  2. Getting people essentials
  3. Keeping people mentally healthy

During the ‘rapid response’ phase we were able to deliver some new products and services into the sector and accelerate the uptake of some important existing ones. So far we have:

  1. secured priority food delivery for up to 1 million social care staff and 1.5 million NHS staff and helped to establish a dedicated website through which 1,000 food boxes have been delivered to NHS staff.
  2. launched an SMS service for those who are clinically extremely vulnerable and are self-isolating due to pre-existing health conditions, issuing  9,371,201 SMS messages to date.
  3. supported the rollout of NHSMail to more than 11,000 care settings enabling better communication with their local health services. 
  4. piloted the use of Facebook Portal, with 2050 devices set to be  deployed across several care homes, hospitals, hospices, learning disability and autism and supported living settings in England. I was lucky enough to ‘virtually visit’ with a 103-year-old care home resident who said she “knew nothing about technology” but had been using the Portal to speak to her family during lockdown.
  5. launched the TechForce19 challenge, awarding government funding of up to £25,000 to 18 innovators with digital solutions that could help those who are particularly vulnerable or isolated as a result of coronavirus. These innovations - which among others, could help expectant and new parents, people with cancer and those with social care needs - are now receiving support to test their solutions, so we can understand the potential and scope for their deployment at scale.    
  6. identified digital solutions to enable those who are vulnerable or elderly to be monitored remotely by family, friends or care professionals from within their homes, these will be tested soon.
  7. worked with our cross-government colleagues and the telecommunication industry to identify connectivity offers for the social care sector. Negotiated broadband offers to enable care homes to boost their connectivity and support the virtual consultations needed for residents or to access important information and services like the PPE ordering portal.

We are continuing to build on our successes through a number of high-priority projects. These include:

  1. a rapid discovery to explore the role of digital tools in enabling vulnerable isolated patients to request, receive and take their medicines in a safe, timely and clinically appropriate manner
  2. close working with our industry partners and the social care sector to: 
  • understand how digital solutions can support  vulnerable and isolated user groups whose needs are not currently being met;
  • ensure that social care providers have access to both the technology and internet connectivity they need, to care for their most vulnerable and isolated patients.

As mental health awareness week gets underway, I want to mention our work with the Digital Mental Health team. Keeping people mentally healthy is an important focus of our work across this cell. We are currently looking at how we can support the mental health of children and young people. As a father of two children, I am aware of how confusing and hard these turbulent times are for young people and the need to support them to develop the skills that will build their emotional resilience.  We are also looking at digital tools to support other user groups including adults in crisis, and adults experiencing anxiety and depression. On this note, I will finish with a renewed call for suppliers to get in touch and find out how we can work together in providing digital mental health support to those in need.   

As we transition slowly from a ‘rapid response’ phase to a ‘sustained change and transformation’ phase, we want to engage with innovators who have the solutions to answer some of the problems that we are trying to solve. We are keen to work with organisations who are already doing great work in this space. If you think that you can help then please reach out to us at