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NHS England - Transformation Directorate

Taking stock of our pandemic digital innovation

In their joint blog post, Breid O’Brien, NHSX deputy director of digital health, and Linn Phipps, patient and public voice partner, reflect on the learnings from scaling digital technologies for people with long term conditions, as captured in Ipsos MORI’s independent evaluation, which was commissioned by NHSX in December 2020 and has been published today, as well as their learning over the pandemic and how it can be taken forward into the “new normal”.

The past eighteen months have been unprecedented in so many ways. We have lived through new ways of working whilst missing many of the things we took for granted. As we move to a more “normal” life, this is an opportune time to reflect and consider what we have learnt both about ourselves, and how we work within the post pandemic world. And, which of the new and innovative ways of working can – and perhaps should – become part of how health and care services work, and work with patients.

Breid: “Leading the Regional Scale Programme (RSP) has been my COVID-19 work story. It's been a privilege to work with colleagues across the country as they’ve worked to harness technology to provide new ways to support patients and service users at home. The use of digital technology has been a huge part of this COVID-19 story for all involved. Health and care staff have quickly adapted to providing more virtual care, and patients and service users have been supported at home for things they would usually have needed to travel to see a GP or visit a hospital. In many cases, people who would have been an inpatient in hospital have received that care in their home environment.

Now we need time to reflect and determine what we want to keep, and what, perhaps, we may choose to leave behind from this experience. This evaluation comes at a very timely moment, and provides us with good insights into what worked well and where we need to improve in the delivery of our RSP.”

Linn: “As one of NHSX’s patient and public voice partners, it’s been great to have the chance to be involved in this project. The team has been very receptive to ideas about how to highlight anecdotal evidence of the value of technology to patients, and how this enables patients, service users and their families and carers to self-manage effectively. It’s also been helpful to contribute to a focus on outcomes and learning, such as emphasising the importance of asking patients and service users to share their stories and experiences with us early on. As in many projects, it has proved difficult to gather the patient's view and more is planned in this area so we ensure that the voice of the patient remains at the centre of everything we do ''.

Breid: Key findings from the Ipsos Mori report, published today, show that by March this year, even under the challenging circumstances of the pandemic, all projects in our RSP had started using the digital platforms they’d procured using NHSX funding and had seen a level of user adoption from patients, service users, clinical, or care home staff. By June this year, 79,643 patients and service users had been onboarded onto the projects nationally. This number is 125,000 people supported at home as of August 2021.

The report also suggests that this success may in part be due to the highly devolved design of the RSP. This means that programme resources were directed to those projects which were considered by regional stakeholders to be most urgent, and capable of success. This approach is reflected in the highly varied activities, condition focus and technology solutions used across the 24 projects.

The evaluation looks at the programme through a broad lens and outlines many more findings relating to the people, process and technology aspects of the programme. It provides us with recommendations for aspects that we should include in other programmes seeking to utilise technology to improve care delivery.

It also provides us with recommendations to strengthen this programme. An example of this being whilst the evaluation team received extremely positive feedback from those who had used the Innovation Collaborative about how useful it was in supporting their scale efforts and learning from others, a proportion of those interviewed hadn’t heard about it. This demonstrates the need to consider additional communication channels for this information.

It is important that we use this report to take stock and respond to the recommendations. We are both delighted to say that many of the recommendations are already being addressed by our team, in collaboration with regional and local colleagues, but some are broader and will take a little more time. With the growing appetite from patients and service users to interact with the health and care system in the way that is best for them, and the opportunity that digital technology offers in terms of workforce flexibility, we look forward to building on the learning from this report to collaborate even more to support people at home. In addition we will be aligning this learning with the emerging findings from other related rapid evaluations, to really understand the overall impact and opportunity this model of care offers to improve patient care and clinical outcomes for the wider population.

You can find further information about the evaluation in the executive summary.