Tag Archives: 2020 Digital Roadmap

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Digital Engagement and Collaboration

Public Service to be saved by digital engagement?

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Using the Devon Local Authority area and demographic as a model, an assessment of this authorities annual social and economic benefits potential for public service digital engagement with citizens has currently reached a staggering value in excess of £2.4billion.

Realisation of these benefits will require the digital solution implemented achieving a true transformation of the current service delivery model, certainly one that services a more pro-active and well-being orientated approach to health and care requirements.

As the NHS England – Five Year Forward View strategy states “we now want to accelerate this way of working to more of the country, through partnerships of care providers and commissioners in an area (Sustainability and Transformation Partnerships).”

The key opportunity is the education and empowerment of the population through digital engagement solutions, the strategy goes onto offer;

“Working together with patients and the public, NHS commissioners and providers, as well as local authorities and other providers of health and care services, they will gain new powers and freedoms to plan how best to provide care, while taking on new responsibilities for improving the health and wellbeing of the population they cover.”

Critically however, digital engagement cannot only be about the NHS and it’s services, these are in essence after the fact and only engaged when you have a problem, the focus needs to shift to social care, and the up-front engagement that occurs with people with the potential to develop health concerns, the primary deliverable has to be about pro-active engagement that services better and more timely interventions and thus delivery of a wellbeing orientated focus.

Carers and Cross Service Collaboration is Key

Aiming for a family / carer orientated engagement approach at the core of any solution, implemented in a way that facilitates much improved cross service collaboration between public service functions, the Devon social and economic benefits to be obtained across service functions presently assessed at: health and social care unsurprisingly achieving the most significant benefit of circa £2.1bn, followed by Education at £151m, Criminal Justice at £100m and Welfare currently coming in at around £74m. With benefits research still underway it is very likely these values will grown by as much again.

A good proportion of these benefits would involve the realisation of cost savings and efficiency gains within each of these service sectors, and potentially at a scale that would make for a significant contribution on top of current sustainability and transformation plans. Given the maturity that exists in digital engagement technologies widely available today, perhaps the timeframe for achieving delivery of these benefits need not be too far away!

Troubled Families a Key Enabler

Whilst the NHS inevitably addresses requirements for improving use of systems and flow of information through the “Global Digital Exemplar” and further exploration and development of the “New Care Models” working with vanguard organisations and initiatives across the country. The more significant opportunity for transformation to a wellbeing orientated digital engagement approach is perhaps better defined by the Department of Communities and Local Government (DCLG), “Troubled Families” initiative (now in a second phase of delivery).

The fundamental differences between the NHS and DCLG approaches, is that the NHS is mostly geared to addressing issues once they have materialised, whereas local authority Social Care service provision in particular is being guided to becoming more pro-active in its engagement, through aspects such as the “Early Help” services targeted in schools to identify children at early stages of need for support, through to supporting adults to live independently and well.

The case for local authorities being the focal point for digital engagement with citizens is strong when you take into account that it is responsible for other key services that affect an individual’s wellbeing, such as education, housing, inclusivity in forms of transportation and access to digital services and other investments in local infrastructure to improve access to employment, all very significant in terms of servicing positive outcomes for individuals.

When we acknowledge that the issues and challenges the public service faces in trying to meet our needs are seldom caused by one single event or distinct set of parameters. We already acknowledge that deprivation and poverty are key issues affecting health and wellbeing, that poverty is also linked to crime, that mental health issues in adults affects the health and wellbeing of children, but that there is also a growing awareness of a significant gap in mental health support for children directly.

There is in fact a large body of work out there that has looked at cause and effect of different social dynamics and more importantly the benefits potential to be obtained from tackling negative social and wellbeing issues. Whilst some of this work warrants updating the models employed as a means of qualifying social and economic costs and thus potential in benefits remains good for today’s purposes.

Focus for Digitisation Strategy and Plans

The key to the client side digital engagement is to consider what can be utilised quickly to deliver benefits early, essentially adopting an agile and incremental approach to delivery. For example, much focus is being given to making patient medical records available and accessible online, but many struggle to appreciate what value is access to medical records going to achieve?

For those in the population that have an issue or pre-existing condition that perhaps is not being coped with or managed very well, wouldn’t just access to information and guidance that was more focused and capable of empowering the individual, and more importantly their personal care circle of family and friends to care better be a start.

Presently, Carers UK has approximately 6.5million registered carers*, and NHS England have identified 1.4 million unpaired carers providing fifty or more hours of unpaid care per week that they wish to better reach out to with engagement solutions, but are they right, is there only that many that care?

There are in fact over 40 million people aged between 16 and 74 years, many of whom have older parents or children under the age of 16 they care about, isn’t it this whole group that the public service solutions need to be setting themselves up to engage digitally with? We all care don’t we?


There is massive potential for social and economic benefits to be obtained by improved public engagement using digital technologies and tools, from a health, care and wellbeing perspective where services are under immense resource and funding pressures, this engagement and delivery of benefits cannot come too soon.

Critically however, whilst there is investment being made, most of it is presently being targeted at addressing shortcomings in inter-organisation information workflows and operational systems integration, which beneficial and therefore worth doing, but by comparison very little investment is being made on the wider opportunity that is direct digital engagement with citizens.

The key to securing the massive benefits potential that exists can only be achieved with a true citizen centric focus on their needs, and the subsequent servicing of this need with a digital engagement solution that services collaboration between carers, regardless of who these individuals are, or how they are funded, or who they work for.

Equally there is no reason why the solution cannot delivery short to medium term efficiency and cost saving benefits arising from better engagement of those with pre-existing long-term chronic conditions, whilst also and at the same time provide the framework for longer-term benefits from early help and intervention on children and adults with emerging issues. To establish a wellbeing orientation that over time benefits society through pro-active engagement that helps people to maintain healthier lifestyles.

Critically, if we are going to truly transform health, care and wellbeing for all and maximise the benefits to be obtained from a pro-active and wellbeing orientated solution, then maybe we need to move the focus from after the fact NHS and health, to local authorities and social care and what should be a pro-active and universal focus on concerns that have the greatest effect on citizens wellbeing and health!

Then and only then, will we see a transformed service delivering social and economic benefits of the scale mentioned at the outset of this article, which when extended beyond Devon and across the rest of the country would quickly amount to £10’s of billions for the UK economy.

* https://www.carersuk.org/news-and-campaigns/press-releases/facts-and-figures

** https://www.england.nhs.uk/commissioning/comm-carers/carer-facts/

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Digital Patient Engagement

Digital Patient Engagement or Participation?

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By 2018 patients should have access to their medical records online. By 2020 this should have evolved into a digital patient engagement solution as health and social care achieves “paperless at the point of care” working practices. But is it just about engagement, or should we be preparing more for active participation and ownership of health concerns and issues.

Digital Transformation of Service Delivery

Most concern I have had shared with me is that the NHS 2020 Digital proposals are still not making adequate plans to exploit the opportunity provided by Internet of Things (IoT), Wearables and Assisted Living technologies at the earliest.

The current focus is being given to resolving internal data integration / flow issues which do need resolving. Acknowledging that there are clinical and information governance concerns as well as care benefits needing to be addressed. But whilst these in the main deliver service quality and improved workflow for people already in the system. Their support for delivery of a transformed and more sustainable service delivery model is limited.

Transformation of the service delivery model and improvement in future sustainability of any significance for health and social care, is largely dependent on the digital patient engagement (or better – participation) and capabilities delivered by technology innovation incorporated to support pro-active participation. The opportunity and benefits potential is significant, when the service delivery model evolves from one that is largely re-active and after the fact, to an alternative and more sustainable pro-active and well-being orientated model.

These benefits are only going to be enhanced by any ability to integrate and exploit technology innovations and automation delivered by IoT, wearables, assisted living and health and care / well-being monitoring innovations and solutions. Adoption of these technologies will increase as they become more capable and with this increase the range of proactive information and data supporting opportunities for further cost saving interventions and / or preventions will also increase.

Data Governance and Management

Consequently the long-term objective of any digital health and care engagement solution, should be about providing the means to help us to live well, and if we are unfortunate enough to have one or more long term chronic conditions or disability, to be empowered to manage our situation as much and as well as we can. It is never though just about us and individuals, we pretty much all care for or are cared by somebody else. So we should be able to gain access to others information too.

All of the above inevitably leads to an explosion of information becoming available, and of the most personal and sensitive kind! Consent, data ownership / management quickly become the most important considerations in any engagement solutions design that needs to be open to accommodate future technology innovations delivering on the pro-active health and well-being opportunity.

It is, however, widely acknowledged that local developments and deployments are not being guided by core common engagement and consent model or universal data flow / integration standards, of concern consequently, the progress to a better model of health and care continues to evolve with massive variations in capability delivered differently across regions.


Until the need for core common standards on data consent, governance and interoperability are fully addressed, then the participation of patients and citizens with the digital solutions will likely remain inhibited, subsequently the opportunity to achieve the £20b of universal benefits from a transformed service delivery model by 2020 will very likely remain an elusive and much less assured target that it could otherwise be.

References and Links

Article produced in response to news item Health wearables firm Fitbit holds talks with NHS published by Digital Health



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