Monthly blog

Each month our digital innovation team, will review digital health advancements and explore whether or not they can help the population enjoy longer, happier and healthier lives. They'll cover a range of topics from apps to virtual reality and genome projects to artificial intelligence.

The power of social prescribing

 

Did you know that feeling lonely and loneliness can be as bad for your health as smoking 15 cigarettes a day?

In NW London the NHS are working to develop a digital social prescribing solution to make social prescribing an easy and safe practice for both GPs and patients. This is a fairly new approach for GPs, but one that I have personally seen the benefits of.

So what is social prescribing and how can it help?

Social prescribing is a way for GPs to help their patients, who are suffering symptoms caused by loneliness, by referring them to social activities or services in their community instead of offering only a medical solution.

This is my story of how social prescribing brought me back from the brink.

Me: “I think I am depressed!

My symptoms:

Mood: “Low. Not only is my mood low, but I have taken to listening to Adele’s entire back catalogue to make myself feel even lower. So I can really indulge in it

Anger levels: “Skyscraper high with accompanying short fuse. I have plotted the demise of the every person on the tube who breaths too loudly

Weight gain: “Extreme. I am getting fat just watching Bake Off. That is a lie, I am getting fat because chocolate equates to 76 per cent of my diet

Relationship with: “Mum/friends/colleagues/train crush*: Non-existent as have chosen to stay in and complete Netflix

*relationship with train crush is non-existent but for different reasons

Energy levels: “At my lowest moment, I opened the window next to the sofa I was sat on so my takeaway delivery man could hand me my take away without me having to get up.

“I decide to book an appointment with my GP after someone offers me their seat on the tube and I break down into uncontrollable tears. This cannot go on.

“I start by explaining that in 2017 I snapped my Achilles tendon twice and spent eight months on crutches resulting in the ‘Big Sit Down’ of 2017. With only one working leg I became too scared to go out and due to the length of my recovery time, my friends (rightly so) got on with their lives without me. It started the spiral, where I stopped going out/seeing people/looking after myself. But this cannot possibly be linked to how I am feeling now, right?

“The GP kindly informs me that she thinks I might be suffering from loneliness. It started with a lengthy stay at home where I only had one working leg and I didn’t go anywhere, and it continued to manifest itself after my leg got better. My GP goes on to explain that loneliness actually has a huge negative effect on your mental health, and therefore also your physical health and probably explains why I have been feeling depressed. I am not alone she informs me, there are nine million lonely people in the UK.

“The GP recommends searching voluntary sector or community services to find an activity I enjoy, where I could meet likeminded people. Maybe join a sports club or a book club. Something that once a week gets me out the house.

“I left the surgery feeling thoroughly underwhelmed and peeved that I don’t have a year’s supply of Valium. But maybe a GP with £1million of training may have a point. So I join a local running club and book into their beginner’s course. I even make a couple of new pals. I start running once or twice a week and call my friends to apologise for hibernation. We talk. It helps. Turns out that how I feel is very normal and completely ok.  I start looking after myself and stop binge eating share bag of Maltesers.

“My mood begins to lift and energy levels rise – some days I have more energy than the entire cast of Wicked.

“The point is sometimes your health doesn’t need to be managed by pills. Sometimes a social prescribing offer is exactly what someone needs to manage their health. We have to start accepting that social isolation and loneliness have a negative impact on health and there is help out there for you.”

Blog by Lindsay Topham - Digital Innovation Officer

November 2018

 

Are we there yet? 

 

Usually a question more commonly heard from the back seat of a car on a journey testing the patience of all, I'll be reflecting on where we are at on journey to a new and exciting place; the NHS’s use of digital technology to improve patient care.

Today, most of us use our mobiles to shop, bank and access news but now we can manage our health online too. Over the past few years a range of great measures have been introduced to improve access to NHS services, but for me the greatest digital innovation is GP online.

So why do I think it’s so great? GP online gives patients the ability to book, change and cancel appointments, order repeat prescriptions and view their health records all from their mobile phone or tablet. The service, which is available to all Londoners, can be accessed at any time, in any place and it's free to everyone registered with a GP practice in the UK.

Why is GP online so important?

The UK is faced with a growing, aging and diverse population which puts pressure on the traditional model of general practice. Practice staff are processing endless appointments, referrals and prescriptions, all of which impact on the time that they can spend on other important matters relating to patient health. 

Practice managers in surgeries with high patient registration for GP online services are reporting a great improvement in their administrative process and improved patient care as a result. 

There are also a number of benefits for those who lead busy lives; carers, parents and those who work. Being able to make and amend appointments at a time convenient to them, not having to go into the surgery to get regular repeat prescriptions and being able to access their health records or the records of people they care for, saves so much time. 

GP online is also great for patients with long term conditions. I have diabetes and use my GP online account to get my diabetes prescriptions and make appointments so that I can spend my time doing other things that are important to me such as spending time with family and friends. Ordering my prescriptions takes two minutes, literally!

Registering is easy, safe and secure. I’m not surprised that in a recent survey of those registered, 89% found the process simple to follow. 

So, are we there yet in terms of digital health transformation in the NHS? GP online is a great example that we are on track and that the NHS has embraced the innovations of the twenty-first century.  However, there is still some way to go, but like the reply so many parents give their little darlings: “Nearly there, just a little bit longer, please be patient.”

Digital Innovation Lead, Kwesi Afful

​June 2018

Artificial intelligence: Ready or not?

 

We’ve all heard the endless debates about using artificial intelligence (AI) in the NHS and rather than discussing the pros and cons of the technology, I'll take a closer look at whether or not the NHS is ready for full rollout.

To date, the NHS is slowly dipping its toe in the AI pond, with individual trusts developing new ways to use AI to improve healthcare and enhance patient experience.

A recent example of AI in NW London is online consultations – a fast and safe way to contact a GP.

Instead of waiting for an appointment, patients can fill out a simple online form, in the comfort of their own home and get a response from a GP in one working day!

Once the GP reviews the consultation form, they will book an appointment or offer advice on what to do next.

Isn't that brilliant?

Patients can describe their symptoms and ask questions about repeat prescriptions, sick notes and much more as part of this new pilot in Brent and Central London.

It saves patients and GPs time and is much more convenient than the traditional method I grew up with. Plus, it helps patients get medical information from a trusted source, instead of searching the internet trying to match symptoms to conditions. (Be honest, we’ve all done it!).

Are we ready though?

While I acknowledge the benefits for both staff and patients, I am very conscious of that fact that other areas of the NHS have much larger ambitions for AI and I’m not sure if everyone’s quite ready for that. For example, there have been recent discussions about robots carrying out examinations, which I feel may be a step too far for some people.

Let’s take into account that a large amount of the population in NW London is over the age of 50. So it will take them longer to get their head around using technology to manage their health, especially in communities where English is a second language.

Let’s take my grandma for example - or some of my aunts or uncles.  Getting them to forgo cultural beliefs and natural remedies and actually make a GP appointment, to talk to a ‘stranger’ about their health is hard enough, let alone using technology to access health services. ‘Lawd God!’ I can just hear my grandma saying and shaking her head, ‘I cyaan do dat’.

Ultimately the full rollout of AI in the NHS is dependent on behavioural change, support and training. We’ll first have to educate patients on why AI can be better to use and then provide training and support for staff and patients.

Luckily, we’ve reached a stage where AI technology can pretty much do anything we develop it to, the hardest part will be getting patients and staff to utilise it.

Sadly this is the case for GP online in NW London, where 95% of practices have just 10% of patients with GP online accounts. This tells me that despite being able to book, cancel and re-arrange GP appointments, order repeat prescriptions and view GP records, most people aren’t buying in.

So the issue is not the technology but perhaps how comfortable patients feel using it.

This is the exact problem that my team and I are trying to solve through the digital citizen education programme we’re launching. Our goal is to empower as many residents as possible to become ‘digital citizens’ - people who can confidently use digital health services to manage their health. To achieve this we will be facilitating one hour training sessions to teach people more about apps and digital tools.

So… to answer the original question, NHS staff and patients are not yet ready for full AI rollout.

To find more about the digital citizen education programme or take part, click here.

Digital Innovation Lead, Kwesi Afful

​July 2018

Is it time for smart health cards in the UK?

 

In a country where patient empowerment, General Data Protection Regulation (GDPR) and digital advancements are at the forefront of discussion, is it time for the UK to adopt smart health card technology?

Before you answer, just imagine…

…One card that fits into your wallet and holds all of your medical records and information!

Sounds great right?

Similar to the way you use your driving licence - always carrying it around and flashing it upon request. Picture yourself casually pulling out your smart health card and presenting it to health providers anywhere in the UK.

Should we have the same convenience when carrying and presenting our medical records and information?

In some countries the answer is yes. So far, smart health cards are being used across all of Western Europe (Germany, France, Belgium, Austria, and Slovenia) as well as Taiwan, Puerto Rico, Canada, Israel, South Africa and India.

There are lots of advantages of using smart health cards, for example they can be linked to existing health apps so patients can access their medical information at the push of a button. They can also be useful in an emergency as medical professionals can use a card reader to digitally ‘read’ a patient’s medical history to find out key medical information such as medication, allergies and personalised care plans. Patients can also have a digital copy of their prescription on their smart card which can prevent confusion being caused over the quantity or type of medication being prescribed.

What I like most is that the benefits aren’t only for patients. Smart health cards make storing and sharing patient information easier for healthcare providers because they have the ability to send and receive digital messages to and from different clinical systems and organisations and have a large storage capacity.  Medical information can also be ‘read’ more quickly, which saves time spent on administration tasks and can reduce administration costs overtime.

I think it’s safe to say that it wouldn’t be hard to introduce smart cards in the UK, because most people are already using apps and online services to manage their lives. In my opinion, smart cards would just be an addition to improving the accessibility of information.

However, despite the benefits, I don’t think it is time for smart health cards in the UK.

Not just yet anyway…

Not until we ensure that GDPR regulations won’t be breached and a robust security system is in place to prevent hacking or any other major security risks.

Once these security measures are implemented I’m confident that smart health cards could become an invaluable asset to members of the public.

Patient App and Patient Online Product Manager, Saira Arif

​August 2018

Virtual reality in the NHS: Are the benefits real...or virtual

Virtual reality in the NHS: Are the benefits real...or virtual?

A couple of weeks ago I attended an event which was hosted by NHS England. Events take place all the time; however, there was something different about this one.

The event was hosted entirely within a virtual world. Attendees were invited to use Virtual Reality (VR) headsets and create their own avatars (animated versions of yourself) and join in the debate about the use of Artificial Intelligence in the NHS. It was an excellent experience and I was able to ask a few questions and discuss some of the concerns that some clinicians have in north west London.

Aside from the novelty of seeing my avatar hover and speak to people, giving them virtual handshakes etc. Are there valid uses for VR within the NHS to actually improve patient outcomes and help the NHS become more efficient? Let's face it, if it's just an expensive, unproven tech option what’s the point? Let's look at a real world example that is happening in north west London area.

CNWL Grenfell Service

The tragedy of the Grenfell Tower fire happened over a year ago. Ross O'Brien, who is the Deputy Director for the Grenfell Health and Wellbeing Service, said that they had to 'change their conventional approach' when it came to supporting those victims and relatives properly.

The team used VR to encourage conversations around how they had been affected by Grenfell. They found that people were very receptive to a conversation immediately following the VR experience. A mixture of positive energy, adrenalin from using the VR itself and a sense of shared experience creates a level of trust and openness between clinician and viewer and encourages positive conversation. The team were then able to simply ask if people were from the local area and had they been affected by Grenfell, or did they know anyone who had.

Read the full post on how Virtual Reality can increase access to psychological therapies by Ross O’Brien here

Other areas where VR could bring untold benefits to patients and organisation include:

• changing wound dressings

• at the dentist

• assisting those that have had a stroke

• assisting those with early onset of dementia

• assisting those that have lost a limb to get used to a prosthetic one

• other mental health interventions

As was the case with the VR event that I attended, the potential to use VR to even change the way we view healthcare is immense.

The digital innovation and citizen team have a VR headset and we will be exploring potential use cases to try it in within NW London. We hope to do a pilot that will enable the organisation's to seriously review how it can benefit the two million residents we look after.

The benefits of virtual reality can be a reality, if done with a clear use case for it.

If you want to know more follow us on Twitter @digicitizennwl and myself @NHSKwesi for more Information

Digital Innovation Lead, Kwesi Afful

September 2018

Why we should all love LHCRE (pronounced Lycra) ?

Why we should all love LHCRE (pronouced Lycra) ?

Don’t worry... this blog isn’t about figure-hugging sportswear. Rather, It’s about a national programme that will impact every resident in England over the next two to three years.

Since the dawn of time, people in England have had an NHS patient record for all things health related and they have had a social care record for all things to do with social care and support (these are services often run by the council). Time after time news stories speak about the disconnect between these records, who can view them and most importantly how YOU decide how it’s shared with people who can help and support.

Health and social care systems don’t integrate and that is truly disappointing. This is where LHCRE comes in... this stands for Local Health and Care Record Exemplar. The LHCRE programme is being started in few sites across England where teams are creating the infrastructure to remove barriers and enable patients to take control of their information. In London we are one such team that is working to bring health and social care records together, to make access for staff and patients better, to provide joined up care and support when it is needed.

To get this right we will be holding engagement events to get resident’s views on how they can access the health and social care information that they need and when. Then we will look at how we can work with the technical teams across health and social care to enable a see less experience for residents. Then we will be educating the workforce, residents and schools about the importance of being healthy, happy and in control of their data.  

Embracing LHCRE will allow health and social care to embrace the digital age to your benefit.

Want to know more and possibly join our engagement events? Please contact us on digitalcitizen.nwl@nhs.net

Digital Innovation Lead, Kwesi Afful

October 2018