As we’ve noted in recent weeks, there’s been a lot of interesting digital developments within the National Health Service (NHS). Most notably, Health Secretary Matt Hancock set up a central tech transformation unit - dubbed NHSX - and appointed Matthew Gould as its CEO.
NHSX will have strategic responsibility for setting the national direction on technology across Health and Social Care organisations, where it has committed to a strong focus on setting standards, cloud technology and interoperability across the NHS.
As the organisation begins to take shape, each week there is an increasing amount of news coming out regarding the future digital direction of the health service. As such, we thought it might be better to pull these together into a single story for easier consumption.
NHS App and APIs
The most significant announcement out this week came in the form of a blog post by NHSX CEO Matthew Gould, regarding the future of the NHS App. Interestingly, Gould has decided (which we think is a good thing) that the NHS App will not be “all-singing and all-dancing”. He wants the app to be thin, enabling the use of APIs and letting others use the platform that has been created to build features on top.
We will expose the APIs, so that other people can develop their own apps to meet their own user need — apps that can plug in, safely let people access their own data and deliver a different user journey.
We know that many of our patients want to interact with the NHS in different ways. We can imagine apps that are tailored around a particular long term condition, for example, or that help the user to book an appointment when their glucose levels are off. I want an innovator who can imagine a better experience to manage their diabetes to be able to build that experience, using our APIs.
We also know that the best APIs are those we use ourselves, so we can feel the challenges and maintain our commitment to keep improving them. I hate the phrase, but we will be eating our own dog food, using our thin app to help innovators see how to use the APIs and seeding the ecosystem we hope to build.
This approach - creating the platform, and letting other people innovate on top of it - will ensure a continuing evolution of products available to our citizens and patients. It will mean those products will respond far faster to user need than we ever could and will provide more features and uses than we could dream up.
Gould rightly notes that this platform approach means that the NHS itself won’t be competing against the market and will mean it won’t have to build or commission everything itself, instead focusing on standards and allowing the market to build on top.
That being said, the NHS will be doing some things centrally. For example, it will be setting data standards and also using the platform to create common features that can be used across the system.
Kudos to Gould for getting into this so shortly after his appointment, we think this makes a lot of sense.
£3bn framework for London Trusts
NHS LPP, a collection of 46 organisations that work together on procurement, have this week launched a new £3 billion IT Services framework, managed by its Clinical Digital Solutions (CDS) team.
NHS LPP said that the existing CDS service offers “straightforward access” to NHS services and that the new framework will cover end-to-end information management and IT, including IT managed services.
The framework will run for four years and includes a number of different lots that focus on everything from finance and procurement software, to CRM, to robotic process automation, AI and blockchain.
Steve Dunkerley, category director of the CDS team at NHS LPP, said:
Technology is at the centre of evolution for the NHS as it improves operational efficiency and therefore patient care. The investment and procurement decisions being made are important, as are the underpinning contract and vendor management
I believe that NHS LPP evolving the CDIS framework speaks to the digital industry that we’re working in, as it too is constantly growing and evolving. Along with this, technology consultancy is likely to increase in response, as the role of technology in delivering patient care changes significantly, not least to help the NHS meet the challenge to go digital. CDIS is the gold standard clinical systems route to market for the NHS.
Through IM&T we are creating a sister framework that will become the gold standard route to market for all other technology and digital solutions for the NHS and wider public sector.
Whilst we understand the thinking behind frameworks of this type - grouping a bunch of organisations together to enhance buying power - they do make us at diginomica/government a bit uncomfortable. Procurement mechanisms, such as G-Cloud, are already available to NHS. I think what will be more interesting is how these develop alongside NHSX’s strategy of setting standards and forcing that certain types of design and system buying take place - will frameworks of this type be needed? I doubt it.
Adapting GOV.UK for the NHS
There was a guest post this week on the Government Digital Service’s blog by Dean Vipond, lead designer at NHS Digital, focusing on how the team there has adapted the GOV.UK Design System for use in their health and care services.
The GOV.UK Design System helps teams in government to efficiently design and develop services for GOV.UK. It does this by providing guidance, code and examples that teams can reuse in their own services.
This is obviously all enabled by the fact that GOV.UK and the Design System is an open source project - free for other organisations to use.
However, Vipond explains how and why the NHS Digital team have adapted the system specifically for the NHS’s needs. He said:
People’s relationship with and perception of the NHS is very different to that of government.
The NHS identity is widely recognised. It’s essential that our users trust our services, so we had to understand how best to express the NHS identity through our design system.
Vipond said that NHS Digital decided not to automatically inherit new updates to the GOV.UK Design System, because some may not be appropriate to the needs of NHS users, or match the NHS identity. Vipond added:
Instead, we have a process of considering each new GOV.UK release, and adopting those which make sense.
This allows us to continue to benefit from the research, design and code that goes into the GOV.UK Design System, while maintaining full control of our own.
Sometimes we had to adapt parts of the GOV.UK Design System to better meet the needs of our users.
For example, our research showed that sometimes users needed content on one long page, covering everything about, say, a medicine or a condition. On pages like this, users tend to scan, looking for particular pieces of information or advice.
We adapted the GOV.UK Design System grid (used for laying out pages), adjusting the measurements and breakpoints slightly, to suit our corporate font, and ensuring a comfortable reading experience for longer articles on mobile phones as well as larger screens.
We also designed new NHS-specific components for guiding people to different methods of care (for example, GPs and A&E) as well as other signposting.