DHEZ Solutions 1

Things are speeding up at Bradford’s Digital Health Economy Zone and I was really happy to take part in their first digital health solutions session. After a quick visit to see Cobden’s Free Trade and Peace statue in the Wool Exchange I walked through the shining Broadway shopping centre to Kala Sangam. The DHEZ’s new offices will soon be opening nearby and there’s a real buzz in Little Germany.

Mark from Konnektis was there already with his wonderful system for helping people collaborate to deliver better care. Konnektis were recent winners of the IoTUK|Boost programme and it’s great to see such close collaboration in West Yorkshire.

The day was divided up into three sessions each led by someone from the NHS with a challenge they wanted to explore.

 

Workforce

In the workforce session we heard how the NHS “needs more people, but a lot of people don’t understand the opportunities”. I don’t know how recruitment works for clinical positions and I didn’t know that the NHS recruit for a lot of non-clinical roles too.

I began to wonder. How does the NHS currently engage with people like me and make it known that they want to hire?

• I thought about the NHS innovation hub in Leeds which is isolated from the city’s tech scene.
• I realised that I couldn’t remember ever attending a design or technology meetup in Leeds that was sponsored by the NHS; I’ve been to many sponsored by other large employers in the city.
• I thought about how at Leeds’ huge digital job fair just a few weeks ago the NHS were notably absent.
• I thought about how the NHS are the only organisation that have repeatedly invited me to innovation events where some people are paid but I am not.

If the NHS struggle to hire good people might it be because other people have had similar experiences?

If so then the NHS’s engagement with the DHEZ and the connections that gives it to technologists is a great opportunity for improvement.

 

Self-care

GPs are a scarce, expensive, and hugely powerful resource. Yet most of their time is spent dealing with health issues that could have been dealt with by patients themselves. This is especially true if families and communities can help too.

Most patients would prefer this. Very few of us want to see a GP unless we need to.

I was really excited to see the focus that almost everyone at the event had on fixing this issue but a bit worried by some the ideas we had on what to do next.

• Why do “we want a localised solution to Bradford”? Shouldn’t we be aiming to bring the best from around the country to Bradford and then share our learning back?
• Why do “we want to co-design with patients and communities”? Most people aren’t patients and the health service struggles to engage people already. Who will a co-design process benefit? Why do we think that communities know how to design a healthcare system?

A better way forward might be to look at My health tools in Kirklees. It already exists, it works, and it could be copied in Bradford quickly and easily.

Similarly, instead of “building a hub where people will come” why not work with the hubs that already exist?

Health is about active lifestyles in sports centres, education in libraries and museums, and decisions in supermarkets, GPs offices, and pharmacies. Maybe that’s where any new health service hub should be, somewhere like a Playbox.

Has this already been tried? Did it work? I don’t know but surely somebody does. We should definitely find out before we try building new hubs.

 

Urgent care

The value in having more easily accessible health records is obvious; if I fall ill I want the people who care for me to have accurate information as quickly as possible.

The dangers are obvious too; I wouldn’t want everyone to know if I had a problem with incontinence.

The NHS is trying really hard to sort out its health records problem but no-one seemed to know how well it’s doing. I’ve heard a lot about Ripple OSI in Leeds but no-one mentioned it on the day. Is there a risk that we're designing new tools when good ones already exist?

What worried me most was that lots of people at the meeting were clear that records should only be shared where a use for that data had been identified and consent obtained from the person generating the data.

I understand that concern but innovation will be slower and more expensive if we already know the answers we’re allowed before we start asking questions. Might we be better collecting more data, even if we don’t know what we’re going to do with it? That would keep our options for innovation open.

I'm sure this debate is happening within the NHS. Could we use the DHEZ to bring that debate into the public?

In summary

Physical changes to healthcare are extremely controversial. Just look at the anger about closing Huddersfield A&E. Procedural and software changes should be much easier but they seem to be happening too slowly to avert the NHS' funding crisis.

I see three big problems where technologists and the NHS aren’t yet seeing eye to eye.

1. Technologists aren’t used to dealing with geographies as small as NHS trusts; I don’t think I’d ever consider doing something differently in Kirklees to Bradford.
2. Technologists don’t currently feel welcome in the spaces for innovation that the NHS has created.
3. The innovation process in a patient-centred and cautious NHS is frustratingly slow for many people outside it. The backlash against Samaritans radar put off me off going anywhere near healthcare innovation.

Perhaps these obstacles are for the best. There's a decent argument that the NHS needs a different innovation model where “moving fast and breaking things” isn’t an option.

Proponents of that alternative need to be clearer about how much more expensive that’s going to be. Then we, the British public, need to decide whether we'll willing to pay for it.

 

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