In a digital age with nine out of 10 households having internet access via computers or smart devices, and 99% of all 18 to 34 year olds using the internet, with over 87% of all purchases made online and seven out of 10 people completing banking online we are expectant and reliant on online services in many aspects of our lives.
The availability of online health and care services is currently very limited and sporadic, and users have limited confidence in where to find accurate and up to date information regarding health and care.
As we continue to see the rise in the availability of online services, it is paramount that health and care organisations start to consider the impact that enhanced access to services can have in terms of providing benefit to the population that they serve.
It is also clear that the digital agenda has a significant role to play in the sustainability and transformation of health and care.
In order to do this we need to make some vital changes, including providing enhancements to traditional health and care services through the availability and exploitation of digital.
In Nottinghamshire it is our vision to transform the way people experience access to health and care services, by providing digital health and care services that connect them to the information and services they need, when they need it in one place.
We want to enable people to have access to health and care in a convenient and coordinated way, promoting independence through the digital tools we are all familiar with in other aspects of our daily lives.
Whilst providing our population with the digital tools to help them manage their health and care is a huge step forward – is this enough?
Often the focus with digital transformation programmes is on the technology, which is only a really small piece of the jigsaw.
Change management and process re-design is all too often left as an afterthought and made to fit the technology rather than the technology acting as an enabler to the change.
When developing our Public Facing Digital Services strategy it quickly became apparent that it isn’t good enough just to provide our population with an app and expect them to be able to change the way they interact with Health and Care services, particularly as the people that could benefit from the use of digital services are those people that are most likely to be digitally and socially excluded.
While overall Nottinghamshire has a low to medium likelihood of digital exclusion, those at medium to high likelihood of exclusion predominantly live in more deprived areas and face socio-economic challenges and are more likely to live in poverty, ill health, have lower education and housing issues.
So how can we address this?
We undertook around 18 months of research before developing a support model to enable us to understand what issues our population faced in order to target our approach.
We learned we had to engage with those people who were hard to reach and most importantly, that we couldn’t expect those people to come to us, we had to engage and work with them in their surroundings in places which they already accessed and felt comfortable going to.
Through this research and engagement we developed the following support mechanisms;
Nottinghamshire Cancer Pathfinder
In Nottinghamshire we are working with people living with and beyond cancer to see how digital may be able to improve their access to peer support, up-to-date information and access to health professionals.
Workshops were run with front line staff, local stakeholders and cancer patients, the output of which led to several support models:
- Utilise the Maggie’s Centre to support people who lack digital confidence, to look for health information and tools online through informal and structure learning
- Work with Self Help UK – Beyond Diagnosis Service by recruiting six Digital Champion Volunteers to work with patients and carers to skill up on digital use
Digital Support Hubs
Across the city and county we are establishing Digital Support Hubs, a space in the community where people can learn how to use digital devices through informal learning, having access to devices and guidance from volunteers to help improve their digital skills and confidence, so they can engage with online services.
The support on offer ranges from keeping in touch with family and friends to following hobbies or managing health:
- Showing people how to get online on a touchscreen device, including basic and more advanced touchscreen controls
- How to download and register for the NHS App
- Ordering a repeat prescription and accessing information on medical conditions
- Accessing trusted online health advice and NHS services
- How to search and explore the internet, keep in touch with email, and use public services online
We have also developed an Intergenerational Support Network which involves students and apprentices providing informal training and mentoring at our Digital Support Hubs on the stuff that matters to visitors; whether that be keeping in touch with family and friends, following hobbies or managing health.
Digital Health Champions
Across the Nottinghamshire ICS a digital champion network model has been developed and a number of roles are being recruited to across the healthcare system in order to upskill our workforce and enable them to provide support to colleagues as well as the patients they interact with.
Digital champions will be trained with particular focus on areas in which deprivation is high and educational skills are low, from extensive research we know that areas such as Nottingham City, Mansfield and Ashfield and Newark and Sherwood are exposed more to these challenges and are more likely to be digitally and socially excluded.
Through significant research with the population of Nottingham and Nottinghamshire we understand that by supporting our population through providing them with the skills that they need to access digital services we’re able to empower, enable and give them the confidence to manage their health and care needs.
It is vital that we support our population to get online and utilise digital health resources to proactively manage their health and care, where they wish to make the most of online services.