Reaching out and testing the waters

Last week saw the big event in the DUEC calendar with the huge Digital Transformation in Urgent and Emergency Care Conference 2019, with over 300 people attending in person and many more online. The conference line up was strong, with speakers from across the spectrum of digital, design and frontline practice, sharing their views on the state of the nation now and where it needs to go next.

Sophie sharing our human-centred design approach with conference attendees

Sophie Dennis and I were chuffed to be asked to speak early in the day, with Sophie framing the narrative nicely by putting human-centred design at the heart of the day, rather than technology products themselves. Service design was the centre of attention in our keynote, giving the audience a service design 101, as well as showcasing the project progress so far.

‘Nadine’s’ journey through emergency care shows an incredibly varied experience

Our slides included some emerging, high-level example patient experiences, plotting patient journeys through the system and demonstrating aspects of the change journey we have to go on to start providing patients and practitioners more joined-up, digital age support, to enable the most effective care. Of particular interest was the feedback I received during and after the presentation about how there are still not enough representations of the experiences, staff and patients alike, and how simple yet potentially transformative those journey maps will be as part of the outputs of this project.

This image is clearly just one example of the emerging journeys from our few weeks in East London. We’ll continue to validate them through further engagement in Somerset and South Yorkshire and Bassetlaw in coming days and weeks. We’ll be setting up some collaborative sessions in June to work through prioritisation of opportunities and co-design of target journeys, so drop us a line if you’d like to take part.

Digital Urgent and Emergency Care (DUEC) conference highlights

Back at the conference, following Sam Shah’s energising opener, Simon Eccles played a blinder to kick off the day. Bringing all the aspects of design-led digital transformation, Simon pushed people to open their minds and expect better; to not just look to digitally-enabled services, but aim for service transformation enabled by technology.

As you can see above, I then riffed off Simon and pushed the audience to imagine digitally enabled services fit for the 21st century, aligned with what people expect of us in the internet age — and how (digital) urgent and emergency care truly has a great opportunity to lead by example across the NHS.

NHSX digital spend

Speaking of enabled by technology, let’s not forget this drop the mic moment from Terence at NHSX. The speech marked a watershed in the NHS digital agenda, where all future technology projects will be required to follow wider government service standards and provide technology that complies with open standards, to allow for better join up care across the system.

However, as Hadley Beeman said in her speech that followed later in the day, this isn’t an end in itself or merely a geeky endeavour, but to ensure the joined-up patient and practitioner experiences we’re all seeking can actually be made real. For this to happen, the digital agenda must be design-driven and technology-enabled rather than technology/product-led; a message that came out loud and clear throughout the day and in many ways representing a break from the past.

Away from the conference…

There comes a time in every project where you take that much needed, if slightly nerve-wracking, step of presenting thinking back to the most qualified and experienced people in the area, to get their feedback and, hopefully, support to keep going.

Last week, this opportunity came in the shape of getting together with the Urgent and Emergency Care Senior Management Team at NHS England to share what we’ve been doing, where we’re at, and how we can work together to deliver on the ambitions of the long term plan. We had a really constructive discussion and were delighted to receive offers of support to weave the existing work in this area that has come before this project to make sure that everything is captured together when it comes to synthesis, design and recommendations.

Much like some of the panel discussions at the conference, one of the key messages was about the need to ensure that designs work with everyday clinical and patient experiences, that they seek to make rapid and immediate “tweaks” to build faith and momentum and also recognise those things that already work or are on path to be delivered and need to be added into the service blueprint. So essentially having a clear view of what’s working well, what we need to build on that is in flight and coming soon, and then new things we need to start doing as well. There was also a keenness for us to learn from the efforts that have come before us over the past 7–8 years and how we might ensure that as much of this work is adopted as possible post-discovery by avoiding similar pitfalls.

The themes of the emerging opportunities we’re going to refine and explore in the coming weeks

At both the management team meeting and our second show & tell, we had a chance to share some of the emergent UEC journeys and opportunity areas you see above. Similarly to the conference feedback, there were helpful discussions in both rooms about the value of visual representations of the reality to get to a shared understanding of problems and opportunities as no one person has the complete picture on the UEC settings. A key point that came out of the show & tell was the value of continuing to map the UEC ecosystem, including funding models and incentives and disincentives that promote or hinder collaboration in a local economy. More on that soon.

What we’re doing this week

We’re wrapping up engagement in Somerset. We’ve been to Bridgewater’s Test and Learn UTC, Minehead MIU, Musgrove Park Hospital, Millbrook Surgery, and a few pharmacies speaking to patients, staff, leaders and commissioners about their experiences and challenges. We have a few more interviews to wrap up. Learning about opportunities for digital UEC particularly in the most remote parts of England

It’s great to also now have South Yorkshire and Bassetlaw on board as a suburban location working as an Integrated Care System. We’ll kick start engagement this week. Thank you to Will Cleary-Grey, Rachel Gillot and Catherine Huby for all your help making this happen. As part of this, we will also be going to Yorkshire Ambulance Service on Monday to meet with staff and observe some call handlers in action on 999 and 111 calls — a huge thank you to Suzie Southey, Cheryl Astbury and Linda Smith for helping coordinate this!

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