Mark McCusker

The Route to Digital Success? Citizen-Centric Roadmaps

NHS digital roadmaps are a hot topic, and whilst the Paperless NHS deadline has been quietly pushed back from 2018 to 2020, we are seeing some progress.

NHS digital roadmaps are a hot topic, and whilst the Paperless NHS deadline has been quietly pushed back from 2018 to 2020, we are seeing some progress.

90% of GPs in England are now reportedly offering online appointment booking and more patients are ordering repeat prescriptions digitally.  It’s a step in the right direction but we still have a long way to go.

A one-size-fits-all plan won’t work in a country with a population as diverse as the UK’s - a fact that’s been recognised by asking clinical commissioning groups (CCG) to develop their own digital roadmaps.

With the finishing line just over the horizon (April 2016),  CCGs advancing on this journey need to be clear that if their digital strategies are going to be successful, they need to be user-first, not NHS first, keeping a laser-focus on the people the digital strategies will serve.

Many users of the NHS are reluctant for it to lose its human touch. People like speaking to people, whether it’s on the phone or face to face. If we are to retain a health service which feels suitably personalised, the road-mappers need to scrutinise who they’re communicating with and how best to engage with them. 

As they form their strategies, health service users must be the starting point (and the middle and the end). Who will be using the digital services? What do they want?  What is the typical journey they go through and what gaps exist which affect the user’s experience? Who uses NHS services most and accordingly who will be impacted most as services move online? What unique needs do they have? 

The greatest users of NHS services (the elderly, people with disabilities, those with chronic illnesses - which can also often be from lower socio-economic groups) are also the most likely to be affected by low digital skills and literacy challenges. It is these people who will miss the human touch most as digital services are introduced. This needs to be fully understood before it can be accommodated within the roadmap.

The facts can present challenges: 1 in 10 UK citizens have dyslexia, 1 in 5 have low digital skills, 1.5 million people have learning difficulties, over 4 million speak English as a second language, almost 2 million have visual impairments*. 

Accessing a digital NHS is going to present significant challenges to many of these people. But by embracing the challenges as you map out the user journey, you can seek solutions to the inevitable problems. 

Solutions come in many shapes and sizes. Assistive and digital inclusion technology, translation software and text magnifiers can be included to overcome many of the issues these users face.

Only by building these considerations in from the ground up will you achieve a strategy that meets organisational needs, and keeps patients at the core. If you take  organisational goals as the starting point and then try to build in provision for specific patients needs retrospectively, problems will undoubtedly arise.

One last thought? Ivory towers are not good places to build roadmaps if you truly want to build a citizen-centric and workable strategy.  
And keep listening! It’s almost impossible to release a complete, brand new system with everything ready for users right from the start. By following a more iterative process where you listen to user feedback along the way, you’re less at risk of promising the sun and the moon but only delivering the sky.

Mark McCusker is CEO of Texthelp Ltd and chairperson of the British Assistive Technology Association (BATA). He is also Director of Camara, a charity focussed on delivering education technology to underdeveloped nations worldwide.

Office of National Statistics



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