“It gives you the opportunity to build those richer, more dynamic, more responsive, more patient focused pathways”: Nick Barlow on the Transformative Potential of Technology in Healthcare

Distilled Post Editorial Team

Digital solutions were a hot topic at this year’s NHS Executive Strategy Summit, co-organised by Meet Health Events and Proud2bOps. The event, held on 7th November, provided a valuable space for discussion for a large number of NHS operational leadership teams. With the onset of winter, leaders from across the Service came together to share experiences, learnings, and work together to develop collaborative solutions to some of the most pertinent problems facing the NHS. Invariably, any discussion of solutions has to involve the advent of new and innovative technologies and their potential role in supporting the NHS and its staff. Present at the Summit were a number of companies offering such digital solutions, including DrDoctor. DrDoctor has developed a number of tools, designed to create a system that works for everyone – patients, clinicians and providers. Its technology centres on their cutting-edge Patient Engagement Platform, which enables patients to take more control over their own care, using  services such as digital booking tools, direct 2-way messaging, forms and assessments for waiting list validation and digital PIFU and a video consultation platform. Distilled Post spoke with Nick Barlow, the Executive Director for Transformation at DrDoctor. Nick has considerable experience from within the NHS, previously holding roles including Chief Digital Transformation Officer at University Hospitals Birmingham NHS Foundation Trust.

The conversation began with a discussion around what resilience looks like for the NHS this winter. “For me, the balance between winter and summer is probably more about the focus and bias between urgent and emergency care in the winter, and elective care in the summer”, Nick began. “Resilience, for me, is the ability to keep both shows on the road every twelve months”. Nick acknowledged that while this might be easy to say, it represents a number of huge challenges. But he was also keen to draw attention to some of the solutions the NHS is already developing to combat winter pressures: he cited on a national level the implementation of rapid response and support services into the community, and ‘care traffic control’ centres that are used to assess the whole system to identify potential pressure points, with a view to ensuring that no individual or provider is struggling under the pressure more than another. He was clear that “staff are our most precious resource at the moment” - staff shortages abound across the NHS, with the cost of living crisis contributing further to low levels of staff retention as portions of the workforce move to more financially rewarding sectors such as retail or hospitality. 

While Nick was quick to acknowledge the fantastic initiatives already implemented to support NHS staff and patients, he also saw a need to layer new ways of thinking and new models of care on top of existing structures. He described this strategy as “a hybrid model of healthcare, where you get the right mix of in-person care where it’s appropriate, blended with digital care where it is appropriate - particularly with regards to high-volume, lower complexity work”. He observed that the debate surrounding digital versus in-person care can be misleading; the solution lies in balancing both, “on a patient by patient, pathway by pathway, condition by condition basis”. Nick identified huge opportunities for digital solutions to help with particular issues, and cited patient initiated follow-ups as an example: instead of booking in patients for follow ups six months down the line, they are given information that instruct them to book in for another appointment if their symptoms flare up again. As Nick summarised, “it gives patients the opportunity for a better experience and it also gives the NHS back precious capacity”. But as always, Nick saw balance as key. He cited a case study involving DrDoctor and University Hospitals Birmingham Foundation Trust, where 2.3 million digital appointment letters have been sent out since 2020. 71% of these letters were opened by a “big, fantastically diverse population”. But Nick was focused on ensuring that the remaining 29% of patients were just as supported: “whenever we implement these technologies, we're really clear that this has to coexist alongside a more traditional method of communication too”. 

The hybrid model of technological and in-person support is at the heart of DrDoctor’s work. “The big prerequisite to make that hybrid model work is we need patients to be fully involved in their own care pathways. And we need to be able to empower them to actually get involved, have control of their own care.” In advance of an appointment, utilising digital services that allow patients to give clinicians more information on their condition can then allow clinical teams to save time by directing the patient to the right healthcare professional, or indeed opting to send the patient for a test first. Collaboration with healthcare professionals is key in the technology’s implementation: “when you switch the technology on, it doesn’t just work out the box, there’s process – behavioural and pathway changes that need to be made… So we put teams in alongside them to coach support, facilitate, provide the tools, the frameworks, the information, the experience, to help navigate that process and go through that process in as quick and efficient and effective a way as possible”. 

It’s clear to Nick that technology represents a potent solution to some of the issues facing the NHS. And DrDoctor wants to be part of that support system to the NHS, to patients, and to providers. The proof of their capability is in the work they’ve done so far. To date, DrDoctor have managed more than 103 million appointments across more than 50 healthcare providers. The benefit? Within the last 12 months alone, there have been 257,000+ fewer missed appointments and 128,000+ unnecessary appointments avoided, creating more than £50 million in value to local health systems and releasing more than 1,000 additional days to be spent with patients.

As Nick said, “technology gives you the opportunity to build those richer, more dynamic, more responsive, more patient focused pathways”.