NHSBSA: Harnessing technology to better patient care
Established in 2006, the National Health Service Business Services Authority (NHSBSA) has centralised a multitude of services under one core umbrella. This includes Citizen Services, (Help with Health Costs and Student Services), Primary Care Services (Prescription Services and Dental Services) and NHS Workforce Services (NHS Pensions and HR Shared Services). The organisation strives to support patients in the daily management of their healthcare needs, embracing new digital tools in order to provide a service that is resilient, seamless and caters for all ages amidst growing consumer demands.
“In terms of a transformation, it's not just around technology. Over the last two years, we recognised that we needed to transform our services to be able to cope with the demand and pressures being placed upon them,” explains NHSBSA’s Chief Digital Officer Darren Curry.
“To increase demand for our services and make them more efficient, not just from a cost perspective but through ease of use, access and speed, my role has been to take the organisation on that journey, developing digital services for our users, customers and other NHS organisations.”
The NHSBSA’s journey has seen its services move towards an increasingly customer-centric model, which has seen it not only transform end to end user experiences, but also the culture of how the organisation views and delivers its services.
“We've altered our delivery model to become increasingly agile, where we are looking at our services from a user need perspective and reacting to those changing needs. We have therefore built a strong emphasis upon user research and creative roles in the organisation in order to build services which meet the needs of those users,” Curry says.
The National Health Services Business Service Authority
Adopting a cloud-first hosting model has been instrumental to the growth and improvement of NHSBSA’s services and enabled it to cater towards growing populations and increased demands on its traditional service model. “Our cloud services were developed in partnership with Arcus and Amazon Web Services (AWS),” adds Curry. “This has enabled us to increase flexibility while reducing deployment times so that we're now deploying multiple releases per month. It’s still less than where we ultimately want to be, but it's a lot quicker than where we were.”
New, digital ways of working have also removed any potential difficulties within traditional, paper led processes and applications, where new digital applications have saved not only time for end users and clinicians while driving down costs for the Authority. Additionally, embracing technology has led to an increased public awareness regarding the types of services and support that the Authority can offer.
However, testing new services and garnering feedback through consumer engagement has been essential. The implementation of cross-functional teams, where midwives, pharmacists, hospital staff and GP’s have been included in the development of the services provided, has only seen services improve and receive positive feedback across the board.
“Developers, project managers, researchers and designers all take these products out and show them to users in real world scenarios in order to improve the access of these services and make them as easy to use as possible,” adds Curry.
One such area of extensive positive feedback is how digital tools have raised awareness of the NHSBSA’s Help with Health Costs services.
“From user research, we identified a need for users to obtain better visibility of the help with health costs they were entitled to,” notes Curry. “This has traditionally been a paper process, with multiple pages and a lot of understanding needed, making it quite difficult for some people to access. Through the work that we're doing, we have made it possible for a user to identify what help with health costs they could get in less than five minutes online.
“Some people we spoke with weren’t getting essential treatment because they couldn’t afford it or were not aware that a service existed. We are therefore making our services as accessible as possible, in order to make a direct impact.”
Working alongside Clinical Commissioning Groups (CCGs) has also seen the NHSBSA develop services which provide analytics to prescribers through its ePACT2 product, a Business Intelligence (BI) tool where data surrounding dispensing trends can help identify emerging trends, but also mitigate particular risks.
One area that this has been used is in Polypharmacy, where a patient may be prescribed 10 or more medicines at the same time. Indicators can be used to identify particular patient groups that maybe at more risk and enable informed insight to prescribers.
“The system allows a CCG to identify trends. It’s predicting these things and utilising historical data. You know patients prescribed A and B, but therefore they now have an increased risk of developing X. It has been well received,” says Curry.
With growing populations and a shrinking healthcare budget, patient services continue to remain under strain, leading the healthcare industry to continue to look at providing digital solutions to its customers. Utilising artificial intelligence (AI), the NHSBSA’s contact centre has piloted supporting users in some of the most routine questions, leading to a drop in wait times and an increase in operator availability.
Working with Arcus and Amazon, the NHSBSA’s initial proof of concept has been completed, where similar technologies seen in Amazon Alexa have also been embedded within the Authority’s contact centre operations.
“It’s providing a number of benefits to users. We implemented this in four weeks and went live with an initial service. However, we also made sure that patients had the opportunity to drop out and speak to an operator at any point in the process, as we don’t want to force people to use it,” observes Curry.
“Through this process, we had a success rate of over 40% of all customers that called in, where their queries could be resolved with the AI which had been put in place. Whilst users can talk to an operator between 7am and 5pm, we've got AI on the phone 24 hours, seven days a week. This is now set to be rolled out.
“I'm looking to explore where we can apply that technology further,” continues Curry. “This will enable our contact centre operators to speak with users who need more support and have complex queries giving people an increased quality of service.
“However, whilst we've made incremental improvements, it’s difficult to be constantly ahead of new technology and new approaches to delivery, which is one of the key drivers of doing the transformation.”
Monitoring all user feedback via data analytics, the NHSBSA continues to listen to its customers in order to develop, enhance and improve its products and services. For example, its prescription pre-payment service, where patients with multiple prescriptions are able to obtain a pre-payment service where for a set fee, a patient may get as many prescriptions as they need, which Curry describes as “kind of a season ticket for prescriptions.
“People were originally a bit reticent due to the look and feel of the service and the payment screen associated with it,” observes Curry. “We identified through Google Analytics that people were therefore dropping out at specific points. When we spoke to users, we were able to redesign these features, and have seen an increase of approximately 70% in cases where people now complete their journey online.”
Working to build capability
Aligned with UK Government ITC strategy to drive innovation and increase efficiencies, NHSBSA is collaborating with established, innovative companies and SME suppliers. Through this, the organisation is increasing self-sufficiency and building capability. One such example is through its partnership with Valtech in the transformation of pension services, supporting the development of the NHSBSA team’s knowledge and skills.
Valtech have been supporting NHSBSA since mid-2016, and has established blended, co-located teams on NHSBSA sites in Fleetwood, Newcastle, and in their own offices in central Manchester. In partnership with Valtech, NHSBSA is delivering a range of new, innovative services within the Digitisation of Pensions, enabling members to manage their pensions more efficiently. From day one, a key goal of the engagement has been to establish and grow in-house capability, reducing long-term reliance on suppliers.
Working with enablement and delivery experts such as Valtech, NHSBSA is employing the collaborative delivery of business-critical services as a catalyst for digital transformation.
“We’re making sure that within these partnerships there is an arrangement to increase knowledge in there,” adds Curry. “It’s as much about leaving a self-sustainable capability and not creating a reliance or dependency as it is about the service. Working with partners such as Valtech on collaborative delivery supports this.”
With Curry describing the healthcare industry as “a hotbed of innovation,” the emergence of health wearables and products to support patients in the daily management of their healthcare needs will continue to inspire the NHSBSA to develop and deliver exceptional user-focused solutions. “In the future, we’ll get a lot more analytics predicting health issues. People will then address them in advance of them occurring,” concludes Curry.
“I think there is a huge opportunity in the joining of social care in the UK. Through the use of technology, we can put the onus of enablement upon the patient or the user to take their health into their own hands.
“We are very much on an ongoing road map for all of our services, delivering the transformation and continuing to carry out user research to the benefit of our patients.”