Changing the NHS – New Technology – Does “New” = “Scary”?

In my introductory piece to this series of posts “The Mechanics and Morality of Change in the NHS” I identified six themes that I believe any innovator needs to consider before, during and after the process of introducing change to the NHS. (New readers may want to read that first).

My last post talked about how to spread new technology.

Today I want to concentrate on a different part of the process – how do we describe what we are doing in such a way as to not scare people about their health and health care?

That thought starts with a critique of my own language. In the last few posts about implementing technology, and in most of my own discourse about it I use the adjective ‘new’ to describe the technology the NHS will need to implement.  I am not alone in this. Many of us feel when we are talk about implementing technology, we should use the word new to describe what we are doing.

I think one of the reasons we like to use the word is because it gives us all the thrill of being at the very cutting edge of change.

In this post I am going to talk quite a bit about developing the scope of the NHS App. Joe Harrison, the excellent NHS Director of Digital Channels recently publicised his aspiration that, over the next 5 years, we can develop the NHS app to manage 1/3rd of all health care actions.

He is right. If this were achieved there would be very considerable health gain for the country. It makes wider use of the app an important method of changing the current NHS model.

But let’s be clear, in terms of technology the use of an app is not really new.   The first iPhone was sold in 2007. We started using apps soon afterwards. Most of the population now use them multiple times a day.  In many people’s lives they are every day – not new.

We use them for important parts of our lives demonstrating important levels of trust in apps as an aid to living.

Like many, my entire finances are dependent on my app. The big things like my bank accounts. The little things like shopping and the medium-sized issues such as paying household bills. I think I use that app more than 10 times a day (and then of course it just does things that require no intervention from me). And of course I don’t think about what’s inside the app. It just works. MY bank did not make me go through a whole distance learning curriculum to explain how an app worked. I don’t care. I trust someone to work that all out.

I am not a driver, so this attitude mirrors my zero understanding of what goes on under the bonnet of a car. Or inside my TV etc

And during the rest of my day I book my swimming, look at bus and train timetables and find my way around new bits of London. Using apps.

So, my main point today is that, in terms of the speed of technological change, using an app is not NEW.

I admit that, in terms of app use, I am probably in the top 40% of the population.

Let’s pretend that apps had been created only two years ago. Would I want so much of my life to depend upon it? Personally speaking – no I wouldn’t. (I do have friends who would. That thrill to use the newest of the new) I trust process of using apps because it has been used billions of times.

I trust this technology precisely because it isn’t NEW.

(So why do I feel compelled to call it new? Those of us really into change so thrill to the use of the word NEW, that we call it such. I know. Let’s stop. Let’s be a lot less self-indulgent),

We don’t thrill to the use of the new every time we use an app. We treat it like a phone or a TV. It’s there to use. When we get a new app – we play around with the new bits it for a while and then simply use it – just like a TV

That’s why we want the NHS App. It will use a tried and tested technology to help improve health and health care.

In the next 5 years the technology that will improve health care the most – like the NHS – will be a bit old.

Many people will not trust their lives to something that is brand new. But they may trust their lives and health to something that is tried and tested.

And this has a direct relationship with what is happening with the NHS and tech today.

The NHS goal that using the app for 1/3rd of all patient interactions will occur digitally within the next five years is, as he says, both achievable and conservative.

And given how I have written about my own life in apps, that strikes me as reallyachievable.

If it can become the front door of the NHS for one third of interactions, the burden removed from primary care by empowering patients with more information and control over their health is fundamental.

And this is a significant departure from five years ago when the then Chief Executive of NHSX Matthew Gold rubbished the idea of an all singing all dancing NHS app. He advised against making it a digital front door.

The pandemic changed this because we all needed something in our hands to show we had had the vaccine. When I took my first trip abroad I printed these out and was frightened of losing them. Then I got the app.

The app meant that I could normalise the difficulty of carrying a Covid passport.

Over the next 12 months more features will be added to the NHS app focusing on wellness and prevention. (For ten years I – and millions of others – have had health and health care information on my phone which the NHS has not been interested in. My primary care health professionals can now see – since I say that I do 10,000 steps a day, whether I do.

Apps use a tried and tested technology and consequently the NHS App will be welcomed by many.

This all seems a very small price to pay for us to resist the obsession with the adjective “new” and replace it with the words “tried and tested”.