Since early 2008, Digital Public Ltd has collaborated with NHS Direct to develop and implement a digital strategy to: • Enhance and increase the reach of NHS Direct’s online public services • Enable more users to self-care where it is safe to do so, and so reduce inappropriate use of other NHS services, such as A&E • Improve users’ experience of NHS Direct services by offering new engagement channels (such as webchat), joining up online and offline channels and reducing the need to provide the same information more than once. Through the activities carried out, Digital Public is also helping NHS Direct to: • Increase the efficiency of its contact centre operations by moving triage online and so reducing avoidable contact • Target services at high-risk and socially excluded groups • Transform itself to meet the demands of its own digital revolution. A key vehicle for these changes is the development of online Self Assessment Tools – interactive questionnaires that enable users to assess their symptoms and elicit clinically proven advice on how best to treat them – either through self care or through NHS services. NHS Direct launched the first two of what will be an integrated suite of tools, on the topics of Colds & Flu and Contraceptive Advice in late 2008, both of which were seasonally relevant. By the end of January 2009, there had been more than 150,000 uses of these tools since their launches in November and December 2008. User feedback has been consistently positive and constructive – which has surprised and pleased NHS Direct staff. The programme continues in 2009 with the creation of the full suite of topics, numbering close to 40 in total.

Policy Context

The context of this project lies within extending the reach of healthcare services to increase greater uptake of health knowledge and self care. It is aimed at building engagement with hard-to-reach populations and increase accessibility to a wider user group.

Description of target users and groups

The target audience are the general public population of England - 51 million people.

Description of the way to implement the initiative

The process relied on a development relationship between NHS Direct (NHS-D) as the service provider and Digital Public (DP), an innovator in digitising public services. DP facilitated NHS-D through a process of discovery and design to generate the digital channel concept. DP then continued in a prime consultancy role, enabling the organisational development and directorate collaboration required to develop this programme. Whilst suppporting NHS-D through these processes, DP also took on key implementation roles within NHS-D in order to ensure delivery of the required products. The product - self assessment tools - rely on an IT infrastructure already used by NHS-D and is designed to integrate efficiently with the telephonic triage and appointment planning service run by NHS-D

Technology solution

1. To use the inhouse technology solution as an interim method. Follow-up is to procure a bespoke system for creating Self Assessment Tools in modular form with re-usable elements. 2. The business logic for these SATs is based in a .NET framework and serves webpages. 3. The technology also has the capability to send user form data to the NHS Direct Case Management System to log user call requests in the same system for logging telephone calls. This is a proprietary platform developed for NHS Direct. All served webpages are AAA compliant, in english.

Technology choice: Proprietary technology, Accessibility-compliant (minimum WAI AA)

Main results, benefits and impacts

Two Self Assessment tools have been launched:

Colds & Flu symptoms: launched November 2008

375,000 users since launch
>2000 callbacks provided
Feedback is 88% positive

Within 24 hours of the swine flu pandemic risk being announced in April 2009, the Colds & Flu symptom checker had been upgraded.
Within a five day period, there were 169,000 visitors to this symptom checker, resulting in over 700 callbacks being provided.
Feedback remains high in +80%.

Contraceptive Advice launched in December 2008
70,000 visits leading to more than 800 webchats.

Benefits:

• Faster access to appropriate advice and redirection to best follow-on services
• Greater reach by NHS Direct to target audiences
• Syndication of content with key partners increasing penetration of NHS Direct online services further
• Increased value experienced by audience over traditional telephony service
• Enables improved efficiency of telephone services

Return on investment

Return on investment: Not applicable / Not available

Track record of sharing

This has not yet been shared in a wider context

Lessons learnt

In order for this project to be successful, the following lessons were learnt and put in to practice [1] Providing support and encouragement to develop interdisciplinary engagement and team work. [2] Understanding the need to balance risk assurance in clinical service delivery against user needs and expectations. [3] The need to understand and manage the impact of clinical safety on project management practice.

Scope: National