Image supplied by @HoneyBeaDHU
On Thursday I attended a talk in Nesta entitled ‘Open Data for Innovation in Primary Care’. Before I found out about the talk, I didn’t know that ‘primary care’ meant GP practices, or anything about the link between GPs and innovation really. I went as a patient/citizen and as a designer interested in innovation in the public sector in general.
Nesta has produced a publication ‘Which Doctors Take Up Promising Ideas?’; the insights were discussed in the talk. The speakers were Michael MacDonnell, Head of Strategy NHS England; Fran Bennett, Mastadon C; and Professor Richard Barker, Centre for the Advancement of Sustainable Medical Innovation (CASMI); the talk was chaired by Jo Casebourne, Director of Public and Social Innovation at Nesta.
The audience was fairly diverse, but we were a bit heavy on academics and a bit light on actual GPs. One turned up – massive kudos to him.
Image from Nesta.org.uk
The main points I took away from the talk were:
– We need to improve care models in GP practices, not just drugs.
– Currently 20% of GP practices adopt innovations in drugs. 40% adopt innovations in technology. But only 4% use patient feedback loops. I wonder what the stats are for normal businesses – what percentage use patient feedback loops? How far does that correlate with successful business?
– GP practices are businesses. (I didn’t know that before.)
– There are no super adopters of innovation amongst GPs – no single significant group with shared characteristics.
– The larger the practice, the more likely they are to take up innovations because they have more time and resources.
– The NHS strategy line is: we don’t have the resource to have ideas for GP practices to implement, but we will support innovation, and lax some regulation to allow this to happen.
– GPs are in a culture where they are not allowed to fail, and this is a huge barrier to innovation. We need to demonstrate that it is ok to fail because you can learn from it and adapt.
– The political ideology being promoted was that citizens should be actively engaged in healthcare rather than passive consumers. See Beveridge report and Beveridge 4.0.
– We need to use open data to measure outcomes but we are not currently doing this effectively.
– Patient groups such as HealthWatch can be agents for change by being demanding and pushing for specific changes.
– Patient expectation of what GP practices can provide is an issue.
What they didn’t say was:
– Exactly how the NHS would support innovation as enablers but not doers. An audience member from Moorfields Eye Hospital raised the point that GPs are not trained innovators or entrepreneurs, and they don’t have the necessary skills or inclination to innovate. So how is innovation going to come about?
– All that much about how open data can practically be used. How are GPs going to access open data? Are they even going to be prompted to consider using open data to inform their choices in innovations to adopt? We have so much cheap data at our fingertips but we don’t know how to use it, or even that we can.
– How we can use qualitative data rather than just statistics. It was agreed that this is an important approach but nobody voiced a way to make this happen. Fran Bennett said that social media could be a red herring because the information isn’t relevant in making changes. Then how can we gain insight? Personally I’m behind service designers doing design research/co-design to gain insight and suggest appropriate innovations. But I think this is still a way off from happening widely.
– Ultimately if we don’t want to have to go to the doctor’s because we want to stay healthy, how can we do this?
As often with these kinds of talks, the problems were discussed in some depth, but not too many concrete solutions were discussed. A couple of examples of good practice were cited: a Moorfield’s Eye Hospital Unit in St George’s which is run on Lean methodology and continues to gather patient feedback, and the East End Health Network, a group of GP practices which share knowledge including innovations.
I get frustrated at these talks that there isn’t some kind of space to discuss and implement actual solutions. I doodled a digital platform the NHS could design to enable knowledge sharing around innovation in GP practices on the way home. Why isn’t this prompted within the session?
Out of this talk, here are some briefs for designers.
– Create a culture in primary care where it is ok to fail, experiment, take risks, learn and adapt.
– Motivate GPs to be interested in innovation and inclined to innovate, especially their care models, not just their drugs. Primary adopters will be larger practices, with smaller practices (one or two doctors) will catch up later on.
– Gather movements of patients who can co-design healthcare with GP practices. Gain insight by researching qualitatively with patients and link up to practices.
– Make it easy and the right thing to do for GPs to adopt innovations and access open data. This would probably take the form of an NHS hosted website for GPs.
– Equip practices with strategies to think of ways to use open data to their advantage.
– Find ways to support, encourage, and reward innovation in primary care, whilst allowing different practices to adopt innovations appropriate for their patients.
Do you know ways that people are currently tackling any of these issues? If so please comment on the blog or tweet me at @liorsmith. Would love to hear about it.
Sophie Reynolds from Nesta has produced a #NestaHealth Storify of the event where you can see my live tweets and others’ from the event. I’m a fairly new live tweeter – I hope I’m getting better at it. Is 50 tweets in 90 minutes too much?
Read more about CASMI’s Innovation Gap theory here and do watch Prof. Barker’s introduction video for more insight.