You might have thought that my first blog as CEO of NHSX should be about something general - NHSX's objectives, or our plans, or even our values. But it's going to be about my approach to the NHS App. Partly because it’s important, but mostly because it says a lot about what NHSX is trying to achieve and how we intend to operate.
The first thing to say is that the team has done excellent work on the app. Between the NHSXers, the NHS Digital team and the Kainos team, they have created something really good. User feedback has been positive (with one important exception, of which more below).
They have built APIs so a patient's data can safely move from GP systems to their smartphones. They have also got an extraordinary number of GP surgeries to connect in a short space of time – over two thirds as I write, with the determination to get to 100% by July.
Despite all this, I don't want us to make the NHS App all-singing and all-dancing. In fact, I'm not sure we should add many more features than it already has. We will keep the app thin and let others use the platform that we have created to come up with brilliant features on top.
We will expose the APIs, so that other people can develop their own apps to meet their own user need — apps that can plug in, safely let people access their own data and deliver a different user journey.
We know that many of our patients want to interact with the NHS in different ways. We can imagine apps that are tailored around a particular long term condition, for example, or that help the user to book an appointment when their glucose levels are off. I want an innovator who can imagine a better experience to manage their diabetes to be able to build that experience, using our APIs.
We also know that the best APIs are those we use ourselves, so we can feel the challenges and maintain our commitment to keep improving them. I hate the phrase, but we will be eating our own dog food, using our thin app to help innovators see how to use the APIs and seeding the ecosystem we hope to build.
This approach - creating the platform, and letting other people innovate on top of it - will ensure a continuing evolution of products available to our citizens and patients. It will mean those products will respond far faster to user need than we ever could and will provide more features and uses than we could dream up.
This approach will harness the extraordinary talent and creativity that exists both in the NHS and in the healthtech sector. Before I’ve even started the job I’ve been blown away by the many clinicians I’ve met who have come up with their own digital innovations and all the British healthtech start-ups who have told me about amazing products they’ve developed.
We need the NHS’s staff and patients to benefit from this talent and we need this talent to see the NHS as a brilliant market for their innovation.
All this means a clear approach – creating the platform for digital innovation and creating the standards that will allow that innovation to plug in safely. It means not competing against the market and resisting the urge to build or commission everything ourselves.
With that in mind, there are 3 important principles that will guide our approach:
- there will always be some functions that are appropriate for the NHS to do itself and that citizens will expect of us - for example, it’s probably right that things like their data preferences should be set through the NHS’s own app, rather than an alternative
- there will be some things that it makes sense for the NHS to build or commission itself, like platforms that can serve common features across the system. For example, we are looking at how both booking and screening can be underpinned by single approaches rather than a myriad of separate ones
- the systems and innovation will only work if they are properly tied in to the wider NHS. One of the early complaints about the NHS App is that its online booking function only gives access to a small number of GP appointment slots. This isn’t just a digital issue and reinforces my determination that NHSX should work in a thoroughly integrated way with the rest of the system, not as a tech ivory tower. So on this issue, the new GP contract will require GPs to make at least 25% of their appointments available online
At the heart of our approach is the belief that amazing things can happen when you create the right platform and let others innovate on it. That is the story of the internet and I want it to be the story of NHSX.