Social Prescribing Digital Skills — some findings
Our first Pathfinder for NHS Widening Digital Participation has thrown up some things that will be useful for other areas.
Context
We engaged 2 neighbourhoods (and their GP practices) in Sheffield to see if Socially Prescribing Digital Skills would improve PAM scores (Patient Activation Measure; which assesses how able people are to manage their own healthcare).
We’ve written up our discovery sessions and how we came to the models we would test, in a Pathfinder Report— we will iterate this as we find more.
The neighbourhoods gave us a model each to try out — these models seemed to satisfy the User Needs that we had uncovered — and they are pictured below.
In a nutshell
Porter Valley Neighbourhood have funded a Digital Champion in their practices for 16 hours per week to see if they can increase digital take up. This digital champion has appointments and an ad hoc service.
South Sheffield Neighbourhood have an existing relationship with one of our Online Centres (Heeley Development Trust) and they prescribe people to their services for digital skills.
There have been mixed results.
The benefits of digital skills in a patient setting have proven to be truly transformative for some— see our case study
Lets try and dissect some of the things that have not gone so well and discuss the next steps.
Lesson 1 — going where the users are doesn’t mean the users want you there
Having a roaming Digital Champion sitting in waiting rooms (as in the Porter Valley Model) is not an effective way to engage people in improving their digital skills. Although, it is a ‘captive’ audience, the Doctors waiting room is still seen as a quiet, private place where people are embarrassed to talk freely — this means that the Digital Champion has found herself trying to find ‘hooks’ to get people to speak to her.
Lesson 2 — a hook or message is only right for the right person at the right time
We at Good Things Foundation are confident that the benefits of digital means that every life can be improved by it. However, just stating one (sometimes inappropriate benefit) doesn’t gain buy in.
E.g. A person who is digitally excluded does not deem ‘you can save time by booking appointments online’ as a good enough reason to gain digital skills. This benefit does work for someone who is digitally included who just doesn’t know how to begin that process of booking online.
A more appropriate ‘hook’ for a digitally excluded person may be ‘have a look at this app it will help you manage your condition and feel better.’
Lesson 3 — trust comes from the Doctor but then from peers
We learned this lesson from the good folk in Stoke (which I now realise sounds like a Folk Festival taking place in the East Midlands). Patients will trust recommendations from Doctors in the first instance. Therefore, if a Doctor/Nurse recommends something digital they are more likely to try it once. In order to get more value from the digital solution, however, patients need peers.
Peers don’t have an agenda like saving the NHS money, so if they say it is helpful then it must be helpful right?
It’s hard to argue with this logic as I know I’m slightly influenced by the number of claps a post on Medium gets but if someone recommends a blog to me I’ve got it up on my phone before they’ve finished the sentence.
This is where the value of Heeley Development Trust (the trust) comes in (see the South Sheffield model from earlier). A Doctor or Nurse prescribes going to see the specialist from the trust (they have their own office in the Doctors surgery). There, the patient has a chat about what is important to them and what goals they have and the guys from the trust invite them to a suitable class/activity at the trust(situated a few 100 yards away) or just show them what they need to know right there and then — like here’s how you find that app and put it on your phone.
The guys from the trust are non-agenda’d (I’m hoping this made up word catches on) and this is important. They are a trusted 3rd party that provide advice and access to others in the same boat.
We know this non-agendaness (even better word) is something that our friends at Nailsea have found important in their pathfinder (see their micro blog)
It is very hard for projects that have been funded to be open and candid and I’d like to take my hat off to the neighbourhoods in Sheffield for being so brilliant in telling us the bits that haven’t worked. A lot of the value in this programme is co-designing services, using best practice from a myriad of sectors and then being able to say what, after all that, doesn’t work — and why. So thank you Sheffield.
So what should we change
3 things that I think would be interesting to test next in this pathfinder would be;
- For transactional assistance like — booking an appointment online or repeat prescriptions we train up the receptionist staff to show the patient, so it looks to become ‘digital by preference’ (to steal a phrase from Matt Edgar and GDS)
- For digital health assistance — Porter Valley builds a relationship with a local online centre in order to investigate lesson 3.
- Use service not digital — it would be very interesting to hear a Doctor say something like ‘as part of our service, Heeley Development Trust are going to show you some things that will help you manage your health’ instead of ‘Heeley Development Trust are going to show you some digital ways to help you manage your health’
I look forward to sharing progress, from this pathfinder and others.
If you want to get involved with the NHS Widening Digital Participation Programme please don’t hesitate to get in touch pete@goodthingsfoundation.org
