I want to build on the idea of compatibility and interoperability in terms of how some of the systems speak to each other. I work in banking and we had quite a radical overhaul because of European legislation and directives so that there is now a system called open banking in the UK. Some of you might be aware of that. Basically, it is a decentralised platform that uses application programme interfaces, which means that I own and keep all my data and have control over whom I share it with. However, I can share it with multiple banks or financial institutions, which can use it in smart ways to provide collaborative services.
For example, I can give my data to bank A to store, but I can always add in data from bank B and they can pull all that together and do smart, innovative things in managing it. For example, they can say, “I know that your salary comes out of one account and that you spend a lot of money in another account. Let’s pull it all together and work out how much you’ve got at the end of the month.”
I question how, in health, we are building on the work of such providers and drawing on and bringing in best practice from the private sector. For example, I use wearables and I note that others on the panel have wearables on or are using them. The question is how we draw in information, whether we share it with our GP and whether they pull it in and use it in a smart and effective way.
I will describe briefly a kind of service journey involving registering with my GP and booking an appointment. Speaking from a personal perspective, when I moved to Scotland, I found that service journey challenging, to say the least, and certainly different from my experience down south. The first thing that I do is go on the internet and look up my nearest GP, but even finding out something as simple as that is sometimes a challenge. However, I then realise that there is no obvious way to sign up on the GP practice’s website. I cannot enter my details or say, “I know my national insurance number and NHS number. Please take all my details. I give you permission to take them from my previous GP practice.”
Consequently, I walk along to my local GP practice at the times that it prescribes, which are times when I should be at work, and say “Please can I register?” The practice then sends me away with a set of forms that tell me that I now need to provide all this information. However, I do not have half of it, so I go back and we have a dialogue about why I do not have it.
I then wait a little while and I get a letter in the post. I live only a few doors away from my GP practice, so why on earth it posts me such things and does not email me, I do not know. From my perspective, that is quite amusing. If any other organisation did that, I would refuse to take on their services. I do not know why we think that that is acceptable in the NHS or in GP practices.
The whole process takes about a month and I get incredibly frustrated because it could have been done very simply. I compare that to something as basic as joining my local gym. For that, I sign up online and say what service I want. I put my details in and am given a code and personal identification number to access the building. I am asked what classes I would like and am given a list of classes that the gym has noted that I am particularly interested in—for example, for leg strengthening or cardiovascular work—as well as a list of the trainers.
Why am I not doing the same sort of thing with my GP? I could go along to the GP and say “I’m struggling with my mental health at the moment. What appointments have you got available on this date with a mental health first aid practitioner?” That would let me self-refer to the right channel. Why are we not using smart triage systems? For example, why are we not using apps like Babylon, which is widely used in many areas? It could be used on two fronts in the GP model. If the GP already has all my data because I am sharing it through wearables and I tell them about certain symptoms, they could say, “Oh, yes—you’ve been here before, so we already know you’ve got cardiovascular issues. Now that you’re presenting with these symptoms as well, we can refer you to the right place.”
I question whether we are taking the right approach on all those matters, whether we are ambitious enough and whether there is the willingness at the front end to implement some of those systems. Ultimately, once we do that, it leads to better outcomes for patients and simpler systems for GPs and others at the coal face. It is a win-win process for everyone.
I wonder whether the committee has any thoughts as to why that message might not have got across and where some of the challenges are. Is the challenge around funding or willingness?