Making health systems – in the broadest sense, across europe in particular, perform better for the citizen is what motivates me. From the clinical, policy and technological prospect – and more, there is much to look at and much of it is interwoven.
Technology is a powerful tool that’s shaking up expectations and possibilities. Consumer health tech being one aspect, but only one. Technology – whether inter-clinician communication, patient monitoring, or other, is also not a solution in itself. Communication, leadership and policies all matters too.
Please follow me on Twitter (bonnaud_dowell) for all things related to healthcare.
These are some of the contemporary healthcare-related initiatives I am involved in:
January 2016 –
HIMSS Europe – Social Media Ambassador
eHealth Week 2016 was organised by the Dutch Ministry of Health, the Dutch Presidency of the Council of the European Union, the European Commission and HIMSS Europe. This year’s educational programme focused on three main themes: Empowering People, Trust & Standards and Innovation & Transition.
With the engagement of experts and advocates on social media, we brought together committed voices across Europe in preparation for, and throughout, eHealth Week 2016 in Amsterdam.
The week promises to be a worthy event and I was grateful to have been given the opportunity to attend, learn and discuss with the varied audience. It was wonderful to meet up with many of the people I had ‘met’ online, in person.
With ‘Twitter meet-ups’, supporting the recent HIMSS WoHIT 2016 (Barcelona) & upcoming eHealth Week 2017 (Malta) the relationship continues.
For more information, please head to the official website for eHealth week to review the work in Amsterdam, and for details become available for eHealth Week 2017 in Malta
NHS England Consultation: Person-centred care for long-term conditions: ‘Our Declaration’
Person-centred care for long-term conditions: Our Declaration is a two page document NHS England and its partners have put together since April this year (see link below). The Declaration is designed to “spread a message and gather support around how person-centred care can improve experience and participation for people with long-term conditions and their carers”. With the consultation and support from a wide-range of people and organisations, including carers and communities, the public, health and social care professionals, policy makers, charities and other interest groups, NHS England appear to believe this Declaration will be worthy of its name.
In my response I empathised my support, as somebody linked to the sector, and feels those of us who have long-term conditions want the services built around our lives and not the other way around, to:
- Ensure that the widest possible number of people are able to be engaged in shaping NHS services. It concerns me that patient engagement initiatives will have a tendency to be skewed towards a relatively monogenic ‘activist citizen’. I’m guilty as charged to thinking about my own needs, but it is critically important to have the broadest possible cross-section of society involved in being represented at some point in the process. For example, transport challenges for rural citizens who don’t necessarily have vehicles nor will they necessarily have ready-access to the internet on their smartphone, potentially leaving large sections of society out of improvements.
- Advocate transparency on service entitlements and possibilities. If you are entitled to it, it should be advertised fair and square. Take NHS-funded EU/EEA/Swiss treatments for planned healthcare – up until now a largely undiscussed in the UK. The various European Union regulations are now clear and I’m currently involved as a Reference member and design event attendee, to ensure the information is out there, accessible to all, to know about it. The same goes for choosing where you have a procedure and much more.
- Seek to build a convincing case for the use of IT in healthcare, which can bring the patient – closer to the health service. Notwithstanding the issues in my first point, IT in healthcare HAS to happen. It will save money, improve experience and ultimately deliver better outcomes. There has been a disastrous failure across european with IT in health, but that doesn’t mean it can be ignored UKHealthCamp ’15 looked at a lot of this. And there is now innovation galore in consumer health, B-2-B solutions, powerful ‘smart’ devices, and much more going on. How this is all connected-up and used in a coherent fashion – technically, clinically and legally, is perhaps the biggest challenge.
Link to consultation page: Person-centred care for long-term conditions: ‘Our Declaration’
NHS England – National Patient Reported Outcome Measures (PROMs) Programme Consultation
Patient Reported Outcome Measures (PROMs) measure health gain in patients, and have been collected across England since 2009. Patients are asked to complete questionnaires before and after their operations to assess the improvement in their health as they perceive it. Predominantly done on paper, and costing £825,000 per year for the four mandated (specified in the NHS Outcomes Framework (3.1) data collections, NHS England is consulting on the future content of the national PROMs programme to learn ‘hot to utilise.. resources most effectively to understand the outcomes which matter to patients, to highlight areas with unwarranted variation in outcome and to consider indicators for service improvement’.
In my response I highlighted the need for reliable data – which goes beyond clinical judgement – as this 1) forced a patient-centric view into the data, and 2) help highlight issues – such as transport, care, nutrition, and other issues, which may be out-of-scope or missed by the treating establishment. As such I was ‘for’ the confutation of PROMs, and indeed felt they should go beyond the four criteria. Whether there is scope to transform the ‘capture’ process into a digital service to enhanced efficiency should be evaluated.
Consultation link: National Patient Reported Outcome Measures (PROMs) Programme Consultation
NHS England – Cancer Dashboard feedback
The development of a cancer dashboard is a key recommendation from the July 2015 report of the Independent Cancer Taskforce, Achieving World-Class Cancer Outcomes.
The primary audience for the dashboard is the health system and health professionals, as an aid to making decisions affecting the development of better services. Patients and members of the public with an interest to achieve a better understand of how cancer services in their local areas are working, were also given an opportunity to comment at this stage.
Some patients, and clinicians, may argue that it this sort of approach turns the patient into an integer, but as somebody who has worked at the european level of health policy in Brussels, I do think it’s critical for people to have better indicators, a capacity to monitor, outcomes included, and an ability to reach for world-leading result. Something, which sadly, the UK in general – if I may be terribly lazy with sweeping generalities – has some battles to fight when compared with some OECD/EU-12/15 figures. Turning the UK’s historic cancel outcomes weakness into a world class innovator with agile metrics and smarter developed solutions for better outcomes can only be a good thing.
December 2015 – July 2016:
NHS England – ‘European Union guidance – Patient engagement’ Reference group.
Invited up by The National Health Service Commissioning Board (branded as ‘NHS England’), I am a Reference Group member and active participant to the reformulation of current communication regarding to the guidance given to patients living in England who wish to access NHS-funded healthcare in another European Economic Area (EEA) country through the ‘EU Directive’ route, and ‘S1’ schemes. Related to this, I recently attended the ‘design event’ with patients, carers, and related organisations to best ensure the communication is concise, accurate, and clear.
Attended by policy, clinical and IT specialists, this ‘unconference’ event sought to collate the challenges, solutions and opportunities for IT within the NHS’s 9,000 organisations. As ongoing efforts of early prototyping ‘NHS.alpha’ and much more continue, attendees remain in touch and share learnings and thoughts.