A Vision For The NHS: A Citizen Wallet

A Vision For The NHS: A Citizen Wallet

Your organisation needs a vision. Without it, you will never be great. You will never advance. You will keep doing the same old things and without any real purpose. A vision gives you a purpose and a focus. But, it needs to have a plan which takes you there. But, without it, how can you ever plan? For any great organisation, you start with a vision.

So, what about a vision for the NHS? I appreciate that I am only a technologist, but I am also a citizen, and I care about the health and well-being of my fellow citizens. I also don’t like bureaucracy and inefficiencies — and I strive in my working life to overcome these. So, our work has generally focused on improving the citizen’s viewpoint of health care.

And, so, I am honoured to present at Digital Scotland 2023 this year, and on a topic which has been our passion for over a decade — a citizen-focused health care system:

I have attended conferences in Scotland and which talk about “citizen-focused health care”, and the audience all go away inspired and ready to build new digital worlds for citizens. But nothing happens, and then we repeat the next year again. Well, this year, I will show that a vision can be created as a reality. With digital wallets, the technology is all in place, and there are no great barriers to overcome, any more.

During the COVID-19 time, there was some hope for digital advancedment and where we saw the use of digital passports — but we have failed to build of these, and have ended up with little in the way of digital engagement between the NHS and the citizen.

So here’s the problem and my vision — and it’s quite simple.

The Problem

I have interacted with the NHS for several decades — luckily, I have never had any medical ailments, but have observed it in relation to others. I have seen some truly shocking practices in dealing with patient records -including for someone in my family have “Do not resuscitate” written on their records without any discussion with the family, and where a physical filing cabinet of patient records had to be moved by taxi from one hospital in Edinburgh to another one.

Overall, there is often great resistance to change and to the adoption of digital methods. The Connecting for Health programme — which cost over £15 billion — had to be eventually cancelled, as it delivered nothing.

Why? Well, one reason is, “Won’t this replace my existing job of writing down the details?”, “Yes, but you can do and do something even better with your time”, “But, this is what I was trained for. Anyway, I don’t trust computers, anyway!”

And, so, recently, I went to register for a GP and was handed a piece of paper and told to find a pen and write down all my details. In virtually every interaction with the NHS, I have had to do this, and perhaps, one day, I will have all my medical details stored on a digital wallet on my phone, and where the GP just scans them in. Once I filled in it, it then went into a black hole — and where I hoped that a human would eventually make sense of my scribbles.

To date, I have yet to receive any confirmation that I have been registered, and I have no on-line place to check my details. The NHS can hardly get to first base in creating a proper online world for my data. It fleetingly sends me the odd email or SMS message, but it still sits behind a high wall.

Overall, in places, it feels like there are still parts of our lives that are stuck in the 20th Century.

The Vision

Let me dream now. One day, I will register for a new GP. I will walk in, and the receptionist will ask me to register. I will press a few buttons and generate a QR code. They will scan this in, and an instant message will appear to say that I am now registered and say that all my details have been registered,

“Ah, Nice to meet you, Bill. I see it is your birthday today. Please can you check your details are okay and consent to its storage?”. “All looks good”.

“How would you like us to contact you, by email or SMS?”, “Email. Please. Here is the QR code for my email address, and you can scan it”.

When I go to see the GP, they ask me for my weight and height, and, again, I go to my wallet and generate a QR code and where the GP scans it in and says,

“That’s great. All is okay. But your BMI is a little high, and a little up from the last time we meet. I will store this in your record, and we can keep a track on it. I will email you some recommendations for your diet”.

How long for this to happen?

How long will it take for this to ever happen? Well, it’s actually not that difficult. We are part of an EU project which has developed the GLASS wallet and which puts the control back in the citizen’s hands:

So, why not come and see it live on 12 Sept in London [here]:

And in November [here]:

Conclusions

We have a dream for an improved healthcare system — and we have had this dream for over a decade. The technology is all in place — we now need to use it and put the power back into the hands of those who really matter — the citizen!