Priority two: Digital options are increasingly available as a choice for people accessing services and staff delivering them.
The ways care is delivered is changing, with an increasing number of services becoming digital, either fully or in part. These range from basic services, such as ordering repeat prescriptions, booking appointments and accessing trusted online information, to the digital tools and products to help people manage their own health and wellbeing at home. Over the coming years, digital services will become the first point of contact with health and care services for many people, and will inform how many will choose to engage with health and care services on an ongoing basis. Coupled with the work on digital access, this will result in an overt 'digital citizen', who is suitably empowered and enabled to use digital technology to support their individual needs.
Some of this is about building on the significant growth in people going online to access trusted information. For example, there were well over 8 million visits to NHS Inform in April 2021, up from under 2 million in April 2018. NHS Inform currently offers digital access to information; however, a growing number of services, such as appointment scheduling for Covid-19 vaccines, are also offered. Linking it and Care Information Scotland into the wider health and care system, there is an opportunity to develop it as a 'front door' service in its own right to a far greater range of services and support across the whole of health and care.
The Digital Front Door
This strategy commits to developing a new streamlined approach to how people navigate their way through services, which will include a safe, simple and secure digital app. This will support people to access information and services directly – like a 'digital front door' – as well as self-manage, and access and contribute to their own health and care information. This new service will be built on a common approach to online identity where personal data is controlled by the individual and people are able to authenticate their identity. It will enhance access and convenience, providing a better, consistent service experience to users. It will also reduce the administrative workload on staff and services.
We recognise that these ambitions will require service re-design, not just at a national level but at a local level too. This is particularly important as we consider the wider steps that should be taken as we recover and re-mobilise from Covid-19 and proceed with ambitious reforms of the care system, including the development of a National Care Service.
Health and care support not only takes place in a variety of formal settings, but increasingly also in the community, in people's homes or in libraries and community hubs. Supporting the shift in balance of care into community settings, by delivering more care at home and reducing rates of admission to acute hospital services is essential to how we plan services of the future. Supporting the adoption of digital practices, including through collaboration with partners across the third, independent and housing sectors, is a central component of how we can achieve this ambition.
All this is about improving services for people. We recognise that people want services that are accessible and simple to use. They want them to be inclusive, designed around their needs and responsive to changes in circumstances. That is why we will ensure that we are designing services around the needs of the people who use them and will support people to play a full and active part in this process from the outset.
Remote Health Pathways: Digital Dermatology
This service lets people upload images of their skin and report on their condition from a convenient place and at a time that suits them. The service allows two-way messaging between the patient and clinician and the information can be shared with people supporting the patient (where consent is given). It stops unnecessary travel to appointments and saves time for patients and staff.
Supporting People At Home
Telecare services currently support around 182,000 people in Scotland to live independently and safely at home.
Telecare devices relay information from a person's home or community to a 24/7 monitoring centre, to be acted on in some way. Telecare services help prevent unsafe conditions developing and enable a quick response should an incident – such as a fire or a fall – occur. Monitoring centres in Scotland handle around 5 million calls each year.
The introduction of digital telecare will support a shift to a more proactive and preventative approach with the potential to integrate and use citizens' data to assess, anticipate and even predict needs enabling earlier intervention and improved resilience and wellbeing.
Digital Mental Health Therapy Services
Eighteen evidence-based digital mental health CBT treatments are currently available covering a range of conditions such as depression and anxiety disorders. Supporting patients and Health and Care staff over 46,000 referrals and self-referrals have been received by digital therapy services in the last twelve months.
Treatment is completed in patients' homes at a time which suits them and is offered with minimal delay greatly increasing availability of service across the population of Scotland.
To improve digital services we will:
- Develop a fully interactive 'Front Door', both online and via mobile, into a range of different services across health and care. This will be a way in to both digital and physical services across the statutory, third and independent sectors, making it more convenient to access timely services across a choice of channels.
- Continue to enable prevention, independent living and healthy ageing through the provision of digital services in the home, such as telecare and the use of smart sensors.
- Facilitate and develop opportunities for digital services as part of social care reform, including in support of residents in care homes and those in receipt of care at home.
- Enable people to book/rearrange appointments online, order prescriptions, update their details and generally conduct all routine 'transactions' online.
- Provide the ability for people to use digital products and services to manage their condition(s). This means being able to access health assessments, diagnosis, monitoring and treatments, making it an option for everyone with a long term condition to use digital tools.
- Expand the range of fully digital clinical and care services, treatment and support available, based on the latest evidence.
- Increase access to evidence-based digital mental health treatments, products and services. For example, build on computerised cognitive behavioural therapies (cCBT) to expand treatment choice, while enabling people to better manage their own mental health and wellbeing.
- Continue to look to bridge the digital divide by supporting the overall national approach to digital inclusion, building upon the success of the Digital in Care Home Action Plan and working to improve digital health literacy, including promoting the use of trusted online health and care information.
- Provide software which is intuitive, safe and supports work-planning across the health and care system.
- Ensure all staff have the devices and equipment they need to do their job, including the ability to work remotely/flexibly.
- Ensure there is one single and secure way for staff to sign in to clinical and care systems and data. This will both improve safe access, and ensure staff have the same experience of, and access to, core digital tools throughout the health and care system.
- Provide user-friendly, role-appropriate information and resources to support the individual being cared for.
- Develop and publish a framework for the development and implementation of digital services.
- Provide better access to appropriate data, to better analyse, understand and improve processes and services at different levels and better inform strategic planning priorities.