By Kasia Zan, Partner, Deloitte Digital

The pandemic shifted public expectations of healthcare irreversibly. Large groups of the population are comfortable taking a diagnostic test at home, engaging in virtual consultations, and seeking information and support through digital channels like search engines, social media, and a raft of digital apps and services. While the disruption caused by the pandemic has exacerbated waiting times, it has introduced new technology-enabled ways of accessing health services. It has also increased levels of patient engagement with their own health and led people to seek new ways of addressing their health needs. Consequently, healthcare systems like the NHS need to reflect these changing behaviours when designing services and patient pathways. This will not only deliver more personalised care for ‘consumers’, who have grown used to ‘self- service’ in many other aspects of their lives, but also enables patients and the public to ‘self-care’, releasing capacity for those who need access to clinicians the most. This week’s blog, the second in our series celebrating the 75th anniversary of the NHS, explores the five critical consumer trends driving this shift in patient expectations and behaviours.

1. Informed, self-directed ‘patients’

Many patients (and the public) are increasingly better informed and educated about the management of their health and wellbeing and will proactively seek the care they need, rather than waiting for their GP or healthcare professional to direct or prescribe what they need. The motivation behind this varies – anything from the worried well, to healthy ageing, to ‘not wanting to worry my GP with a niggle’. The result is patients who have created their own ‘pick ‘n’ mix’ of interventions and treatment. The challenge for public health systems like the NHS, which rely on general practices as the gatekeeper to other services, is to work with this change, rather than against it, and avoid trying to force patients into clinical pathways that no longer meet their expectations.

2. Patient ecosystems

Patients, especially those with long-term conditions, live day-in and day-out with their condition but only get to see a clinician for a small proportion of their time. They therefore often build their own ecosystem of formal and informal carers and friends around them. Patients, or even the worried well, also often require more regular access to information, support, care, and a sense of community from a range of different sources, in addition to the information they obtain from clinicians. These personal care ecosystems are often as critical to recovery and wellbeing as the clinical treatment itself. This does, however, bring challenges with ensuring patients are being given accurate information from the different sources influencing their decisions.  

3. The power in your pocket (or on your wrist)

The proliferation of easily accessible and user-friendly devices, services and diagnostics, and specifically the pervasiveness of the mobile phone is fundamentally empowering and educating the public to take control of their own health. Indeed, a number of well-designed and effective digital technologies and services are helping to improve the management of long-term conditions, such as diabetes. The NHS App is also a great example of the public’s appetite to use these types of services, as evidenced by over 30 million downloads since its launch four years ago.¹ The challenge now is to deliver the vision for the NHS App of making it the effective “front door” for patient care.

4. From episodic to continuous lifecycle management

Our current healthcare paradigm is designed around acute episodic interventions. The NHS has acknowledged the need to actively improve and manage the health of specific population groups and has made population health one of the core strategic aims of the new integrated care systems (ICSs) with a remit to integrate datasets and adopt a population health management approach.² However, this is not straightforward. It is still early days and has yet to be adopted at scale or indeed, proactively funded. This provides an ideal opportunity to learn from tactics, which are successful and commonplace in the private sector in driving consumers behaviour change such as loyalty management, behavioural science, incentives, personalisation and rules engines like next-best action.

5. One size does not fit all

Despite the strong appetite for change and the opportunities to improve health outcomes through adopting the range of innovative digital products and services available to consumers and patients, it is clear that no one size fits all. Indeed, meeting the needs of the most excluded and vulnerable in our societies is going to be critically important. It continues to be a core principle of the NHS to serve all that need its services equally. Yet the evidence from the past three years has demonstrated quite clearly just how unequal access is and how prevalent health inequalities are.³  Moreover, disparities in health and digital literacy means digital solutions risk increasing inequities.  Healthcare leaders have a responsibility to ensure that the consumerisation and digitisation of healthcare do not create greater health disparities and that the inclusion principles that are central to the core values of the NHS are applied to all parts of the NHS. Inclusive Design principles, like meeting and exceeding digital accessibility standards, starting design with the edge cases, and seeking opportunities for diverse input from excluded groups are critical to the design of products, pathways and services.  

Conclusion

As we celebrate the 75^th anniversary of the NHS and reflect on learnings from the significant challenges faced in recent years, the critical importance of equitable access to services and support for patients has become even more pressing. Addressing avoidable or remediable differences in health between different population groups mean some groups or individual are likely to require more or different resources to achieve the same outcomes. While easy to use, consumer-friendly, self-directed, digital health services should help resolve some of the most pressing problems today, such as access to clinical services, there is also an opportunity to use these tools to empower patients and the public to live well for longer, and alleviate problems like obesity, addiction and mental health.  Embracing these technologies and the associated behaviour shifts has the potential to change the social contract between the patients, the public and the NHS.

Kasia Zan, Partner, Deloitte Digital

Kasia leads the User Centered Design (UCD) practice at Deloitte Digital. She is focused on using digital technology and innovation to directly and indirectly improve the lives and health of populations, patients, clinicians and health systems and inspired to design health services of the future. She is expert in using human-centered and design thinking methods to uncover problems, design and deliver digital solutions that are user-friendly, effective and robust.

Email | LinkedIn

_____________________________________________________________________

1 https://digital.nhs.uk/news/2023/nhs-app-hits-over-30-million-sign-ups 

2 NHS England » Population Health and the Population Health Management Programme

3 The Future of Public Health: Identifying the gap | Deloitte UK