The what and the why
Quarter three of 2022 has seen Patients Know Best, and many of our customers hit some milestones in patient registrations, data sharing and usage. On the 1st of August, our 2 millionth user registered, just 9 months after we hit a million users in November 2021. Many of our customers’ regions and organisations have hit new highs in digital patient engagement which will be touched on throughout this piece.
But first, why is digital engagement so important? Why do we care so much about getting patients registered, how much data is shared with them and how much they use the platform? Well, for PKB as a business, this shows we are delivering a product that is useful for our customers and their users, but for the NHS there has never been a more important and beneficial time to get patients digitally engaged and enabled. The current method of service delivery in the NHS is unable to cope with the demands being placed upon it. Waiting lists are ever-growing and the capacity to manage the number of patients needing assessment and care is not enough. Even prior to COVID-19, the long term plan talked of reforming service delivery and placed great emphasis on the use of digital tools to support this redesign.
Digital platforms can be used to reduce demand and streamline services, where appropriate, but the success of these recovery programmes depends on the engagement they get with patients. This engagement is not just enabling transaction services such as booking appointments, but truly educating patients to understand how to be active participants in their healthcare outcomes, working in partnership with the NHS to ‘do’ healthcare rather than have healthcare ‘done’ to them.
Digital is not the answer, patients are the answer, and digital is the enabler. This starts with getting patients onboarded to digital platforms.
Once the digital foundations are in place, onboarded patients can be better managed on waiting lists, prepared for their assessments and admissions more effectively, and in-person routine care can be reduced. Programmes like patient-initiated follow-ups (PIFU), waiting well/preparation lists and safe, early-supported discharge can be achieved by equipping patients with digital tools and materials to manage their health to the best of their ability, and get back in touch when they need additional support. You can read more about supporting elective recovery here.
The growth of registered users is a testament to the progression in our customer rollouts and patient engagement strategies, as well as the progress and maturing of national supporting programmes including NHS App and NHS login.
Some of the customer achievements we wanted to highlight and their specific achievement awards are noted below, with further explanation on how they have achieved these milestones, and their ongoing strategies.
‘Most registered patients’ – North West London (NWL) ICS currently have over 447,000 of their population (19%) registered to use PKB (branded as the Care Information Exchange) with three of their Acute Hospitals in our top 10 organisations for registering patients. NWL have been the PKB trailblazers for many years, being the first to switch on automated data sharing at scale for many clinical documents, test results. This brings together data from multiple organisations in one region to collaborate around a shared record for their patients benefit. NWL are now able to build on this scale to do more digital engagement with a large volume of their patient population.
‘Highest % of population registered & data diversity equity and inclusion’ -Sussex ICS started with individual deployments of PKB, and over the last couple of years have brought their strategies together to approach this as a whole region to maximise strategies and learning resulting in the regional ‘My Health and Care Record’. This has paid off as Sussex now have 20% of their population registered for their PKB record, over 340,000 patients! Our largest % of population registered, for a ICS wide deployment.
In addition, the region has worked together to ensure all patients across East Sussex Healthcare NHS Trust (ESHT) and University Hospitals Sussex NHS Foundation Trust (UHS), their two large acute Trusts have parity in the data they get access. Both Trusts in the last year enabled documentation (letters and lab results), with one Trust sending radiology results and appointments, and the other following within the month. The ICB has worked with the region to ensure consistency in the ways these are configured and delivered.
‘Best patient engagement and communications’ Nottinghamshire ICS were pioneers in instigating and using the PKB/NHS App integration. This integration, and their ongoing programme, including a big focus on digital inclusion, has and continues to be shaped by what their citizens are telling them they need and want from a digital system. Examples of Nottinghamshire’s fantastic communication campaigns are touched on later, but this has resulted in great local buy-in and ongoing engagement.
Finally, Humber and North Yorkshire Health and Care Partnership, who similarly to Sussex started with one organisation but have expanded to an ICS wide contract this year. Their contract set them a target of achieving 5% of their total population to be registered each and every year of their contract, with them already achieving over 15% from two projects within the overall programme.
Importantly, the region also has a strong start in clinical and service transformation/redesign, with Hull University Teaching Hospitals NHS Trust (HUTH), progressing with many projects focused on change in service delivery, underpinned by use of the PKB portal. These processes and blueprints are shared across the other projects in the region, to support an efficient overall programme approach and best practice in learning, spread and adoption.
‘Top 10’ Individual organisations
In addition to the regional programmes success, many individual organisations are making strides forwards in their digital patient engagement, with several topping 200,000 registered patients, and many topping 100,000 with several fast following estimated to join them soon.
As of the end of September the following organisations are on:
Imperial College Healthcare NHS Trust = 296,000 registered patients
University Hospitals Sussex NHS Foundation Trust = 245,000 registered patients with a fast follower in their neighbours East Sussex Healthcare NHS Trust, due to hit 100,000 patients in October
Chelsea and Westminster NHS Foundation Trust = 141,000 registered patients
Hull University Teaching Hospitals NHS Trust = 120,000 registered patients with a fast follower in their neighbour York and Scarborough Teaching Hospitals NHS Foundation Trust due to hit 100,000 patients in October
University Hospitals of Derby and Burton NHS Foundation Trust = 110,000 registered patients
The Hillingdon Hospitals NHS Foundation Trust = 109,000 registered patients
Sherwood Forest Hospitals NHS Foundation Trust = 103,000 registered patients
The Mid Yorkshire Teaching Hospitals NHS Trust = 103,000 registered patients
What are some of the successful strategies?
Examples of the great practices these organisations and regions have utilised to get these levels of registrations and engagement include:
- Expanded use of NHS login as a registration method
Prior to PKB’s NHS login integration, which launched in 2019, patients would need to be registered via collecting verified emails, or tokens sent via letter or SMS. Whilst these methods have a good conversation rate and are still promoted and used widely, they require longer to enable technically (tokens) and typically need more professional input to collect verified emails. The use of NHS login has provided a secure, trusted and easy method to register patients, requiring minimal manual input. Patients can be prompted at various points on their pathway to register to the platform using this method.
- Enabling the PKB/NHS App integration
The PKB/NHS App integration allows regions to turn on additional functionality, provided by PKB, in the NHS App. This allows patients to access a number of new pages, to view their:
- Events and messages
- Care plans
- Test results
Once this integration is enabled, it provides further opportunity for patients to register, as clicking on one of these pages will prompt users to either log in to their PKB record or register if they have not yet claimed a record. In addition, this supports ongoing engagement as it allows patients to enable and receive in-app notifications around new data. Combined with their email notifications, this increases the speed and number of data points accessed. More information on how to promote this and expand the usage of the existing integration can be found in our toolkit here.
These improvements and methods were particularly important during 2020/2021, when many patients’ routine appointments were cancelled or delayed. This meant they were no longer being prompted to register in clinics, and had reduced appointment correspondence. PKB’s continued commitment to engaging and supporting national services such as the NHS App and NHS login is a testament to the impact we know these have on our customers and their patients. This is why these have and will continue to feature on our company roadmap.
- Improved automated invites
Many organisations have established an effective workflow to ensure patients who are not yet registered are prompted in their paper appointment letters to claim their records (using tokens or NHS login). Whilst this automation has seen improvements to registration rates, some organisations are now taking this further to ensure that patients are prompted more frequently than just via appointment letters.
Imperial College Healthcare NHS Trust, has designed a workflow that prompts a patient with an email and an SMS to register via NHS login. This occurs when they have an outpatient appointment, have checked in to a service, or have an Inpatient or Emergency Department admission and have not been invited in an agreed timeframe.
By engaging with patients in this automated way, at more points in their pathway, earlier digital conversion is achieved. This makes every contact count more effectively as patients are more engaged, educated and empowered.
- Engaging communication campaigns
As noted in their achievement, Nottingham and Nottinghamshire have deployed a strong communication campaign to support the rollout of their digital programme. From 2017 to 2019 the programme engaged with their population to find out exactly what the people of Nottingham and Nottinghamshire wanted from digital technology. Throughout 2019 and 2020 the programme worked on promoting the functionalities of the NHS App and wider features available via the Patients Know Best integration, through a variety of forums. Following this, and on an ongoing basis, the programme continues to involve people in the evolution of the projects to ensure maximum uptake and benefits realisation.
These engagements have spanned a range of forums.
- Roadshows to raise awareness, provide information and promote digital services and support that was available to their population.
- Monthly Key Message emails to update stakeholders
- Local hospital walk around sessions to inform and support staff
- Weekly and monthly segments in stakeholder bulletins
- A system wide Communication and Engagement Focus Group
- Radio adverts
- A four month Social Media campaign, consisting of:
- NHS App call to action
- Targeted PKB feature specific promotion
The benefits of engaging in communication campaigns are widespread, but these contribute to engagement and usage by ensuring that not only has the programme been designed around peoples needs but also informing those who are unaware and giving them reasons for both initial registration and ongoing usage. If patients/users do not know what benefits signing-up will give them, they are less likely to do so – making them aware of a programme, what it means for them and ongoing improvements, increases the likelihood of those benefits being realised.
Just some of the ways organisations are increasing engagement via different communication methods:
- North West London NHS healthcare organisations promoting the Care Information Exchange (powered by PKB) via their website.
- Healthcare across Sussex promotes My Health and Care Record (powered by PKB) via websites that tell a story. They also directly email their patients to make them aware of more data feeds that have or will be enabled shortly.
- Internal communications at Hull University Teaching Hospitals to promote clinical engagement including how teams are using PKB via case studies.
- Promotion of PKB across the hospital at University Hospitals of Derby and Burton with roller banners, videos, posters, screensavers and internal comms.
- Regular and updating communications across social media platforms to raise awareness of PKB for patients and staff at Mid Yorkshire Hospitals.
- Cheshire East ran an in depth communication campaign focusing on building their local brand and then promoting this via videos, social and digital audio advertising, outdoor media, printed booklets posted door to door, and local PR, to name a few. Reflection on this campaign are noted here by the local comms lead.
- The most important, increased data access for patients…
The best way to ensure patients both register and continue to log into their record is to give them valuable data. We know that when new data is made available in a patients record 73% of these data items are accessed by patients. The more data you send to patients, the more they will log in!
The most consistent negative feedback we get from patients is that they do not have enough data/useful data in their record, either on initial registration or on an ongoing basis. This makes them question the point of the platform and the benefit it will bring to them. The more you give your patients, the more they give back. This is best tackled in two ways:
- A good integration and clinical usage plan – we know that not everything can happen on day one and embedding may take time, but having a plan allows you to maximise the benefits at your go live and give your programme the best possible start and ongoing improvements. For our new customers, this is why we put so much emphasis prior to signing your contract on confirming a plan with you, including clarifying your resources and timescale to maximise your roll out.
- Clear communication of the plan – once you have a plan, internal staff comms and external patient/user comms are key to setting expectations, gaining momentum and keeping this going. If patients know what new data, or clinical usage is coming, they are both excited and better prepared for this engagement.
We’re incredibly proud of the progress many of our customers are making. Currently over 20% of the UK population covered under a contract, either with a whole region or an individual Trust. Our customers and implementation teams have developed strong strategies and standardised methodologies of work to give every project the best chance of success, with new learning continually being fed into our advice, guidance and requirements.
However, there is more we can all do including earlier engagement/introduction to patients of digital tools, support ahead of initial engagement and streamlined ongoing digital transformation supporting making every contact count. Patients Know Best are working with many customers to blueprint and capture the success of these programmes.
If you are a current customer wanting to explore methodologies that can be applied to your programme get in touch with your Account or Success Manager. If you are not yet using PKB, but looking at how you can implement digital programmes to support your patient empowerment, elective recovery programmes or transform your services, get in touch with us to find out more about our capabilities.