Special feature: Moving quickly up the queue

In January this year Scotland’s first minister conceded that there were “unacceptable crises” affecting parts of the country’s National Health Service. John Swinney told an audience at Edinburgh’s Heriot-Watt University that some patients were not getting the care they required at the right place – or right time. 

It will not have come as news to many of us who are increasingly joining the 8am rush of telephone queues to book a call or appointment with a GP – or spending hours in A&E and experiencing lengthy, sometimes painful waits for elective surgery. 

As a much-needed addition to improve patients’ interaction with the NHS, the Scottish Government has announced the launch of the Digital Front Door, a health and social care app that will begin rollout from the end of this year, starting in Lanarkshire, and which it is hoped will become a central and important access and management point for health in Scotland. The Digital Health and Care Division is working with a broad range of stakeholders to deliver the project.

Danielle Henderson is a primary care access improvement expert who is regional sales manager for X-on Health, a pioneer of digital solutions such as advanced cloud-based healthcare telephony, and she believes the need for digital transformation has never been greater. 

She has spent much of her career helping GP practices optimise patient access, streamline operations and adopt cutting-edge technology to meet evolving healthcare needs and now, based in Scotland, is helping the company supporting primary care teams across the country. 

By leveraging existing and emerging digital technologies, she says that patients can be empowered to access primary care and community services appropriately, mitigate unnecessary demands on general practice and – crucially – free up clinical capacity for those with complex health needs.

The company’s cloud architecture, she explains, allows user connectivity on any device such as a mobile, desk phone or softphone, which provides ultimate mobility and transparency.

Moving communications to the X-on Health cloud also provides users with greater flexibility than with traditional premise-based systems, with enhanced and easy upscaling/downscaling achieved easily – and this flexibility she highlights also comes with a considerably lower cost per user, making for a compelling case for migrating to the cloud.

Based in Woodbridge, Suffolk, X-on has become a leader in the healthcare communications sector over the past 20 years and has worked with thousands of customers across many sectors, working with professionals to provide cost-effective communications systems such as Surgery Connect, which allows primary care organisations to transition from legacy phone systems to a secure and flexible Cloud-based system.

With growing concerns over data security in the digital space, this is clearly a key factor and the company’s Trust Centre provides in-depth information about security, privacy, compliance, certificates and credentials across its products and services.

The advent of Scotland’s Digital Front Door, adds Henderson, affords the opportunity to create a seamless, integrated healthcare experience that balances accessibility, efficiency, and workforce sustainability and she believes X-on Health’s technology solutions fit seamlessly with the priorities of the Scottish Government.

“We already supply more than 60 per cent of England’s GP practices with telephony solutions and are now bringing those and others that have been successful there to Scotland, she says. 

“The ultimate aim of the people who work here and the ethos that runs right through the heart of the company is to improve the overall health of the nation and how we do that is by helping to optimise access for patients coming into primary care – because we know that there are many inquiries that come into general practice that don’t need to come that far.”

She adds that one of the most effective ways to relieve pressure on primary care is by improving communication between patients and their providers with digital tools such as cloud-based telephony, Al-driven triage, and unified communication platforms, all helping to help manage demand by ensuring they are directed to the right services at the right time.

The cloud-based telephony employed by X-on enables intelligent call routing and integration with electronic health records, helping avoid the surge in calls associated by that notorious 8am rush while AI-driven systems can analyse symptoms and make sure that clinical time is focused on the most complex cases, reducing unnecessary visits to a GP. 

That means, says Henderson, that on subsequent occasions, patients are less likely to phone their GP practice. “From our experience, that is much more likely to push and offer those services at the point of need to guarantee greater efficiency and success.

“Given that we know that so many people would be happy to use digital tools, then by virtue of the fact that so many people are going online and not phoning into the practice, what’s left is more open queue for those that really do not want to use digital tools for whatever reason.

“Some might feel digitally challenged or have disabilities that would preclude them from using such services – but if you free up that queue, it means you can answer those types of queries from those types of patients more quickly and give them the time and attention that they need.”

The cloud-based telephony employed by X-on enables intelligent call routing and integration with electronic health records

The Digital Front Door, which was included in the Scottish Government’s programme for government in 2021 is described as a ‘safe and secure digital app’ that would allow users to update their personal information, manage who sees their data, book and attend appointments virtually and place prescription orders. 

The technology to be deployed, says Henderson, is an excellent fit with X-on Health’s approach:  “We’ve learned to be extremely agile in terms of reacting to what the market is looking for and that is made so much easier when you have those development resources in house.

“If you’re reselling somebody else’s platform, that degree of agility is compromised by when that product is actually developed in-house, you can quickly  respond and change it to the fast-changing changing requirements of the NHS.”

She stresses that it is this ability to engage with the customer that has that driven the company’s research and development programme with regards to Surgery Connect, the cloud-based phone system and adds that digital tools must be intuitive and user-friendly, helping patients gradually transition to online services rather than excluding those who are less confident about using technology. 

“By integrating these tools into a national framework, we can create a system where patients can self-serve for non-urgent needs, which reduces unnecessary pressure on GP practices and allows clinicians to focus on those who need their expertise most.”

Last year, X-on joined forces with Hanley Consulting to further strengthen its range of technology, data analytics, and expert services. Hanley, it says, brings its own IP in the form of primary care’s first NHS-approved AI-enabled digital assistant – a patent-facing chatbot called Surgery Assist aimed at helping patients navigate away from the phone toward appropriate services, such as Drink Aware and mental health services. 

While the specific nature and specifications of Scotland’s Digital Front Door are still being revealed, Henderson says that it will be important in enabling a range of options for patients.

It will integrate AI, machine learning, telehealth and data-driven healthcare and take on board lessons from international health systems, including Denmark’s eHealth model and insights from NHS leaders, policymakers and industry experts. 

Henderson points out that if everything goes once through one very narrow silo into GP practices, that results in demand outstripping capacity and leads to the delays that many patients are currently experiencing.

“Whereas if you can make services available via multiple channels, such as Digital Support Assistant and telephone systems that signpost you away for certain queries you can give a much better level of service.”

X-on Health believes that further embracing these digital tools now can relieve some of the immediate pressures facing primary care and that Scotland’s Digital Front Door is an opportunity to create the kind of integrated healthcare experience that balances accessibility, efficiency, and workforce sustainability – focusing on patients’ needs as primary healthcare faces increasing pressure from rising demand, workforce challenges, and health inequalities.

Henderson and X-on Health are clearly enthusiastic about the benefits these digital tools will mean to Scotland as it the country rolls out its Digital Front Door programme.

“Because of our experience in England, we are now fabulously placed to help Scottish practices, and we have a fantastic offering,” she says. 

“And I’m noticing in my encouraging conversations here with key people in digital transformation roles within Scottish Government and other organisations in the sector that there are good grounds for us being extremely excited about the difference that we will be able to make here.” 

This special feature is in association with X-on Health. X-on Health provides a full range of training resources, both during and after onboarding, and using in-house dedicated, training and support staff. A webinar on April 29 will focus on a practice in the north west of England which has used available technologies to redesign the way that its patient community accesses primary care services.

www.x-on.co.uk/scotland