Researching barriers to interoperability in health NHS England and Improvement

An ambition to make health and social care interoperable was proving difficult. We gathered evidence to help shape a national strategy.

The challenge

In March 2021, the Secretary of State for Health and Social Care gave a speech about the critical importance technology has played in the coronavirus response.

He highlighted how interoperability - joining up IT systems to allow instant data-sharing - has the potential to transform health and social care.

We were engaged by NHSX (now NHS England and Improvement) to carry out a discovery phase into a digital solution that could move the government closer to its ambition of an interoperable health and social care system.

Mapping out the problem space
A workshop plotting out types of interoperability standards

Identifying the problem to solve

Over 4 weeks carried out a discovery that explored:

  • the user groups and their role in building, commissioning and enforcing interoperable health tech
  • their needs and pain points
  • the extent to which NHSX’s proposed standards catalogue would meet their needs

In total we carried out 28 sessions with users, identifying over 60 user needs and 9 high level problems that need to be solved for interoperability to be achieved. These are:

1. Difficulty finding standards - standards are published by multiple organisations and there’s nowhere to see standards by care setting or use case.

2. Low levels of understanding - interoperability, standards and the benefits they bring aren’t well understood.

3. Lack of mandation and enforcement - users want the NHS to decide which interoperability standards to use and then mandate and enforce them.

4. Issues with contracts and procurement - contracts don’t always list the correct standards or stipulate that data must be owned by care settings.

5. Standards development can be slow - early adopters are happy using experimental standards but others are waiting for them to be finalised.

6. Uncertainty around funding - there’s no funding to align health care providers’ existing solutions to minimum standards.

7. Healthcare providers have competing priorities - with many other problems to solve it’s important to win hearts and minds.

8. Difficulty accessing central data services - this includes services such as the Patient Demographic Service.

9. People find it hard to get support - this is a niche area so connecting people working on similar problems can help drive adoption.

A screenshot of a user neeeds board
A section of the board used to capture all user needs identified in discovery

A clear way forward

NHS England and Improvement now has a rich source of clear evidence with which to inform their overarching strategy.

To help them move forward we produced:

  • a user ecosystem map visualising the 50 different user groups and their relationships to one another
  • a user needs board with the 60 identified user needs, categorised into themes that can be taken forward in separate work streams
  • a list of prioritised user needs to inform the design of the standards catalogue in Alpha
  • communication materials to help inform and engage stakeholders

Feedback from NHSX’s senior leaders has been extremely positive.

“I just want to say: amazing work all! Thank you. Really impressed with [your final] report” Irina Bolychevsky, NHSX Director of Standards and Interoperability

More on this project

Designing solutions to join up health tech

Building the NHS Data Standards Directory

Get in touch

Whether you’re ready to start your project now or you just want to talk things through, we’d love to hear from you.

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