NHS Digital consults the public on data and tech

Recently, NHS Digital has published two public consultations that are of broad public interest and deserving of comprehensive feedback. They are looking to define principles and standards for the use of NHS technology and data.

I’ve summarised and linked to them below in the hope that you will take a bit of time to take part.

Continue reading “NHS Digital consults the public on data and tech”

NHS Hack Day – What is a pitch, and who should do one?

This is a shadow copy of the blog post published on (NHSHackDay.com): (http://nhshackday.com/blog/posts/2018/01/17/everything-you-ever-wanted-to-know-about-pitching)

If you’re new to NHS Hack Day (and even if you’re not), the thought of pitching your idea to an entire room of people is quite daunting.

So who should pitch at NHS Hack Day? And what even is a pitch anyway…?

Let’s cover the what and who bits first.

What is a pitch?

A pitch is a short opportunity for a person to share a project idea to tempt others to work on it with them.

At the start of NHS Hack Day, anyone with a problem or project they think might be interesting to other attendees can speak for up to 60 seconds to explain it to the rest of the group.

Based on these short pitches, other attendees decide what they’d like to spend time on on during the weekend.

The pitches are short, and so it is not possible to use slides or to show demos on the projector. This is almost always a good thing — you can focus on making your explanation as clear to as many people as possible.

If you really need to show something (seriously, you probably don’t), you could hold up a sheet of flipchart paper (we’ll have lots of this) — but try not to over-complicate or over-think it 🙂

Who should pitch?

Short answer: Anyone.

Longer answer: This is an opportunity for anyone with an idea that they’d like to explore, or a problem they have in their day-to-day work, to tell a room full of smart and motivated people about it, with the aim of coming up with a joint solution, or even ‘just’ some more information about the problem.

The weekend will be a great opportunity for you to learn about what other people in your sector are doing, and how they’re addressing the problems they face; but of course this will work best if everyone buys in.

I’m still not sure

Ok, so now you know why you are totally someone who should pitch at NHS Hack Day, but you’re still not sure?

Here are some common concerns about pitching:

1. I’m not very good at presenting to audiences

Firstly, you are probably a whole load better at it than you think you are.

Secondly, the NHS Hack Day community does not attract polished speakers with years of presentation experience. It attracts people just like you and I, who have the same apprehensions.

The quick-fire pitching style is actually fun. It’s so different to a formal presentation that people won’t even think about the sort of things you’re worried about.

And if you’re still not sure: talk to an organiser or hang back down the queue a bit, watch some other people pitch first, and then see how you feel. Every hack event we’ve held has had at least one last minute idea pitched where someone gets inspired by the other pitches.

Lastly, no one will even notice if you decide not to go ahead. 🙂

If you think that talking through your pitch with someone might help, do get in touch with our team of volunteers on the event Slack, on Twitter, or at hello@openhealthcare.org.uk and we’ll be happy to try and help you.

2. My idea is not developed enough to be interesting or useful

This is just not A Thing!

The best ideas for an NHS Hack Day are those ones that have plenty of room to be developed. That’s why we’re at NHS Hack Day in the first place, right?

People come to NHS Hack Day for a number of reasons: to work on an idea or problem they have, to get stuck in helping other people develop their ideas, or just to learn about what’s happening and to meet people.

In any case, what you have to offer is valuable to the community – we promise.

Your pitch might be as simple as describing a problem that you’ve encountered, and there will be people in the audience for whom that is enough for them to get problem-solving with you.

You might have a clear idea, but feel like you haven’t developed the ‘how’ enough yet — that’s great! Tell the audience this, and ask them to help you work out the ‘how’. Again, this will be a really interesting proposition for some people.

Be careful here not to pitch a solution rather than a problem, see Tip 5 in our first blog (http://nhshackday.com/blog/posts/2017/11/15/top-10-tips-for-awesome-pitches) for more info on this!

There is no idea too small or too early to pitch – you’ll get a feel for this as soon as you see what other people are pitching.

3. My idea isn’t interesting enough, or the other ideas will be more interesting

“Interesting” is a personal thing. You really can’t guess what will or won’t be interesting to other people in our community.

NHS Hack Day often ends up with only some of the original pitches actually being worked on; this is entirely normal, and is a result of the self-organising that happens at these events.

It is possible that your pitch won’t make it all the way to the end of the weekend, but this is not a reflection of quality, interest, value, or you. You might even decide that you’d rather work on someone else’s idea (this happens ALL the time).

Go on, give pitching a go

Don’t be shy: do consider having a go at pitching. Your friends at NHS Hack Day are the best people you could do this with for sure.

And lastly, as always, if you have any questions about anything in this post (or indeed about anything else), do get in touch with our team of volunteers on the event Slack, on Twitter, or at hello@openhealthcare.org.uk and we’ll be happy to help.

The Zen of Interoperability

I was having a discussion with a colleague this week about architectural options for some specific interoperability use cases we are tackling.

The conversation touched on implementation choice – how much flexibility should there be in how to approach specific interoperability use cases within the NHS?

I’ve thought about this quite a bit, and struggled with the complexity that “many ways to do the same thing” can introduce. I naturally found myself quoting PEP 20 — The Zen of Python | Python.org.


There should be one — and preferably only one — obvious way to do it.

Could this be a reasonable principle for us to take with NHS interoperability?

I wonder if there is a place for “The Zen of NHS Interoperability” – to define some guiding principles for all of us working hard to make interoperability useful for the NHS.

Here is a slightly tongue-in-cheek attempt at a “Zen of NHS Interoperability” 🙂

The Zen of Interoperability

Elegant is better than messy.
Explicit is better than implicit.
Simple is better than complex.
Complex is better than complicated.
Open is better than controlled.
But controlled is better than proprietary.
Readability counts.
Special cases aren't special enough to break the rules.
Although practicality beats purity.
Errors should never pass silently.
Unless explicitly silenced.
In the face of ambiguity, refuse the temptation to guess.
There should be one-- and preferably only one --obvious way to do it.
Although that way may not be obvious at first unless you designed it.
Now is better than never.
Although never is often better than *right* now.
If the implementation is hard to explain, it's a bad idea.
If the implementation is easy to explain, it may be a good idea.
Clear Standards are one honking great idea -- let's have more of those!

What are ‘dispositions’ in Urgent Care?

The majority of the content in this post was provided by a colleague.

In Urgent & Emergency Care, dispositions play a key part in helping us to categorise patients and ensure they get the right response for their clinical need.

‘Dispositions’ are defined here: http://medical-dictionary.thefreedictionary.com/disposition.

It is the third definition we’re interested in here:

3. the plan for continuing health care of a patient following discharge from a given health care facility.

My version of this, with the added context of how we use dispositions in NHS urgent & emergency care is:

A disposition packages the perceived clinical need of a patient in the form of a skill set and a time frame.

e.g. “Speak to a clinician | within 2 hours”

We allocate dispositions using information / input data from the patient and our clinical expertise, and are there to help consistently communicate a point-in-time assessment of a patient’s clinical need in terms of what needs to happen next; they are really only ever recommendations.

Although dispositions are essentially recommendations, some scenarios may have pre-defined dispositions that are considered appropriate.

For example – specific clinical conditions might require a disposition that denotes a response by an ambulance, or Key Performance Indicators (KPIs) such as National Quality Requirements (NQRs) might define a maximum amount of time within which a patient should receive a call back from a General Practitioner (GP).

The decision-making process taken to reach a recommended disposition (skillset and timeframe) will vary between entities too. Different organisations, regions, even clinical IT systems may use different reasoning dependent on specific external factors.

For example – a local region may have recently experienced a high number of clinical incidents with unwell children, and therefore decide that all children are seen by a specialist paediatric service, regardless of their presenting features.

E.g. Disposition of “See paediatric specialist | within 2 hours”

This is still a disposition representing a clinical recommendation – i.e. the recommendation that a child be seen within 2 hours by a paediatric specialist – however the decision on which disposition is appropriate was affected by different factors.

In all situations disposition are based on a combination of expert opinion, relevant evidence, and situational factors and therefore they are always subject to change and re-evaluation.

How are dispositions used?

Once a perceived skillset and timeframe have been “packaged” into a disposition, the response to the patient’s identified need will, and can, vary depending on the availability of services locally, the risk appetite of the responsible organisations or individuals, and the prioritisation within services that are available.

How does this relate to prioritisation?

Prioritisation is the next step and can only ever be relative.

A “package” of information has led to the disposition but other factors will decide which of the patients assigned a similar disposition require priority.

More external factors come into play here, such as the age of the patient, their specific condition, and any co-morbidities they may have.

Again, it is ultimately a matter of expert opinion as to which factors have the greatest weighting when deciding priority (although as we do more with data this is likely to be come more evidence-based and less dependent on pure expert opinion).

All the time expert opinion is a significant part of the decision-making process there will be conflict between different expert perspectives and belief systems.