About this Episode

One of the world’s largest organisations are moving from a paper and fax based information structure to an end to end digital environment. The NHS is in the top five organisations in the world, alongside the Chinese Army and all the variations of MacDonalds around the globe. Therefore, moving this enormous organisation into the digital world is not an easy or quick task.

Starting the transformation is the opening up of the underlying data network. For the last 16 years, a single organisation has provided a network based on the requirements of the pre-modernisation environment. For the last year, the N3 network is being migrated to the new Health and Social Care Network (HSCN) built by co-operating Suppliers in a competitive market. Not only has substancial savings been achieved, the infrastructure to build the new world of care has been upgraded and made more flexible to cope with the changes required.

One of the organisations that has helped in this migration, Exponential-e, is now looking to help NHS, the patients and health suppliers to increase efficiency and reap the rewards of the change.

However, with the fast moving digitisation of health services, are we leaving behind some of the more vunerable members of our society? The ones with the greatest need of Care? What can we do to make sure the new applications can benefit the old and the less able as well as the young and capable.

In this episode, Lynne Magennis talk to Afshin Attari, the Public Sector Director at Exponential-e about these issues.

Afshin, and Exponential-e will be at the Public Sector Network Summit being held in London and Leeds in September 2019. If you would like to hear more, please drop by their stand.

 

Afshin Attari

Afshin Attari

Public Sector Director, Exponential-e

Afshin has had more than 20 years of experience of delivering Information Communications, Technology, Services solutions notably cloud, contact, collaboration, converged secure applications & services to the Financial Services, Public Sector, Utilities and Enterprise markets.  He  is currently responsible for leading, managing and growing Exponential-e’s Public Sector Business Unit.

Afshin currently lives in North London.

Lynne Magennis

Lynne Magennis

Director

Lynne is the Innopsis Director focused on Podcasts and Design.

From a chemical process research background she has moved into the telecommunications business. Her day job is working for the Daisy Group.

 Outside work will find Lynne tending for her horses and dogs in the Home Counties.

About this Episode

About Exponential-e

Exponential-e is an award-winning, privately owned British Cloud and Connectivity provider.They pride themselves on delivering super-fast, low latency Connectivity, flexible and resilient Cloud solutions and world class IT Services.

Their Cloud infrastructure is fully integrated with their 100 Gigabit Carrier-Class Ethernet Network utilising premium grade enterprise compute. It is supported by their UK based 24/7 x 365 customer service desk to deliver a non-stop compute platform for their clients.

Their closely integrated Cloud-Network model has helped hundreds of organisations seamlessly transition to the Cloud – and they firmly believe that “Your Cloud is only as good as your Network.”

Quite simply, they aim to deliver ‘Peace-of-mind-as-a-service’.

About the Public Sector Network Summit

Tuesday 17th September 2019, One Great George Street, Westminster, London SW1P 3AA

Tuesday 24th September 2019, Royal Armouries, Armouries Drive, Leeds LS10 1LT

With discussions around the Future Networks for Government (FN4G) gathering speed, Government Digital Service’s statement that ‘the internet is OK’, a potential shift away from PSN, NHS Digital’s outlines for the future of HSCN and the launch of Network Services 2 there is a growing emphasis on future public sector network services, connectivity and security.

No one solution fits all, and as public sector organisations by their very nature have differing levels of connectivity, security and service requirement we will look to break down and discuss the varied options open to the public sector’s technology departments and teams. We will discuss the potential of cost benefits, increased efficiencies and improvements to public services which can be obtained by the use of current and future network options.

The Public Sector Network Summit will address these issues whilst also focusing on the new Network Services 2 framework and the added benefits to the public sector that this new procurement model provides. Issues around security, zero trust, perimeter defined software and cloud connectivity will also be discussed in detail to provide clarity in this ever changing network landscape.

Attracting circa 150 technology and network professionals from across public sector The Public Sector Networks Summit offers delegates the chance to hear and discuss policies, case-studies on excellent work already taking place around the country, engage with solution providers and network with public sector peers from central and local government, the NHS, emergency services, education and the voluntary sector.

 

Intro  In the next few episodes of the Innopsis podcast, we will be exploring the contributors to the Public Sector Networks Summits being held in London and Leeds during September 2019. If you find the topics interesting, then you’ll be able to explore further with the guests at the Summits. For details of the Summits, please look at the shownotes or visit our web page at www.innopsis.organd click on events. The migration from the N3 network to HSCN has created new opportunities for both suppliers and customers alike. One company that seized the opportunity is Exponential-e, formed in 2002, they have focused on technology led services for connectivity, cloud, unified communications and security. In 2018, they surprised some people by winning the majority of the London area for NHS services. Those who have looked closely at Exponential-e were not surprised. They have invested heavily in their core business and have delighted many customers with their approach. In this episode, Lynne Magennis talks to Afshin Attari, the Public Sector Director from Exponential-e about how the digitising of our health service is improving services and who is being left behind. 
Lynne: Welcome to the latest Innopsis podcast, today we’re going to Afshin Atari, and he’s from Exponential-e. Would you like to talk a little bit about your position within Expo-e?
Afshin: I’m the director of public sector within Exponential-e, and I’m a member of the leadership team within Exponential-e, and I’m responsible in managing Exponential-e’s public sector business.
Lynne: Give us a bit of back ground on what Exponential-e have been doing recently in public sector, because I think they’ve been pretty active.
Afshin: I’d like to draw to one example, which is very significant for us, where we’ve been appointed by a NHS-Digital through the Once for London procurement for the health and social care network. To provide high quality, scalable, cost effective connectivity across London for primary and secondary care organisations. So we’ve been selected to provide site services to three of those STP’s, which are the Sustainability and Transformation Partnerships, STP’s, North West, South East, and South West. What that covers, is it covers 45 health authorities, most importantly, the GP’s when in those areas, which we’re covered by the clinical commissioning group. So in effect, would be serving 20 CCG’s across those areas, and serve and connecting them through fibre, which is a major success for us. But more importantly, I think it’s a major change in how the NHS is going to be connected with a primary fibre connectivity bearer.
Lynne:  So, ultimately our aim is digitising the public services, especially within health, so how do you see that panning out?
Afshin: I think digitising health has many phases to add. Naturally, what we want to do, is to move to an environment where it’s digitally lead, and that could be through applications where patients, or citizens, engage with our health service. Not having to call the surgery, eight o’clock in the morning multiple times, to pick an appointment, could be a way forward. But before we get there, I think, the underlying challenge is ensuring that we have resilient, robust infrastructures to be able to carry these applications. And this is where I think the HSCN initiative can bear those fruits. Once that is in play, the next challenge is ensuring those apps are available for use, and I think the third phase, and more importantly, is to ensure that the citizens, or the patients that are going to be using these digital services, are trained and aware, because we do have a diverse population. Some are more akin with using technology, and some, less. So the training, and the development, and the awareness, is going to be a key part of this digital health agenda, and it won’t happen overnight. Certain it’s going to take a few years for it to come into play.
Lynne:
How do you see that training actually happening? How’s it going to take place do you think?
Afshin:
I think there’s an opportunity to run Alpha or Beta trial applications with nominated users. I certainly use one of the apps in my area. I book my appointments through that. Repeat prescriptions, and actually, I have access to my test results. So, I think monitoring the services to the individuals who are prepared to make use of that, will allow us to get a sample of the challenges. And the second point, I think it is that we may have challenge with getting digital applications working with the older generations. And I think that the way of addressing that is, giving them mechanisms that are not just app based. Potentially telephones, yeah, calling the surgery and integrating the electronic patient record to the receptionist to pull up the patient records, could be a way of taking those burdens away. So I don’t think there is one solution to all. I think we just need to learn from the experiences and adopt a way of engagement based on the occurrences that we see ahead of us
Lynne:
And how does the government see the future for the NHS?
Afshin: With Matt Hancock’s future view around the NHS service, clearly data applications and digital is a key theme, but as we know, the HSCN initiative to replace N3 has been around for a few years now. So the refreshing of infrastructure programme, if I want to call it that, as has been play, but the governments aspirations for Matt Hancock’s forward view is that we actually enable digital health. And the challenge is, and the opportunities that I had explained, in the context of resilient infrastructures applications, which can integrate into that infrastructure, and the consumers, citizens or patients being able to use those applications, are certainly change programmes which need to come into play, and it’s going to take a few years. So, I think the technology adoption could happen fairly quickly if there is the ambition. The user experience is something which is going to take a while to adopt.
Lynne:
Yes, I was going to say, my concern is, primarily, I think that the infrastructure, and the technology are going to move ahead rather quicker than the population. We’ve done a number of these NHS podcasts recently, looking at health issues, and I always bring up what I would consider not perhaps the lowest common denominator, but certainly heading towards the bottom being my mother, who is in a rural area of England, unable to transport herself mainly for her health care. But I feel that she, while she is a computer user, and she is On Net, she may not be ready to be accessing the kind of applications, perhaps, that we’re talking about. And going back again to the profile of people that we would want to be using these apps, in many cases, it will be the people who are our lowest common denominators, who will have most need of those apps. It’s going to be the elderly, disadvantaged in whatever ways is applicable, that are going to need them. So, I think I’m going to return to this training element, and accessibility, and try and get, try and delve a bit more into your opinions on those.
Afshin: Sure, and I think that’s a very valid observation, and I do share those observations with you. I think the challenge is to…  if we forget about digital, just think about engagements, and consider the furthest step of engagement, doesn’t necessarily need to be digital. It can be digital through the users which want to use a digital platform. Call out the telephone example. I mean, even now, when patients call GP surgeries, and I’ve been in a GP surgery, and I can see how busy it is and number of calls coming in. Most cases, you don’t find an integration of their telephone systems into patient records. So, just taking the burden away from the receptionists and the GP, by integrating electronic patient records into a phone number coming in, which is recognised, and pulling up the patient records, could take some of the burden away for the patients which choose to use the phone service to interact with the GP surgery. That could be delivering efficiencies. In the context of digital, the question is where can you move the digital tools into the hands of the user, and the user being comfortable and making use of those digital tools. And I don’t think I have a straight answer for that, because it’s a big challenge and a big opportunity. What I would say is, as we look at the demographics, by definition, we will find a proportion of the population, which are familiar with applications, because they do their banking, they use apps for various engagements, and maybe we can start with those, and that’s in the outsets, we’ll get efficiencies to start with, which will take some of the burden away. Over time, the adoption could take place, but it’s a matter of using the right medium. Be it an application, be it a web interface, or a telephone call. The question is, how can we make the health service more efficient? In responding to the needs of the patients. I think that’s something which is on the table, and most of the professionals are thinking about it, then there’s a technology coming into play every day.
Lynne: So you see, I believe, changes are coming, so how do you think those changes are going to manifest themselves?
Afshin: I think the first step of that change is, as we discussed, is ensuring that we have the fit for purpose infrastructure, and delivering the digital aspects of E-commerce into the health service. The lowest denominator, and the most important denominator, is GP’s. With the advent of HSCN, there is a directive that GP’s should not be using copper based services at all. Everyone should be moving to fibre. And that is a good move, because we have instances where we’ve engaged with our customers, where GP practice leads have had to come in an hour earlier, because where they were based on a copper based service, just to log on to health systems, just in preparation for the patients arriving. And you can imagine that is not a good experience. So moving to a fibre environment, in every GP surgery, and that’s what’s been advocated, and that’s what we’re rolling out across London, is a very first step of that. With that fibre environment, it allows you to deliver applications over that fibre connectivity, unified communications on that platform, and that’s the first step of the journey. The application layer, is one that we’ve discussed, and it needs to be discussed how it’s integrated, how its implemented, how to what base, its adopted, and possibly, there needs to be some sample customers, or patients, on that, so experiences can be gained. As I said previously, I don’t believe it’s a one solution to all. We need to adopt that engagement, and it could be applications, but it could be telephone contact for the older generation, which were more comfortable with using telephone technologies other than using apps. And I think the learning from that will inform us to deliver a better service, but the underlying infrastructures has been, and is, a crucial part of that experience. But the challenge is this, I use the app to access my GP now, because I’ve used that. I’ve got my patient records, I can get my repeat prescriptions, I can make appointments, but through the app, you try to make an appointment, doesn’t have any appointments.  I try, and I sent an email because I’ve had a blood test, and I actually can see my doctor, just a routine, and I couldn’t get an appointment. I had to send emails, so how do I see you? Because it wasn’t even giving me an appointment three or four weeks out. It was saying no appointments available. So, you can make the front end more accessible, but then you need to be able to deal with the demand. Yeah? And that’s the point, because if you can’t deal with the demands, you can make it fully digital, then you give people accessibility, but then that demands gonna start flowing in. And then you’re going to have to deal with it. And the other aspects could be maybe to do video services for GP’s. You get GP consultants on a video because see, you become much more efficient than people travelling to a surgery. You can actually do a video call, yeah? If people are happy to do that.  But I think what you could say is the GP could do much more ten-minute appointments on a video call than cause no shows, people coming in, extending time, etc. It could take some of the work, but I don’t think there’s one solution. I think there are many solutions but, they need to be co orchestrated, coordinated and delivered, I think that’s what NHS intended to do, because these initiatives have been around for years. Yeah? The process for N3, its not just happened overnight. They’ve just woken up to the fact that we’ve got in infrastructure, now how do we make it digital? But the point you make is, a valid one.
Lynne: So we are talking about wholesale culture change. I’m interested to explore your opinions on how to break what I think is a bit of a loop, unfortunately, because we have so much digital adoption within the younger generation, I feel that we may have left out in the cold, the digitally excluded. And as the rest of the world moves on, I feel we’re leaving them behind and we’re actually closing the doors, which we could have used to bring them in. Again, talking from personal experience I suppose, that, actually my mother is becoming less computer orientated than she was, because she’s not being encouraged to do so. And I know there are a lot of initiatives, and there are a lot of samples, and there are lots of cases out there where digital inclusion is top of the agenda. But I do wonder sometimes if we’re not going about it in the right way, and using the media that this particular area of our population does not have access to. I think we’re leaving them behind. I think we’re into our web based interactions, but the telephone contact is a dead end. How do we get people online? So I see, possibly, that other media, like television, and radio encouraging people into web based interaction. There seems to be a dearth of it now. There doesn’t seem to be anything like that anymore. It seems to be an accepted thing, that if you watch a BBC television programme or whatever, that you’ll automatically know exactly how to access the internet. The fact that they no longer put www. at the beginning of web address, and things like this, it seems to be completely accepted that people will know how to access the internet, and we’re losing the people who aren’t. And there are still a lot of them.
Afshin: Agreed, and that is a big challenge. There’s two sides to this. If you look at the health service with engaging with the local authority, everyone has the engage for that environment. It’s not a choice thing, it’s not consuming or its not buying services, it’s an obligation which needs to be fulfilled, and everyone makes use of health service, and we need to serve the citizens, and patients, in that way. So the question is, how do we do that more efficiently? In some cases, we can empower the patients through the tools, where they’re informed, to take that burden away. Banking, yeah? I’m happy to bank through an application, at night, at my own will. And some parties aren’t happy doing that, they like going into a branch, but it’s a matter of choice. But the parties who are prepared to take that engagement, we need to enable those parties, because that will help those individuals experience, because their expectation is that the health service are moving to the digital arena, but also, will take some of the burden away from the self-service and having to deal with, I would say, analogue ways of working. Not digital. And take some of those burdens away. Naturally, there is a certain part of the population, which don’t feel comfortable making use of that, so the question is, how do we make the health service more efficient? And the use of technology, where some of the tasks and the burdens that they would have to go through, which makes them inefficient, and calling up information, accessing data, could become much more automated in responding to those needs. And I think the third piece around digital inclusion is, my mother is 77, and I have the same challenge. It’s because she’s not very technology au fait. The question is, could we think about developing applications which are more user friendly towards the population that are not digitally aware? My experience with her is that she’s not very good at using the computer, but she uses the iPad and her iPhone with much ease, because they’re application driven. She can, for example, access Facebook through an application on her iPhone, but if you ask her to log in through PC, and moving to Facebook, she won’t be able to do that. So the question is, how can we make applications more user friendly, more adaptable, and more responsive to that generation which feel comfortable making use of that technology? But It’s, as I said, its multiple routes to solve a problem. The first point is around efficiency in the health service, and the second point is the user experience. And I think it is a challenge that most companies, organisations, government authorities have as we move down this digital age, because there is space of capabilities in it, that our younger generations are much more capable, compared to the older generations.
Lynne: I think there’s still a way for all to public information films on the television.
Afshin: Yeah.
Lynne: I have to say, I’m just amazed, it’s a slight bug-bear of mine I think, as for internet banking. I can’t remember the last time I saw an advertisement on the television or on the radio actually extolling online banking and showing what you can do, because I’m sure that many people, because the medium I feel most applicable to our parents is the television and the newspaper, or the radio. And I don’t see them being used at the moment enough, to try to drive the digital message out to those users, I really don’t. I don’t see advertisements on the television telling people how good online banking is. I don’t see advertisements from the NHS saying “These kind of applications are available for you, they will make your life easier if you start to use them.” And actually showing people what they can do, and say, if you want to get online, contact these people, because that part of it now, seems to be in the past. It almost seems like if you’re not online at the moment, you don’t have that ability to break in. It’s much easier for my mother and your mother, because they have us. But if they don’t have us to do that, how, as an older person, do you, one day decide that actually, I’ve seen this advert. I’d quite fancy getting on this NHS applications lot, I’m going have a go at this blow driving to the surgery ten miles, but how do I actually start? There doesn’t seem to be any way they can actually get in apart from literally getting in the car and driving to a well-known computer emporium, and walking in and saying I want to get on the net, how do I do this? Because I don’t even know that some people are even able to take that step. And it’s not necessarily a question of people not being comfortable with using the internet. I feel that its past them by completely. I have another parent who has no access to the internet, and no interest in doing so, but I do feel that as she gets older, it would be to her advantage, but getting her moving in that direction is very difficult, and she sees no benefit in it. I think NHS-Digital should be sponsoring advertisements on the television to get to people, that’s what I think is the route to digital inclusion, in my opinion. So, Exponential-e, what’s next on your agenda?
Afshin: So we will be at the public sector network summit planned for September 17th, and we will be pleased to meet people, and discuss some of the points we’ve discussed on this call, and also explain to them that what we are doing in the context of health, but more importantly, not just in health, in central government, local government, and education,
Lynne: Fantastic, thank you very much Afshin Atari, for your podcast. We will see you at the network summit. Thank you.
Afshin:
Thank you.