Patient portals: How to open the digital front door to better NHS care

All non-specialist acute trusts must have procured a portal solution by September. In the light of NHS England’s mandate, Bruno Botelho, director of digital operations at a major London trust, explains how to roll out a portal that delivers huge benefits for patients and staff

We continue to face a significant challenge in managing elective backlogs. Wait times increased during the pandemic and there is clearly a risk they may take much longer than we previously anticipated to return to pre-pandemic figures.

But there is also an opportunity to fundamentally change how patients access and engage with services within the NHS. New national expectations set by NHS England, which require all non-specialist acute trusts to establish patient portals in 2023/24, present a potential turning point for some of the longest-standing challenges facing the NHS.

Empowering patients

At Chelsea and Westminster Hospital NHS Foundation Trust, we’ve been working to develop our patient portal technology with DrDoctor – and we now have a mature solution in place that brings significant benefits to patients, staff, and the overall patient journey.

We started to see the real power in portal technology when we concluded a pilot in our endoscopy department. We sent out pre-assessment questionnaires for patients to complete ahead of their hospital visit, which ended up saving around four hours a day for endoscopy staff and led to a substantial reduction in missed appointments.

Since then, we’ve expanded the use of our patient portal across the entire trust, where it’s being used for the management of digital letters, appointments, patient-initiated follow-up (PIFU) requests, questionnaires and more.

The results speak for themselves: by giving patients the option to play a more active role in their care through our portal, our productivity has the potential to increase. Two in three patients are choosing to complete their endoscopy pre-assessment online, while between 70% and 75% of patients have embraced digital letters, including nearly half of patients over the age of 90.

Clearly, patients across all age groups are ready and willing to adopt new technologies for a better healthcare experience. Our patient portal has allowed us to reach patients faster by empowering them to engage with us through a single digital channel; and by giving patients the option to play a more active role in their care, staff can spend their time more productively.

Cutting the backlog

The functionality offered by our portal also means we are successfully delivering on NHS England’s new expectations for patient portal technology.

The requirements for trusts expect portals to improve waitlist validation, reduce DNAs, streamline perioperative and postoperative processes, and increase PIFU rates. At Chelsea and Westminster, we’ve been effectively validating waitlists with our portal technology since 2018, putting us comfortably ahead of the curve of the national targets for 2023/24.

By being able to quickly contact patients and identify those who no longer need to be seen by us, we have been able to reduce our backlogs and ensure that patients who do require care are seen more quickly. At the same time, the easy integration of the technology with other tools within our Care Coordination Solution has enabled us to simplify and automate processes. As a result, we have more engaged patients, more productive and motivated staff, and a more accurate read on service demand, releasing pressure on teams throughout the trust.

From a patient perspective, not having to dial into already incredibly busy phone lines is also a massive benefit – as it is for the staff tasked with managing said lines, which is hugely resource-intensive. And, thanks to the electronic broadcast messaging functionality provided by our portal, we can instantly alert patients to changes to clinics or appointment types, again reducing rates of missed appointments and freeing up capacity for patients with more urgent care needs.

Transforming NHS engagement

Given that all non-specialist acute trusts must have procured a portal solution by September, the onus is on IT and digital teams to prioritise this work. Finding a supplier with demonstrable experience within the NHS is crucial to getting this right, and we have been lucky to have found a partner who shares similar patient-focused objectives to us.

Of course, our success can’t be attributed to a single digital solution: it is the result of a collective and concerted effort by multiple stakeholders working together to support the delivery of better patient care. The implementation of patient portals requires an operationally led, IT enabled approach with a senior responsible officer (SRO) at the helm. If these three conditions are met, trusts should be in a favourable position to accelerate their portal implementation in line with NHS England’s timeline.

Digital-first models of care aren’t just something NHS England is pushing for: patients want them, too. The expansion of patient portals presents an opportunity for NHS trusts to make significant improvements to pathways and transform the way people engage with NHS services.

DrDoctor’s portal will be rolled out across North West London ICS over the next two years. Working in a digital-first way will improve wait times and cut missed appointments, as well as bring significant time-savings to overstretched staff.

We hope other trusts will be inspired by our success. With funding from NHS England and with the right partner on board, trusts at any stage of their patient portal journey can transform how patients interact with the NHS and tackle some of the healthcare service’s most urgent – yet solvable – challenges.

Bruno Botelho is deputy chief operating officer and director of digital operations and innovation, Chelsea and Westminster Hospital NHS Foundation Trust