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HEALTH


A strategy for an ‘agile’ development process proved invaluable in the Covid-19 public health emergency


Alistair Hann’s step-by-step masterplan for the National Digital Service


BY KEVIN O’SULLIVAN


When Alistair Hann first outlined his vision for a national digital platform for health, he used a cartoon strip outlining two very distinct ways of building a car. Going horizontally, the top pictured a single wheel, followed by two wheels, the body and then the roof, whilst the bottom depicted a skateboard, scooter, bicycle, motorbike and, finally, the complete vehicle. Te point he was making was


that although your end goal might be the car, it’s better to have some- thing you can use in the meantime – even if different to what was in- tended – rather than components that are useless on their own. Almost two years on from that


blog post launching the National Digital Service (NDS), and the former chief technology officer (CTO) at Skyscanner has largely stuck to that diagram and what software engineers term the ‘ag- ile’ development process, which is building and releasing products and making improvements as you go along.


In response to the Covid-19


public health emergency, the approach could not have been more useful as an NDS technical team led by Hann as CTO of NES National Digital Service set about developing the nationwide SMS/ text message service for vulner- able shielding groups. “Tat was a remarkable project


in a way because the letters went out on Tursday and the service was live on the Saturday, it went up in no time at all,” says Hann. “Tat was a very agile way of project delivery because the first version was getting people signed up, and then it was, ‘Do you need a food delivery?’ and then, ‘Do you need one box or two boxes?’ “And it got more sophisticated


over time as we found out that actually some people would rather have supermarket deliveries, but they were having difficulties get- ting slots, so we could then change it to something in their postcode that could say here are the super- markets that could deliver to you. Tat was out of left field. “Te SMS service was not


something we were planning on, 22 | FUTURESCOT | WINTER 2020/21


but it was a good foundation in citizen communication, so I think we’ve learned a lot from it,” says Hann. “Sometimes when you’re delivering a service you think could this exclude people or lead to them not getting access to the things they need, or not everyone having a mobile phone. Actually, we now have some very concrete data on the people in the at-risk group, the various age groups in high level areas, and on how they would work with an SMS service, so it’s a two-way service unlike sending a letter.” Hann and his team adapted


and refined the system along the way, so it kept meeting the ever- changing requirements of the shielding community in Scotland, which numbered around 120,000 people, including children, who were at very high risk of severe illness from Covid-19. Another urgent project from


government was a request to develop an emergency eye-care referrals service. Because of the severe restrictions on community optometry services, many high street branches had closed their


At the launch of the National Digital Service, Alistair Hann’s strategy was designed to join up sources of data and information in the vast disjointed healthcare landscape


doors to limit the spread of the vi- rus. NDS worked with colleagues in NHS Grampian and NHS Forth Valley on an eye-care product. Te service introduced an open- source electronic patient record (EPR) for ophthalmology called ‘Openeyes’ onto the National Digital Platform, to enable virtual consultations with patients and to share the information needed to treat patients between optom- etrists and ophthalmologists.


Although Covid-19 led to unanticipated work for NDS, the core teams involved in much of it have now been able to get back to their original purpose. Set up by government in June 2018 following the publication of the Digital Health and Care strategy,


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