Our Director of Operations and Development attended the King’s Fund ‘Digital Health and Care conference: Learning from COVID-19’.

The King’s Fund, is an independent charitable organisation working to improve health and care in England. Spanning across four days, experts from the NHS and other parts of the digital health system came together to discuss how COVID-19 had transformed the delivery of health care services.

Changes that were thought to require years of careful planning happened in many cases overnight, with technology proving to be a key factor in supporting patients and staff in the delivery of care. One of the interesting things about these rapid changes, is that it isn’t so much in the technology itself but more in the willingness to use it, for example having a telephone consultation is hardly novel, but the increase in usage was exponential. The NHS 111 online, a service that was readily available long before the pandemic saw an increase in traffic of 95 times that of pre-pandemic.

The NHS 111 online, a service that was readily available long before the pandemic saw an increase in traffic of 95 times that of pre-pandemic.

The rapid implementation though, has left the sector with a number of questions, in particular what the future of health and care looks like with increased digital access. This conference gave those in a position of influence a useful platform to reflect on the changes implemented so far.

We were pleased to hear other charities sharing their positive experiences of the wider digital reach, including improved efficiency and capacity and increased engagement for some demographics. However, there are negatives too; some due to the rapid rollout, but others concerning for the longer term. For example, those with multiple conditions may be expected to use numerous different digital platforms, placing a burden on individuals.  A question on everyone’s mind is whether these changes are increasing health inequality. So far though, there is little data to back this idea up and increasingly the sector is accepting the principle that just because everyone doesn’t have access isn’t a reason not to do it. Indeed 100% adoption isn’t essential for it to be successful.

The Chief Executive of NHS Digital, Sarah Wilkinson, spoke quite frankly about the surprise to find that the NHS is capable of absorbing new systems and talked of a future where they must trust they can embrace them.

NHS and industry leaders, who played a central role in bringing about the new digital reality for health care, discussed the lessons learnt during the pandemic so far and shared their views on how they managed to adapt. The Chief Executive of NHS Digital, Sarah Wilkinson, spoke quite frankly about the surprise to find that the NHS is capable of absorbing new systems and talked of a future where they must trust they can embrace them. Of course, they also noted challenges including the length of the pandemic and the pace at which things have transformed.

We heard from the Kings’ Fund team with research updates on the impact of remote working on general practice teams. They found, through interviews, concerns from staff including a strong opposition to full time or majority remote working, fears of loneliness and isolation, a worry of lack of appropriate infrastructure and concerns over the quality of leadership practice.

It was also interesting to compare the UK’s approach to adopting digital access to health services with that of Sweden with the views of a leading Swedish consultant. Digital consultations have been widely accepted across Sweden, however, surprisingly in the UK NHS Digital found in August 2020 less than 1% of primary care visits were digital consultations and that phone calls were the preferred choice. According to Matt Hancock 99% of practices have access to video consultations but most aren’t choosing them, tending to use photographs instead. Perhaps the UK can learn some lessons from how places like Sweden are encouraging a higher uptake.


Sweden's approach

At the time, Sweden had avoided lockdowns in response to the global pandemic. Technology had been embraced in health care though and they found it doesn’t save time for the clinician but is more efficient and does save time for the patient, which is important for the economy. They also noted patients were happier not having to travel and some patients were more relaxed/engaged being on ‘home turf’.

The successful adoption of all things digital was attributed to leading by example, spreading the word and systems promoting use.

In Sweden, they reviewed whether their systems truly promoted use. For example, whether the reimbursement was higher for in person consultation than telephone consultation. The Swedish government promoted use of technology, ensuring there was no difference to the clinician regardless of which method they used. Resulting in them being able to offer complete flexibility so care remains patient centred.


The conference reflected on engagement with patients too. National Voices, a coalition of health and social care charities in England, shared highlights of their report centred around a research study designed to understand the patient experience remote consultations titled ‘The Doctor will Zoom you now’. One of the key areas of focus was on how patients and clinicians can get the most out of remote consultations.


Top tips for patients for getting the most out of virtual health and care experiences (Excerpt from the National Voices’ report ‘The Doctor will Zoom you now’. July 2020):

  • ask for a timeslot for when your remote consultation will take place,
  • let your health care provider know how you prefer to talk by phone, video, or in-person,
  • find somewhere quiet and confidential and, if this isn’t possible or is tricky, make this clear when you are making your appointment,
  • start with a phone call if you’re not confident with video technology,
  • ask for help if you need it and, if possible, do a practice run with a friend,
  • take some time to prepare in advance, consider what you want to say and key questions you would like to ask,
  • ask your health care provider to summarise the next steps at the end of the appointment,
  • remember remote consultations can be useful for routine appointments or ongoing care with a health care practitioner but not all appointments are suitable for remote consultations, if you would like to see someone in-person please say so.


The opportunity to reflect wasn’t limited to health services, with time also to review the impact on social care. There are some ongoing important issues that need addressing if social care can truly embrace the digital age, including concerns around infrastructure, trust, and data security. It was reassuring to hear that despite the challenges, the social care sector remains focussed on keeping people at the forefront of care.

It was reassuring to hear that despite the challenges, the social care sector remains focussed on keeping people at the forefront of care.

Mostly, we are encouraged to know conversations like these are happening sector wide. We especially need to think about how the digital transformation will impact the dystonia community. Since the conference, we have been collecting evidence and developing policy on the topic which we will provide updates on in the future. We know there are several factors to be considered when diagnosing, treating, or living with a movement disorder like dystonia and are working hard to ensure that any future changes take this into consideration.