Some older adults in East London can expect thirty years of poor health, compared with just twelve elsewhere, and this programme aims to close that gap by training junior healthcare staff to deploy digital tools. The NHS faces a severe staff shortage alongside rising demand from long-term conditions like heart failure and diabetes. Many proven digital diagnostics and management apps already exist—such as smartphone urine analysis and digital pharmacy services—but they are not widely used. The main barrier is digital exclusion, affecting not only patients but also staff and entire organisations. This project tackles that by redesigning three frontline roles: expert carers who use digital diagnostics to spot deterioration, healthcare assistants who prescribe apps in GP surgeries, and administrators who guide patients through digital recovery programmes. If successful, the programme could improve patients’ confidence and ability to self-manage, while increasing workforce productivity and remodelling care pathways across East London’s two million people. The approach is designed to scale through training, investment, and adoption partnerships, potentially offering a template for other regions facing similar pressures.
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"_""**Long term conditions** are now a central task of the NHS'_Five Year Forward View **_Lack of staff_** _is ""the biggest priority that we have now... in the NHS""_ Jeremy Hunt We propose to tackle these challenges together. Some in East London can expect thirty years of poor health, compared with just twelve elsewhere. Our mission is improving outcomes and experiences for older adults with long-term conditions, while reducing costs, across the 2 million people of East London. The diagnostics, smartphone applications and management tools in our proposal are already making dramatic contributions to people with long-term conditions. They are Test Bed-ready, and are already being used by senior clinicians and savvy patients. However, there are a range of barriers to their wider use. We think of this in terms of varying types of **_digital exclusion_** faced by: * Patients * Staff * Organisations and systems We will look at the power of junior members of the workforce to overcome those barriers, in partnership with patients: Expert carers -- domiciliary carers using digital diagnostics and data to spot deterioration and better manage medication, using: * Whzan Telehealth - digital measurement of vital signs * Healthy.io - digital urine analysis * Echo - digital pharmacy Digital prescribers -- Healthcare assistants in primary care prescribing digital applications -- and supporting people to benefit from them - to prevent deterioration of long-term conditions, using: * Our Mobile Health - the platform for digital prescribing, integrated into EMIS * Sleepio - proven digital medicine for sleeplessness * Liva - a digital platform connecting patients and health professionals to drive behaviour change Administrator patient supporters within acute care - administrators using digital pathway tools to support patients to change their lives, using: * DrDoctor - digital appointment and pathway management * Tickerfit - digital programmes of education and exercise for heart failure Through innovations within these three roles, we will seek to: * Improve patients' confidence, health outcomes and ability to self-manage * Increase skills and work force productivity * Remodel areas of the workforce and service pathways across East London * Scale these models, backed by training, investment and dedicated adoption partnerships Care City is an innovation centre for healthy ageing, based in Barking. We will lead the delivery of this programme, with our eight innovators and supported by the following partners: * Nuffield Trust - evaluation * Innovation Unit - service design * Good Things Foundation - digital exclusion and co-design * UCLPartners - system change"
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