In conversation with… Yinka Makinde, Head of Innovation at NHSX
Yinka Makinde began her career in clinical pharmacy, switching to healthtech in 2004 and moving into various roles including Director at DigitalHealth.London. There, Yinka single-handedly set up the Digital Pioneer Fellowship, which works to support NHS professionals build their leadership skills for digital projects.
In 2020, Yinka took on a Delivery Lead role at NHSX, before being promoted to Head of Innovation in October 2020. Here, we ask Yinka about her career to date, her theory of why NHSX was set up, and what the NHS needs to do to make digital a reality.
Yinka was interviewed in May 2020 - this piece was originally published as subscriber-exclusive content in June 2020. Yinka is now Director of Digital Workforce at NHSX.
Tell us a bit about yourself and what your role entails.
“I grabbed an opportunity to move out of my mainstream pharmacy profession, but the launch of my healthtech career was based on my clinical expertise.”
“I started at NHSX just as the pandemic was really getting bad in March last year, so when I first joined it was all hands on deck. I was getting involved in the Medopad roll-out initially, but I was very fortunate to have interviewed for a role that came up which turned into Head of Innovation.
“Much of my work now is around clinical pathways and digital transformation. My particular focus at the moment is on cardiovascular disease and working closely with the system, clinicians, and non-clinicians, to scope out what the opportunities are for transformation and then also starting to implement some of those interventions.
“And how I came to do this? Well, I’ve been in the healthcare system for about 27 years – initially starting as a clinician and then changing to healthtech in 2004. My healthtech career has evolved over the last 17 years and my last job before NHSX was running DigitalHealth.London.
NHSX is a relatively new body, why was it set up and how would you describe its mission?
“I have a theory about why it was set up, but it might not necessarily be true. Basically there was a review about the NHS’s ambition to become paperless by 2018. We didn’t hit that target unfortunately, and there was another target imposed for 2020 which we also didn’t make.
“My theory is that NHSX was set up in response to the fact that we weren’t on target to achieving the paperless NHS.”
“But also, digital was being done in many different places and they weren’t necessarily connected, so NHSX was really to bring together the leadership, the policy and the strategy from NHS Improvement and the Department for Health and Social Care.
“Our role is increasingly delivery focused as well. During the pandemic we had to keep delivering things at pace. Now, we need to keep the focus on digitising existing information services and ensuring that information wasaccessible and can flow in an efficient way between different care settings and different organisations within the same care setting. That is fundamental and will create the bedrock for allowing us to deliver a fully connected and sustainable NHS and health and care system going forward.”
How has the pace and direction of policy in healthtech changed due to COVID-19?
“There were some legacy programmes that were already in train before the pandemic hit for example, the implementation of Microsoft Teams - it’s not sexy, but it’s important. We were already making headway with respect to teleconsultations before the pandemic came round but we ended up achieving 99% uptake in video consultations across GP practices during the pandemic, compared with a much slower uptake pre-pandemic. This was out of necessity.
“It also initiated things that we had been thinking about for a while that hadn’t gotten off the ground, such as virtual care and remote monitoring technology. For example, we managed rapid implementation of a remote monitoring platform for COVID-19 patients. And I say rapid because we got this out in three weeks and that’s unprecedented. We use that word a lot, but it was unprecedented for the healthcare system to roll out anything in three weeks – least of all a digital platform. It was a brilliant example of partnership working to make something happen for the good of the patient. The legacy of the pandemic is that we are now taking the remote monitoring work that we did and scaling it nationally.”
How is NHSX working on the goal of a paperless NHS?
“The paperless NHS goal underpins all of our policies, really. The new target is 2024 and we all know that this is still an ambitious target for NHSX and the system as a whole to meet. But we are doing things to try and achieve it. Prior to NHSX there was already the GDE programme (Global Digital Exemplar) which offered a significant sum of money to sites or trusts that could demonstrate a high level of digital maturity, to help them accelerate even further. They were meant to be hailed as the best organisations across the country that other organisations could learn from.
“We also want to level the playing field. Sometimes it’s not only the ones doing well that needed the help, oftentimes it’s the ones who aren’t doing so well. So that gave birth to the Digital Aspirant programme for trusts who are not hailed as the most digitally mature, and that’s doing well. In the previous batch we had 23 trusts, and in March this year we announced an additional 32. They’ve been given seed funding to help them develop business cases for further digital investment across their organisations.
“We are also getting prepared to publish is a set of guidance called “What Good Looks Like” (WGLL) - this will impact every organisation, particularly ICSs (Integrated Care Systems). The WGLL guidance outlines what an aspiring digitally mature organisation and ICS should look like and what they need to have in place. It will also provide tools to assist them in getting to that point so it will be useful for all organisations at any stage in their journey. That’s on a policy level, but NHSX also has a number of different foci, all trying to develop digital capability within the health and care workforce, paired pathway transformation, and developing standards that will inform integration and increased worked for social care. There are a number of different areas where we have a footprint of work to try and influence.”
How do you think that digitisation can be best utilised to support the paperless NHS goal?
“The ambition is that irrespective of where you are or where you travel to, should you need to seek medical treatment, the receiving clinician will know a bit of background about who you are and your history. From the touch of a phone, we can navigate the healthcare system. It’s all about creating a seamless, pleasant experience for the patient and this requires information to be shared by the right people at the right time irrespective of where they’re using it or where they are geographically. This is a mission we have been on for years.
“We don’t want clinicians to have to be logging into multiple systems. At the moment, we are defining what integration and API standards need to be so that all of these digital solution suppliers can bolt into the larger incumbent systems to try and create that connected care architecture.
“What will sit beside the NHS app is a trillion different solutions and at the touch of a button patients and clinicians can get all the information they need.”
“We still have a long way to go to achieve this but that is ultimately where we want to go.”
How do you set best practice guidelines when there are well over 200 individual trusts?
“I haven’t personally been involved in setting guidelines yet at NHSX, but I do have a little bit of awareness about the WGLL approach [Note from Editor: you can read our take on the subsequently published WGLL here]. A lot of it is done with the system, so it’s not just developed in a vacuum and then published. They’ll engage with multiple different stakeholders at different levels, particularly the decision makers, to understand what they need and what their requirements. There is also reflection on what has been done before and I’m sure that for the WGLL they’ll have reflected on the blueprints that were created around the GDE programme so rather than duplicating they’d want to evolve things already out there. It’s done very much with the system.
“In terms of take up, we can’t impose this as it’s not mandated, but we can provide the tools to assist with the implementation and uptake of the guidance. It’s about finding a way to bring and connect all of those different data sets and that is where integration comes in.”
What project or policy goals are on the horizon for NHSX over the next few months?
“Soon we will be launching the revised digital transformation plan for health and care. That will set out a strategic vision and there will be a delivery plan and a series of set measures. It’s the next version of the original tech plan that was launched early last year. Then we will also be publishing the WGLL and “Who Pays for What” guidance. It’s a framework for digital investments, and it shifts NHSX’s role to one of supporting investment and setting standards and delivering national products.
“We will also be introducing the Unified Tech Fund which finds and consolidates the tests for accessing technology funding. This is aimed at the ICSs. Then we will continue our work on remote monitoring and developing the connected care architecture to scale the remote monitoring across the country. Our work will also continue around AI and data, and there are other bits focused on social care.
“In social care we are increasing the amount of work we are doing around that and providing access to GP records, providing data protection guidelines and toolkit. And that’s just the tip of the iceberg! There are loads of other things too.”
If the NHS could do one thing tomorrow to make digital a reality, what do you think it should be?
“That is a hard question. The thing is… digital already is a reality. I think the question is more around how do we drive scale and how do we achieve a level playing field so investment isn’t just going to the richest providers and the ones that are already known to be digitally mature.”
“One area that I would like us to get right is in how we support the ICSs. We have a really unique opportunity with their emergence and introduction, and they are going to need really robust digital strategies that incorporate not just acute providers, but primary care too. We need to really get that right because there is a danger that a lot of the funding will get diverted to the acute sector when actually the primary sector is a fundamental component of any receipt of investment because a lot of the disruptive innovation happens there.
“We can then start to leverage some of the benefits of the remote virtual care interventions that we have been pushing throughout the pandemic. This will help with elective care recovery because some of the activities that are happening in acute trusts, for example, don’t need to happen in acute trusts. They can actually happen in the community when the patient is still at home, which will reduce the burden and some of the turnaround times for the provider organisation.”
