It’s always better to be lucky than smart,” says Ian Crichton, reflecting on a fortuitous decision taken just days before the first lockdown on 23 March last year to move his people onto Microsoft Teams. “We got the green light on the Friday, and then on the Monday Boris Johnson said we all had to self-isolate. So, from that moment on we were able to work completely remotely and not miss a beat.”
Crichton is chief executive of digital care software company Servelec and has led his 450 colleagues from his home in the Scottish Borders ever since. Based in a remote part of the country, he’d long been a video conferencing advocate and with the end of lockdown in sight he is adamant that he is not about to demand a rush back to the office.
“The days where the only way you could measure how well HEALTH someone did their job was by having them sitting in front of you are long gone,” he says. “I’d far rather our people were happy and productive. It’s not as if tech companies do everything in 2D, but a blended way of working really will help in future.”
Crichton joined Servelec in mid-2019; its products include the Rio electronic patient record platform for the community and mental health market, and Mosaic case management software for social care, the latter of which has five local authority customers in Scotland. But he is ambitious, and with a deep knowledge of how health and care services work (he led NHS National Services Scot-land for eight years), he wants to use an evident passion for public service reform to make bigger strides north of the Border.
In his view, joining up health and social care, though mandated by law since 2014, is the one big area where tech has a huge role to play in service transformation, but progress has, for a variety of reasons, been painfully slow. He puts it down to a combination of reasons: government has been put off by big IT problems, there is a chronic underinvestment in technology – particularly given the healthcare prevention benefits it can land – and too often there has been a tension between competing national and local priorities. According to Crichton, the situation is improving with the realisation that government can’t do everything, and that setting the right technology standards at a national level and allowing local leaders to get on and do their job, is starting to emerge as a better model going forward.
And recognising that the market has moved away from massive IT procurement cycles, he says interoperability – bringing systems together to share important data – is increasingly where Servelec can add the greatest value. “We’ve been integrating things in the cloud through our platform, Conexes, which connects our software to other systems, not just our own,” says Crichton. “Imagine that your average public sector outfit will have a lot of legacy kit and it’s tremendously risky and expensive to change it; well, what we’re saying is that you don’t need to change it all at once, modernise what you need to, then all you really need to do is fill any connectivity gaps that greatly improve your processes and output.”
Using application programming interfaces (APIs), the platform has chalked up some notable recent wins. It has helped to link hospital patient discharge and social care records together for Nottinghamshire County Council, making the transition between acute and community care far more efficient, for both the authority and the end user. It’s not just cost and efficiency where such an approach is proving attractive to public sector digital leaders, as Crichton explains.
“Going bit by bit might be far more effective than the big bang,” he says. “Interoperability is far less scary from a systems trans-formation standpoint, as you can pick the pace you go at.”
He adds: “And it takes a different view in that it says your ageing software may actually be largely ok, but what’s missing is modernising your processes, filling any gaps and connecting it up. Perhaps if you start with that, you can move that agenda forward further.”
A big piece of work for the company follows from winning an NHS Scotland contract to design and build a new Scottish Child Public Health and Wellbeing System, which goes live in summer 2022. Built on the company’s Rio platform, it’s an opportunity for a national single system to hold every child’s vaccination records, and much more besides. In software jargon, the system is being built according to “agile” principles, which allow developers to work on the product iteratively alongside the customer rather than design an overly prescriptive solution immune to change.
Crichton says: “Credit must go to NSS (NHS National Services Scotland) for working with us in this way, in the end we will finish with a software product that is made in an efficient, modern way. That isn’t always the case for a lot of public sector solutions, so I think of all the things we’re doing right now, this is probably the one that I’m most excited about.”
Servelec has been carrying out an industry engagement campaign in Scotland, hosting a series of virtual roundtables across the country, to try and better understand local needs. It has also recently joined a local government procurement frame-work – managed by Scotland Excel – for social care technology, which comes at a crucial time as the focus moves towards more of a self-service model.
In that context, Crichton mentions the recent Feeley review of adult social care, which called for digital advancements to be embedded in adult social care, whilst emphasising that services must “remain person-centred”.
He adds: “I think the Feeley report is absolutely correct. And what we’re trying to do more and more is to involve our customers in product development so that we understand what they need, and what we can do better, but that takes time. The challenge in Scotland is how do we make sure that public services get better engagement with the IT industry, so we can deliver to those aims. Getting on the Scotland Excel framework is a great step for us, because it opens up access not just for us but for other suppliers as well, and I think good competition is something that has been lacking for a long time.”
Going forward, there will be challenges for healthcare leaders as Covid-19 restrictions begin to be eased, as a result of pent-up demand in the system. Crichton believes, though, that digital health and care solutions have a role to play in helping to shoulder some of the burden.
Digital therapies in particular, can support already stretched services in mental health, where there is likely to be significant pressure points post-pandemic. Servelec launched its Mood diary app, which integrates with its Rio electronic patient records system, and allows those being supported by mental health professionals to record their daily mood patterns, helping to keep them engaged with their own treatment and clinicians to better understand where intervention may be required.
Servelec has also developed a patient flow management solution for hospitals called Flow, which uses real-time analytics and dashboards to give managers better oversight of where pressure points are building up. Servelec has started to develop its systems so they can be accessed as software-as-a-service (SaaS), enabling smaller healthcare charities, for example, to utilise the product which ordinarily they might not be able to afford. It all forms part of what Crichton describes as his company’s “purpose”, which is to use technology to improve people’s lives.
“We’re actually a pretty com-mitted bunch of people who think we can use technology to make a difference and we’re keen to be given the opportunity to do it,” he says. “Our people really do believe in it; they work here because the more we do to join up systems, the more we have to invest back into improving people’s experience of care, reducing cost and enhancing service quality. And that’s a win-win for everyone.”