Hospital media ‘making a meaningful difference’

Tim Kelsey of NHS England, and businesswoman, entrepreneur, and philanthropist, Baroness Martha Lane Fox, called for Wi-Fi to be made available free of charge throughout the NHS back in 2015. The vision of NHS England’s then National director for Patients and Information, and the former UK digital champion, was to give patients greater access to digital health apps, self-help tools, and social networks, in ways that could ‘support recovery and promote wellbeing’.

It was a bold and positive move for the health service that now, in 2024, has been widely achieved — at least from a technology standpoint. Free Wi-Fi is available to patients across the NHS estate, but with continuously growing pressures in the health service, and ever evolving patient expectations, enabling access to the internet only goes part way to achieving the goals that sat behind the vision. That is one of the reasons that more and more UK hospitals have been taking a different approach to media services.

Moving away from outdated technology

The entertainment services provided on many screens you might find on an arm at the hospital bedside have all too often been the subject of negative publicity. Currently, there are around 40,000 terminals still in place on hospital wards in the UK, that are at best more than a decade old, and indeed many are significantly older. Sometimes charging patients more than £10 per day to watch home television channels, such devices are often barely used on wards, despite a requirement for them to be always powered on. They can be difficult to operate, and do little to serve the needs of patients or the NHS. It’s for these reasons that many Trusts have in the past chosen not to provide patient media services to patients.

However, with lengthy agreements coming to an end, a drive to re-think a patient entertainment model that was first introduced a quarter of a century ago has been building momentum within the NHS.

A drive toward patient stimulus technology

Trusts now want to do much more than provide basic entertainment services. The opportunity is to stimulate patients in their care. That in part means being able to distract patients and support them in their recovery, with access to the same sorts of media and streaming services that they are used to having at home, but it also means better engaging patients in their care, and supporting a better overall patient experience. The aim is to provide patients with access to digital assets and patient-facing apps that can inform them about their care. Systems should be able to amplify information about the operation a patient has had, or provide further insight and actions that patients can carry out after their procedure in order to optimise their outcomes.

Digital tools can help to support patients in their onward care journey — for example allowing them to find and choose care providers for when they leave hospital. Media services can allow patients to do everything from arranging time with the hospital chaplaincy service, to speaking to friends and relatives, to ordering from on-site retailers.

Hospitals can also use the same systems as a means to capture patient feedback — such as the NHS Friends and Families Test.

Modern approaches often require media platforms to integrate with other hospital systems, in ways that can release time for busy nurses — for example providing patients with the means to order their meals, request a glass of water, or find out when they are likely to go home, without needing to ask a question. Many NHS Trusts have been enabling this type of service entirely free of charge to patients. So far my team has worked with some 150 NHS organisations, where in every instance a decision has been made to remove costs for the people receiving care. Although entertainment has been part of every one of those deployments, each has responded differently to differing patient needs.

Pushing boundaries for younger patients

Healthcare providers regularly bring forward different challenges they need to solve. One conversation centred around helping young people. While now widely possible, at the time the organisation in question was one of the first to explore the idea of streaming content to tablet devices, rather than it being confined to bedside terminals.

For some younger patients, being moved away from the ward — perhaps for an imaging requirement such as an X-ray, might lead to them becoming upset or unsettled. In addition to distress for patients, this had the potential to create challenges for nursing teams. A decision was thus made to enable patients to take their entertainment with them, meaning that they didn’t need to interrupt their favourite programme, and that they were more likely to remain entertained and distracted as they are moved from the ward, and more relaxed as they awaited their diagnostic procedure.

Just as younger patients have particular needs, hospitals have also told us about the benefits of moving to free models of media provision for elderly care wards. In one instance, a hospital had decided to move away from a pay-to-watch TV model, which had been seeing little use by patients on the ward. Nurses fed back that simply being able to ask patients if they want to watch television in itself made a substantial difference to patient satisfaction. It acted as a distraction, and with fewer requests being made of busy nursing teams, they were able to better focus their time on treating and caring for patients. Staff reported that the ward had become a much calmer place to work.

The team at one spinal injury centre, for example, told us about their particular patient experience concerns. Severely injured and disabled patients were faced with significant mobility issues. Patients who were quadriplegic were reliant on hospital staff for everything — including the ability to watch television. Patient and staff feedback suggested that the ability to control the television could make a significant difference — with the potential to provide people receiving care with a form of independence often taken for granted. We were able to work in partnership with the centre, and a specialist technology provider, to develop a system where through the movement of the eye, patients could control television channel changes and turn the volume up, down, on, and off.

The market for such an approach is limited, but it’s not always about the commercial scalability of every development — it is about meeting the needs of hospitals and their specific patients. That’s part of the ethos companies should take when trying to deliver the best for patient experience.

Listening and co-design in action

What is clear is that the appetite for providing patient entertainment systems that are free at the point of care in the NHS is driven by patient need. Whether it’s a single specialist ward, or a major multi-site Trust, that need is about much more than about simply installing televisions, and there is arguably no one single set of NHS needs. Every organisation we speak to has different resourcing, and different patient cohorts, who need to be engaged in different ways. Equally, as needs differ from one hospital to another — so they differ in varying care settings — for example in mental health, where healthcare teams may need the ability to control or restrict certain types of content, to avoid the risk of exacerbating anxieties or distress for people in their care.

To stimulate, educate, inform, and entertain patients effectively, the starting point is listening to specific needs. We need to collaborate, to explore the challenges on wards, and also to shine a light on the art of the possible — some of which might not have been considered by the healthcare provider. Patient input is also key. Many hospitals now choose to deploy such technologies to concept wards, testing them on a limited number of beds, and gaining feedback from patients in order to adjust and refine the system, and define the full deployment. This is about active listening — and designing the solution with the people who will use it, to address their requirements.

Overcoming cost barriers in an age of inequity

With healthcare equity now a priority commitment, access to media technology, and the potential it offers for enhancing the care experience, shouldn’t and doesn’t need to be determined on the basis of whether patients can afford to pay. Resources are stretched more than ever in the health service, and it is easy to dismiss investment in such systems as unnecessary, but feedback from both staff and patients — where this has been done well — tells a different story of value and impact.

Models can be put in place to make this possible everywhere in the NHS, especially if providers of such systems work with Trusts in fairer ways than older contracts have allowed, listen and understand the pressures faced on wards, and collaboratively create genuine solutions that respond to strategic healthcare needs.

Strategically important now

A national focus on the way patients experience the NHS has been renewed. Sitting as a priority at the centre of government policy, this experience will be influenced by a great many things — from access to GP appointments, to waiting times for surgery, to clinical outcomes. When patients are in the hospital, their experience of services could also be shaped by relatively easy wins, such as the examples I’ve mentioned here.

The Chancellor’s Autumn Budget set out a priority to ‘harness technological opportunities that will transform the patient experience’. This doesn’t only mean investing in major electronic patient records, diagnostic scanners, or artificial intelligence — but is about getting the things in place that can improve how patients experience their care when they receive it. It’s something that c-suite leaders in different Trusts have long been supportive of — including during the construction of new hospitals. The aim for some: to help to modernise what it feels like to stay in hospital. Initiatives such as the New Hospital Programme also create opportunities to embrace better media services for patients.

Taking this forward at scale is a priority being driven from within the health service. Of the 150 or so hospitals and hospital facilities that we are fortunate to support — from entire hospitals to individual wards — the appetite to make the most of technology is inspiring. My sense is that appetite is continuing to expand within and across organisations every day.

The last decade saw NHS leaders seek to create social impact through the introduction of Wi-Fi. Prior to that, the early 2000s saw a central push for ‘patient power’ through bedside communications. Now policymakers might consider how to seize on the building momentum in the 2020s, and build into national strategies how the NHS might stimulate patients by using media in ways that make a meaningful difference.