DrDoctor Will See You Now

The Era of Choice: What Happened When Imperial Gave Patients Control

In the latest episode of DrDoctor Will See You Now, we explore the intersection of technology and operational change in the NHS with Milica Stjepanovic, Deputy Divisional Director of Operations at Imperial College Healthcare Trust NHS. With Tom, she discusses giving patients options, control and agency through Choice Booking of appointments, as well as the operational and patient experience benefits this has delivered. (Part 1/3)

Healthcare Under a Microscope: Time Bombs, Frightened Horses and…the NHS on WhatsApp?

In this final episode of our two-part series, Tom Whicher and Professor Joe MacDonald take a look at what the NHS needs next: build on what already works (shared care records, EPR foundations) and add the missing coordination layer that patients and carers feel most acutely. Joe argues the NHS is unprepared for the “demographic time bomb” of ageing, multi-morbidity, and end-of-life care, and that today carers often become the de facto integrators across fragmented services. They also explore a (not so distant) future where AI assistants reduce admin, support clinicians with triage and summarisation, and enable more care at home. The closing message? After a long “trough”, the NHS has changed culturally and could lead the world if it regulates for open standards and invests in scaling proven innovations. Buy Joe's new book FHIR and Loathing in Las Vegas here: https://www.amazon.co.uk/FHIR-Loathing-Vegas-Prof-McDonald/dp/B0FRYDV52G

Goldilocks and the Big Shiny Project: Why Government IT Programmes Fail

In this episode of DrDoctor Will See You Now, Tom Whicher speaks with Professor Joe McDonald (clinical psychiatrist; former National Clinical Lead for IT in mental health; advisory board member at The Access Group; and Digital Health royalty) about why large, centralised government IT programmes repeatedly fail, and what the NHS should do instead. They explore the “Goldilocks” project size: when budgets get too large, incentives and behaviours distort, and delivery becomes politically driven rather than user-driven, as well as the current state of UK digital health innovation, where we are seeing major near-term opportunities in ambient voice technology (AVT) to reduce clinician admin burden and unlock productivity. Plus, the longer-term promise of NHS data to enable better treatment decisions and proactive risk identification, cautioning against the ethical risks of LLM-based therapy chatbots for serious mental health needs. Buy Joe's new book FHIR and Loathing in Las Vegas here: https://www.amazon.co.uk/FHIR-Loathing-Vegas-Prof-McDonald/dp/B0FRYDV52G

From Letters to Lifelines: A Conversation with Oxleas NHS Foundation Trust, Episode 3

DrDoctor Co-founder & CEO, Tom Whicher and Oxleas NHS Foundation Trust CCIO, James Woollard and CDIO, Alison Furzer conclude their conversation on digital transformation at Oxleas. In this final episode, we explore how ambient/AI scribe tools, agentic AI and tight EPR integration can remove “grit” from clinical workflows while protecting the cognitive space clinicians need to think. Value won’t come from flashy standalone tools but from small, compounded frictions removed across pathways - referrals, booking, documentation - and from better design and governance. What is truly needed is pragmatic risk-taking powered by fast feedback loops, simulation, and shared learning across Trusts. The destination is a more personalised, hybrid model of care where patients choose how they interact with their healthcare. Here's a snapshot of what they discussed: * Ambient/AI scribes are promising but unfinished: Core capability exists, but the last 5–10% (identity context, EPR data pull-through, admin niceties) determines real value and adoption * Friction kills adoption: Tiny annoyances aggregating into “marginal pain” that erodes clinician goodwill * Protect clinicians’ thinking time: If AI drafts notes, we still need to make space for reflection previously embedded in manual write-ups * Prompt engineering as operating discipline: Prompts are the practical bridge between policy and reality; overfitting prompts to one team harms generalisability * Pathway redesign > bolt-ons: Why we should aim for standardised capabilities applied across settings and full “vertical” pathway changes * Risk, agility and feedback loops: Enabling safe experimentation by starting small, instrumenting feedback, and building an organisational “nervous system” to course-correct quickly * Personalisation at scale: Moving beyond “letters” to structured data and interfaces patients choose (text, voice, avatars) * Culture is the unlock: Successful change blends operational, financial and clinical rationales, shared learning across Trusts, and design literacy

From Letters to Lifelines: A Conversation with Oxleas NHS Foundation Trust, Episode 2

DrDoctor [../../] Co-founder & CEO, Tom Whicher and Oxleas NHS Foundation Trust [https://oxleas.nhs.uk/] CCIO, James Woollard [https://www.linkedin.com/in/james-woollard-17bb4539/] and CDIO, Alison Furzer continue their conversation on digital transformation at Oxleas. They look at why digital change in mental health and community services is less a tech problem and more a people-and-process one, unpacking staff assumptions, the tension between clinician control and patient agency, moving from time-based to data-based follow-ups, and what actually unlocks adoption. Here's what they discussed: * Culture > tech: Some of the biggest blockers are actually behavioural, like assumptions about patient preferences and worries about getting things “wrong” * Patient agency shift: Let patients choose if they want to move to digital, instead of staff deciding who is "appropriate" * Clinical leadership matters: Successful uptake correlates with senior clinical champions who tolerate a period of double-running and drive new ways of working * Boots-on-the-ground enablement: Admin teams guiding patients through first-time logins during calls builds “muscle memory” and cuts future phone traffic * Friction is fatal: Even small hurdles push staff to “least-worst” paper choices; embed access and simplify IG flows * IG as an enabler: Modern information governance is collaborative, shifting from blocking to pragmatically enabling safe, high-ROI use * Integration vs surfacing: Technical integration has improved, but the win is where and how information is surfaced for staff and patients  * From read-only to transactional: Shared care records need to evolve from viewing data to acting on it