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Let's move on to the first session of the day and it's about the digital future because that is part of the transformation. And we know there's been a very significant move in that direction in recent years, and there is a lot still to be done. I want to bring up to speakers. We're going to hear from them for about eight minutes each, and then we have about 10 or 15 minutes for some questions, and hopefully we'll get some from the floor as well. So can I invite up onto the stage? Dan West, who is the chief digital information officer at the Department of Health here, and also Professor Sultan Mahmoud, who is director of healthcare for BT. You're both very welcome dot No stranger, of course, to a conference. Um, although it's been virtually over the last. So the whole digital thing has been tested and worked very well. First over the last two years. Nice to see you both down. Are you gonna start first you happy to do about eight minutes and then we'll hear from Sultan and then we'll have a bit of a chat together. So the stages here. Excellent. Good morning, everybody, uh, it's it's absolutely brilliant to be here in person and thank you to Heather and her team and to to Michael, the totemic leader who turns up and does the talking. So, uh, you know, it's brilliant that we've managed to get this together this year and thank you all before I do my eight minutes also of initial address. I wanted to share a reflection, uh, myself on yesterday's proceedings. Um, And as for those of you who know me, you will realize I'm generally quite a sort of high energy. Be kind of individual. Uh, I found it quite hard during the course of yesterday to be optimistic. And the big challenges that we were all talking about, how we will address together, uh, the financial position that we find ourselves in this year. Uh, and and the winter that we're all collectively facing into it did feel hard to to maintain a kind of beat attitude. Uh, no, not everybody was able to make it to the dinner last night, But one thing that I found incredibly inspirational, uh, and and it it kind of got me back on a on a fairly positive mindset. Um, with the stories that colleagues told you we had, uh, Molly and Bill, Mark and Heather That did a bit of a double act, and we invited a few people who had had some recognition of their accomplishments over the course of the last 12 months or so. Talk about their experience is their stories, their contributions. And And it really warmed my ankles and it and it got me back on to a more positive and optimistic headspace. And what that showed me was the amazing group of people in this room and what they can achieve. So, congratulations to all of you and to those individuals in particular before I start again. I did want to make a slight correction in order not to disenfranchise um, somewhere between the third and a half of the people in the room. And the title of this session is about healthcare. And I think we all forget that we are an integrated health and social care system, and therefore I'm going to talk equally about health and social care. Um, so I will use some slides. I'm not sure everybody will be able to see them, and it wouldn't be the normal approach for a presenter to ask everybody in the audience to get out of smartphones. Um, it's a bit distracting, and as much as my narrative normally is, is fairly dull. Let's be honest. I am gonna ask you to get your smartphones out with it, which is a risk, and have a have a quick hover over this QR code. And the reason that I'm doing that is I'm really excited today and to launch the Northern Ireland Health and Social Care Digital Vision and strategy. And it's been in development for 18 months or so. Um, and we we published it in May this year for a socialization exercise. So that is an opportunity, having been somewhat inclusive in the in the creation of the strategy. Um, uh, we we needed time as a group collectively after coverted, to think about what this strategy document says, and for people to get the opportunity to, to understand it and to comment on it and to provide feedback. So that's that's taken from May until today, and I thought I would use the opportunity while I'm on stage to do the full formal launch. Uh, so here it is. Download it. Take a look at it. Um uh, the feedback that we've got during the engagement exercise that we've done over the last few months, uh is that and I'm characterizing a little bit here Is that the strategy in what it says is fairly in arguable. We should get better at using data as a system. We should drive forward on our digital ambitions. And you heard it in the room yesterday morning from the minister from Peter. Frankly, in most of the conversations that we've had over these two days, that digital and data is a really important part of where we're going. The concerns that we got from all of our stakeholders who have spoken to this far is sounds great, Dan. But there's a lot going on. We're not absolutely certain we're going to be able to take this journey that you set out for us. It's pretty ambitious and deliver ability, affordability, achieve ability, really big considerations. And what I thought I would do today is finished on that point. What are we going to do to respond to the feedback that we've got about deliver ability? But first, for those of you who haven't had a chance to look at the strategy. I'm just going to do a little bit of an overview, just so there's a bit of familiarity in the room. People can go away and and take what I say to you now, uh, and use that as part of your process, too. Then understand yourself what we're saying, but also talk to your colleagues about it and provide feedback while the socialization exercises over. That doesn't mean that we are not taking feedback anymore. Um, I know not all of you will be able to read all of these slides. So you do feel free to download and take a look. So the the vision that we have trying to capture what this journey is about, what the time between now and 2030 is going to be in terms of modernization and digitization of health and social services. So our strap line is making lives better for the people of Northern Ireland, using digital to transform the way we deliver healthcare and wellbeing services, being inclusive on on all of our organizations and the services that they deliver to our citizens. So the mission has really got five cubits in it. So design development delivered digital services. That's fine. Of course I would say that I'm on the CD I Oh, but the key things are those services that we deliver from a digital perspective support everyone to get the best care. They support our people, our staff at work, by streamlining information, sharing across systems, and you can replace organizations for systems. They're optimizing the use of data and improving through that the safety, quality and experience of our services. So you'll see in the document as this This image, which is tries to just unpack a little bit of the vision that I've just set out there and what it really tries to convey is that the technology itself is a means to an end. Right? Technology for technologies sake isn't particularly useful. What we need to try to do collectively is foster a bit of a cultural change in the way that we see data and technology and reimagine the relationship between the patient or a client and their health care team. Try through that to put people at the heart of everything that we do. Not that they're not already but more as empowered partners in their health and care experience is using the digital tools and data. Is the stimulus an opportunity to transform towards consistent ones for Northern Ireland services? And they they just flipping back one second? There are eight aspects to how we've set out the vision. Um, the first one is about leveraging data to drive insights to create care journeys that are digitally enabled every step, not just in parts, um, to invest in world class technology, uh, and deliver that technology and the benefits that it brings to us all through agile, adaptive and innovative working to embrace the latest diagnostic and therapeutic technologies to deliver personalized care through streamlined processes to empowered connected patients and clients. Um, the next bit, which says some of the same things that I've already talked about here is our strategic outcomes. So we've articulated, um, these six strategic outcomes as a way of trying to encapsulate the work that we'll do. Uh, and I guess the important thing to understand, Um, that isn't visible in the strategy. But there's some supporting documentation that provides this is that this isn't just vaporware that's going to sit on a shelf and get a bit of dusty over the next few years. Um, it's probably a reasonable observation that we've got quite a few strategies and reviews in health care in Northern Ireland, and having another one that sits on the shelf probably isn't very much use. Uh, and what this is about is the energy that it's going to take to get to a different future in the next few years. So underlying this document and underlying these six strategic outcomes, there's, um, there's 100 and 60 individual initiatives. Those 160 initiatives have been costed, uh, some of them costed with a reasonable amount of sophistication and fidelity and the way that we've got about doing that, some of them. There's a bit more of a T shirt sizing approach to them at this stage, particularly those that are further out, and and that that big data set the spreadsheet of death is my team. Refer to it, and that's what's driving the conversation that we're having about affordability and deliver ability. Um, I will show you another image just before I move on, which is the strategic framework. Um, the strategy document isn't one thing. Uh, it is a master document with 90 pages. I'm not necessarily suggesting that everybody here would find it useful to read all of those 90 pages. But what we have is a structure that is then repeated through that main document and some child strategies that deal with some specific parts of the journey that we're seeking to take together. So the data strategy, for instance, that many of you might have already read the innovation strategy. How do we create an innovation ecosystem and embrace and leverage the energy that there is in Northern Ireland to to drive value for health and social care through digital innovation? And then, finally, the cyber security strategy as we're using data more? How do we do that in a way that that maintains the privacy and security of the information that we hold as the data controllers? So this structure that you can see vision, mission, strategic outcomes and then digital enablers and capabilities as supporting aspects of the of this journey that we're seeking to take, that that structure is then rift out through all of the strategies that we've developed. And it's just a common way of summarizing the journey that we're seeking to take and some of the y. So I would suggest to you all that it would be a fairly useful use of your time to maybe take a look through some of these documents. The bit that I wanted to just share before I hand over to Saul is reflecting on the feedback that we've got. Um, it looks quite hard down there. There's a lot of work to do, and they're all fairly busy. We're not sure that the journey that you're sitting out for us here is achievable. And so what we're doing with that feedback is a further round of engagement for development of an implementation plan. And that implementation plan isn't something that's being developed in an ivory tower by the digital guys up in the department. It's something that's very much co created with the system, and there's a few questions that we really need to reflect on as we go through that process of defining what is a more achievable journey, setting out something that that is an achievable and it's too hard for us to do together. It's just going to make the current situation worse. So the questions and they're just seven examples here on the screen that you can see the questions that we want to reflect on with you and your teams is Do we have a coherent and deliverable body of strategic wide system change? So the department is asking the service to do a set of things. Is that set of things in itself? Ignoring the digital question? Is that deliverable? And do we need to do some prioritization collectively, uh, in order to to deliver a wider, achievable body of work, the digital portfolio itself. So thinking about all of the things that were already doing encompassed my limbs and AIPAC's DWP, all of those big programs that will deliver technology. How do we make that affordable? And how do we take what we've learned during Cove ID to work in a more agile way? How do we apply that to the portfolio going forward to create a good trajectory of technology investment? The trust side projects So all of the trust and they're strategic priorities need to be reflected back as we're trying to develop a shared implementation plan so that it's not a center out with a collective view of what all the workers that we've got coming up over the course of the next few years. Workforce, capacity and skills. It been a constant through these last couple of days. Workforce, workforce, workforce. So from a digital perspective, how are we going to build the capabilities that allow us to take this journey? How do we attract and retain and develop the right digital talent for us to be successful as a as a digital enabled health care sector and then the trust enablers? So it's a problem for all of us to leverage data better. There are particular teams in the trust, for instance, the trustee teams in HR that are particularly burdened by this collection of programs and projects that the portfolio describes. So how are we going to work with those teams to try and liberate some of the capacity that they need to be able to take this journey? Thinking about be a you operations? It's great thinking about transformation are funding Challenge this year means that transformation is going to be hard to afford. How do we focus in on our ability to continue to run our services safely, and then finally, um, the staff and their ability to adopt all of these systems and innovations in a way that's coherent for them and helps them to do their jobs better rather than frankly, just being a baffling set of new training and new tools that get deployed to them over the course of the next couple of years to try and create a coherent change journey for staph so that implementation planning activity is under way. We will be continuing to do it with all of your organization's over the course of the next months, and that will get us to the publishing of an implementation plan to realize the strategy that we've set out launched here today in the coming months. Thank you very much for your time here. I'm going to hand onto So who's going to talk to you for a bit, and then I have some questions. Thanks dot good morning conference. How are you feeling? Last last week's audience was much better. How are you feeling? Very good. I'm I'm sort of on the director of healthcare for Bt and and I've been here for a couple of days and first of all, I want to thank Heather Chair for a wonderful conference. I think people coming together and really exchanging ideas and kind of a way forward after 2.5 years where we've all been cooped up is phenomenal. Um, and I want to kind of share a bit about myself. But I want to start with a quote from heaven because I think the NHS will only survive as long as there are people who have the fight left in them to keep it going and not just keep it going, but absolutely flourish, I paraphrase somewhat, but what I've seen here is a level of cohesion, a level of intent to kind of improve patient outcomes that I've not seen in any other ICS and I'm up and down the country, and I've traveled globally around healthcare system's, I think genuinely this is the Goldilocks of health care. So I would say to the people here you have got the social asset based to do perhaps what no other healthy economy can do anywhere in the world, and I've got 25 years of experience in healthcare. I've spent my career in primary care, secondary community care, social services, system, regulation, system management, NHS England, you name it. I'm one of those lucky mongrels who's had access to all of the system, and, you know, it's really, really interesting where we are. So I talk about fight now. What's what's this fight? And I'll get into that. But a couple of really insightful people said, Why the bloody hell of BT here? What are they going to do with healthcare? And it's a really good question. I'm really glad when people ask me so hopefully in the next three or four slide because I think the important thing is the conversation with Dan, um to just give you an overview where Bt are are kind of how we're trying to change the interpretive frame for the N. H. S and ourselves. Actually, as a company who recognize we need to change to something more wholesome where we link purpose, Um, with with our day to day business, you know, what do you do? Help people look after our friends and family? What do you do? I sell some cards. Yeah, you get the gist. Right? Okay. So Bt's vision and mission, if you like. Um, you know, I I always say to the company Let's begin with the end of mine and we want to be the most for most trusted, innovative and effective partner to the N. H. S. And those words were chosen really carefully because trust is the fuel. That kind of moves transformation. And some of the things I've seen between the trust here, the social care system, the ambulance service, the primary care. I think trust is really good. I think it could be even better. So trust for us as a company. We are working really hard to build trust in a way that's helpful to the NHS and social care. Innovative. So, you know, we recognize that we live in the fourth Industrial Revolution. Data is king, and innovation is absolutely needed, because if we carry on doing what we are, the workforce challenges, you know between 10 and 14% gaps if you like, depending on who you ask across the country, um is not going to be fixed overnight. The demand exceeding supply. It's a really wicked problem because our multi more big population across the UK, um, is not going away, and we all know that roughly 6 6.5% consume about 85% of NHS social care resources. It's that revolving door cohort. So how do we look at those people in a in an anticipatory way and effective? I've spent many, many years on the other side where somebody turns up to my office and says, I've got the best thing since sliced bread. Do you want some? Um, unfortunately, the partnership between industry and the N. H s has been hampered by that. There's a trust issue. There's a kind of we know, best issue. And also, let's be really honest. The NHS is not an easy customer to navigate, but actually, if you spend the time and effort, the NHS is a wonderful customer, so b t he's having that end in mind. We want to be trusted, ineffective and effective. We want to do stuff that actually matters and counts. So our strategy Really simple strategy. Three pieces, future ready infrastructure. So it's all of the things that we talked about and the 100 pay 100 pages, then Christ 100 pages. Yeah, yeah, I did a lot of things 100 pages. It's going to require a new sweet of infrastructure, so, you know, systems are getting thirstier and I call them gigabit thirsty. And we are setting up a sweet of propositions across Bt that was very, very specific to the N. H s. We have over 1000 years' worth of experience of NHS operational, clinical and strategic management as well as technical management now recruited into the company to ensure that are offers back to the NHS are kind of customer centric for the first time in in in roughly 10 years. So future ready infrastructure is getting understanding your infrastructure to make it ready for the future, ready for your challenges without the need to uproot. But to augment the second bit of the strategy at the bottom is what we call customer driven solutions. And that's that's really around the co creation space. We have lots and lots of customers. We have five over 500 in HS customers and they all have similar challenges, but they but they're unique to their own prism of reference. And what we're trying to do with a select group of customers who are open to kind of create is create new solutions based on their instructions. That way, BT gets to kind of build something that's useful and grain credibility. But also the customer gets exactly what they need, as opposed to kind of what the tea or anybody else wants to sell. And, as Dana said, the future is data, um, and and the power of aggregator platforms, I think, is the future. So in an average English hospital, there are 352 160 data generating units, from theater systems to any systems to kind of pass systems two point solutions that people are putting out in the community, monitoring, um, patients in their own homes. All of it's generating data. Does that data join together to make sense? What do you think? I tell you, last week's audience was much better. What do you know? Know? And it doesn't. And it's not for the want of trying. Yeah, but data connecting together, aggregating to make sense. Yeah, and drive actual insight. Actual drive The next best action is really important. I did on call for 23 years, almost, and at the weekend you'll hit from anything from a drain blowing up in a Andy to kind of 23 ambulances outside, and the minister saying What are you going to do about it? Yeah, And the way that the system runs, you know, we have some brilliant innovation, but largely it's a bit health to skelter. And we all know in other sectors, um, it seems a bit more organized. So how how do you bridge that gap and no one's busted, But I think a community of people of subsidy, and it's kind of coalescing that thought leadership for scale and adoption across the country. So that's the broad kind of strokes of the strategy. Um, again, as we as we set off, you know, the first thing I did, and and many of the, you know, C regime from the from the trustee. Many of the colleagues will do this. Any big decisions are kind of really well thought through when they're clinically lead. So everything we're doing, I've got a group of wonderful clinicians with, you know, brilliant experience of ICT implementation as well as kind of clinical transformation across the company. So, you know, Professor Ameri Canopy has worked across the Globe Doctor Giuliani, who's a former medical director in England, you very much Michel Quinn again, a brilliant informatization, a job in nephrologist, but his system's thinking is second to none. And there's a group of people who have done some really interesting, and their job is to be my moral compass. Essentially. So anything we kind of bring out to the NHS makes sense as opposed to kind of, you know, it's got the best position. Yeah, and that's a big shift for a company like Bt and again, what we are doing in terms of kind of building a digital strategy with the future ready infrastructure were thinking about aggregation. So how do we aggregate services, infrastructure partners, solutions in a way that works for you that builds, um, platforms for change? Uh, that's about working with ecosystems that are present and not Uprooting them, which is what companies tend to do. And it's a big misstep. Were bridging the gaps between disparate systems were doing really interesting. Working from our Vanguard's co creation, I've I've mentioned and and actually kind of delivery technology that works into communities and and hopefully into primary care and bridge the gap between primary care and secondary care and again, the vanguard peace. And this is the last slide. I promise the Vanguard piece is about that procreation space. It's about kind of an appreciative inquiry approach, understanding what's going on in a healthy economy or a trust developing two or three use cases and actually testing, refining, failing fast and then developing. It came from the new care models idea that Simon Stevens kind of put forward very simple approach. We have to test things that are slightly out there to see if they work, and if they work, that's kind of knowledge transfer across the system in Northern Ireland. I'm pleased to say that down his team, the healthy economy here is a key vanguard for us because we see a lot of cohesion here. We see a lot of thought leadership here. We see a lot of relationships here, and I think those are probably the most critical, um, ingredients for success. Um, you know, and by Northern Ireland. I call it the Goldilocks A. The system is cohesive. The operation of strategic layers work together in a way that I haven't seen elsewhere and again, what potential that has. There's some real innovation happening here. Yesterday's awards show a colleague from a hospital, uh, Paula, I think her name was 383,000 people vaccinated as a result of social media. Where's that Use cases elsewhere? So you have some real champions here. Um, the culture is really positive. I feel incredibly excited based on the conversation of the last two days around kind of the forward looking this of this economy, digital maturity. You know, the system is put in place with the encompass program and and the strategy a level of technological maturity that perhaps will stand you in good stead for the next kind of 20 or 30 years because care processes will be completely subverted. And I think you're getting ahead of the game. And I've mentioned in Compass. So I think you are the Goldilocks of the healthcare world, and BT are here to help and help in the way that you think is fit and I'll sit down now. Good morning. Yeah, but that is not the end. There's there's another little bit where people might want to ask some questions and seek a little bit of clarification. Um, it's it's It's very interesting, I suppose. I was just thinking about not having been here at a real conference For two years we've done the virtual conference and things have changed so much. You said something that I was just separately writing down, which was about the you know, that the challenge of understanding what's happening in the digital world. A lot of people are very nervous about it. A lot of people think, Well, we have a system. We know how it works. I'm comfortable with it. Why do we need to keep changing things? But then when you actually look back on a couple of years, how effortlessly people have dealt with, for example, vaccine passports. I mean, we all have them on our phones. We all needed them. If we wanted to go somewhere, that's just people just had to deal with it. It was straightforward. They got on with it. And now it feels like it feels like an odd point even to have to make, doesn't it? Which, from your point of view, must be a good thing. Yeah, Um, so it is absolutely true that during coverted everybody be their citizens or staff members embraced digital at a pace that was unimaginable as a technologist years ago. Uh, the reality, though, now is we don't have one unifying priority, which we did. Uh, we have 100 or more priorities and from the staff members perspective in trying to cope with the pressure that the system is under, uh, if all of our projects and programs that are delivering these new technical widgets reach out to staff and engage them and train them and bring them into how that technology product can help them to do their jobs better and for them to be able to operate at the top of their license if that happens individually in silos, Frankly, it's baffling. Um, so what we need to do and we haven't done yet, But we will is stitch together the journey that we're on and describe the future state that we're trying to get to and why that's a good thing for everybody in particular our staff members and then describe the journey that were taking in some coherent steps. And I think with that our staff have shown that they are very reactive, very flexible, very resilient, and if we can describe a journey to them, I think they're happy to take it with us. Let's just try not to make it to baffling. Do you also have to prioritize because you cannot deliver everything for everyone at exactly the same time? So everybody in this room has a digital priority. I really wish that you would sort this particular issue out for me. But if everybody came up to you and told you what you know, you could have a notebook full of priorities. How do you decide what gets onto page one? There are some things that we have to do. There are some technological Cliff edge is coming up for us. We need to do in compass because it replaces a bunch of systems that are too old to survive much longer. We need to do my packs, and we need to do is these are These are big clinical system transformations that we're doing, so that creates a bit of a foundational base upon which you can then make some prioritization decisions about what else you try to do and how much of that you try to do concurrently. And this implementation, planning, planning process, pardon me? That we're doing at the moment will give us an opportunity to choreograph and sequence a logical, deliverable, achievable, affordable set of things that we can take to the service to drive benefit in a way that doesn't overburden people with change. You're nodding, Sultan. Um, you're very familiar with the conversation, Obviously. Is it something you think that that that your company has to be an important part of, um and can help people like Dan to deliver on? Yeah, I think I think I can speak for my company and probably a wider wider, uh, commercial cetera. So if you think about the narrative, so we all agree that the pandemic has accelerated digital delivery in healthcare setting is between four and six years is the general consensus, but it needed that unifying force. If you like that Really burning platform, other industries have got on with it quietly but progressively. So. If you think about your bank, you know you're building size of your other parts of your life are incredibly digitized. And the public expectation is why isn't my healthcare service like that to make this work? I think Dan's absolutely right that there has to be a level of prior authorization. But you know, I said, I said about the good fight that even talked about the fighters Attitudinal. Yeah, digital is not an adjunct. It's something we do when all the budgets are there is absolutely critical to meet the challenges I mentioned. Workforce, you know, we are all realizing the days of 1 to 1 care are gone. The days of one too many care is here. The power of data to do that exists. Systems around the world, you know, monitor your New York State College in Israel. People are doing this, but I think in terms of priorities done, I think I think across the sectors, um, there needs to be a level of orchestration to deliver this really complex strategy. And as far as strategies go, you know, I can't I can't read it three times. I can't fault it. But what are you going to drop? And are you forgetting anybody's my question? Yeah, That's, um see who might like to ask a question from the floor. I see a hand right up in the middle. Um, and we'll get together to get you the microphone. Thank you. Hi. It's an O'Reilly. Um, I'm here from the social care Counseling Belfast Trust. I just wanted to ask in the spirit of integrated care systems does this Is this going to widen out to, say, primary care? Is it going to widen out to the patient being able to operate smartly no matter what part of the system they access? That's the first question. And the second question is, what about sort of the digital divide? Does that still exist or is coated settled that? Okay. And thank you very much dot Do you wanna take those? First, let me answer your first question. Really? Honestly, uh, our digital plan focus is a lot of its energy and and through that, a significant proportion of the money on secondary care. And and I don't think that's right. I would like to do more in primary care. Um, interestingly, there's There's something Ursula Mason referred to it briefly in her address yesterday. Um, there's something that we might do with PT as a vanguard in Northern Ireland around, uh, primary care. Um, what encompass brings is a digital portal that allows patients to be galvanized in and and part of the care continuum and interact in a digital way with their healthcare professionals. So that's good for sure, but that that doesn't really embrace some of the opportunities that we got in the way that we deliver community and primary care services. So we will do more. It's talked about in the strategy, but it's not in detail in the Spreadsheet of Death, and we'll get their digital divide quite an interesting point. Um, what we saw during Cove, it was, uh, there was no limit in elder demographics around adoption of digital technologies. They needed a bit more support, but it didn't diminish their ability to embrace and utilize those technologies. I think we do have an issue around reality, though, so I don't think we have equity in digital access in a way that will allow everybody to embrace some of these tools. And I think we really need to think about it and actually interesting. BT is an organization that we could probably talk to a little bit about addressing that. I think it's a really important question around parts of the system. I think primary care. We all know that, uh, 90% of care provided is done in primary care. We all know certainly my experience in England, you know, it's really difficult to get an appointment the sentiments changing kind of British social attitude surveys around. Kind of primary care is kind of challenge now, and what we see is my primary care colleagues are working kind of day and night and to end as well as my secondary care colleagues in my community colleagues. But it's the same cohort of complex patients they called, You know, it's really important paper written by Chapel back in 1980 he kind of says the patients don't sit in these wonderful pathway diagrams that management consultants produce. Yeah, don't know, dig, dig right. But they are multi morbid and they're erratic and they appear across the system. So the people that are causing US issues around demand and capacity are the same cohort of patients and citizens in social care. Primary care. Primary care is incredibly important. We have the richest kind of data set in the world in terms of kind of primary cares been coding data since kind of the nineties. If we can link primary care to kind of some of our brilliant secondary care providers here in a way, that's kind of meaningful and it doesn't require organizational change, it just requires an attitudinal shift and a willingness to share data and improve access. We really need to start the process around kind of how we manage the logistics problem. Starting in primary care. Getting people in the right lane is really, really quickly. So if you think about a GP practice, you know that you know, practices C 34, 300 people, larger practices. That's kind of same as a D. G h, and we always hear about the queues in A and B, but we don't tend to hear about the queues in primary care. Doctors haven't suddenly got lazy and said, Oh, I can't I can't do it anymore They're really, really busy. But technology can really help this and putting people in the right lanes and and people operating at the top of the license around allied health professional is a real answer. Linking that work to social care some of the stuff that's going on globally around remote sense of technologies and what they can do with cohort of people. Now imagine a clinician or a group of clinicians that collectively hold the risk but can manage better. Smith across those three settings social care, primary and secondary care and then decide between ourselves. Actually, it's best that down goes and sees better today because he can make, you know, the the sensors are saying this and the data saying this or actually it might be, you know, the practice nurse does it, So it's that kind of triumvirate working. I think the technology needs to enable that, and and perhaps it can be an enabler for that in a way that it hasn't been before. You can use it as a catalyst for the actual service model change that we're looking for. So yeah, happy to help them? Can I just come back a bit on that? It's just as opposed for me, it is about really deepening into the culture, piece around how the system is organized and governed unaccountable. And I do think it sounds like primary care has got enough of a deficit already and then also, we're just putting more into the secondary care system and I am going away thinking, you know, we've got to start thinking, go back further down the food chain for some of the solutions and that's your primary care and your community care. But we're doggedly attached doggedly attached to the secondary care world. Okay, and thank you very much indeed. I'm not going to get everybody because were virtually out of time. There's somebody with a microphone right back on the middle there on the right hand side. I'll take it quickly if you would question from some a small Northern Ireland ambulance service. But the question is coming from a public health perspective and pick up part of it. There, just in terms of digitization, is obviously the way to go. But looking at after the pandemic, there was a piece of research carried out in Ireland this year, actually, and burn in mind our population profile and health inequalities here. What it showed was that residents and care homes less than 60% of them have access to online services. People from Travelers Community less than 25% have access people from black and ethnic minority groups. Less than 40% have access to one mind services, so I just think we need to be mindful of that. It's another challenge in terms of quite often those population groups use our services the most, so that's a significant challenge that hasn't really gone away after the pandemic that it's a point well made. You want a quick word on that? Uh, if you build systems that are only available on computers, you're dead, right? There is an equity of access. Issue across the number of determinants. If you build access for smartphones while you don't solve the problem, you make it a lot easier. Okay, Final quick word. If you want just to reiterate what Dan said so digital divide. It is something that we're all mindful of. I drew my experience from some something I kind of experience firsthand in sub Saharan Africa, where quite a lot of digital care happens and it's probably kind of in a way that is profound. Dan has mentioned this already. If we can kind of get a lot of our access points and coordination and self management for a particular community that you've mentioned into the mobile phone space, there is a lot that can be done and and myself and other companies, I think we've got a responsibility to kind of enable that we certainly believe in our model of connecting for good and around accessory for of data, for for communities. I think we need to look at that. But I think the mobile phone stuff is probably the biggest thing we can do quickly. Okay. I'm sorry, folks, but we're out of time. And to be fair to the next session, we're gonna need to move on. And I know a few of you wanted to come in. I suggest that Dan and Sultan are going to be around for the morning, so none of them have a chat with them directly. They'll be more than happy to have a word and just Well, all of the slides and information available from down from everyone else, in fact will be available from Nikon if you want them after the conference. So thank you very much to Sultan. Thank you very much indeed. To Dan. And, uh, I'm going to hand over to