Written by John Noble CBE, Advisory Board member 

In the second instalment of this blog (read part 1 here), Reliance acsn Advisory Board member John Noble CBE shares his experience of working with NHS Digital and government bodies, and explores the consequences of the additional pressure it has come under as a result of the COVID-19 pandemic.

COVID-19 has placed tremendous additional demands on the NHS, across the board. NHS Digital is no exception, and staff there are doing some amazing work to support their colleagues in Health and Social.

The urgent challenges they have had to rise to include:

Providing advice to the public to help take pressure off clinical staff

Early on in the pandemic, it became critical for people to be able to obtain information on COVID-19 and begin a triage process using resilient and websites, without requiring access to already overburdened medical staff.

NHS Digital created a new module of the NHS 111 online service specifically for coronavirus in late February. Knowing that it was going to be in high demand, they tested it up to twelve times the usual level of around 10,000 visits a day. In mid-March, it was getting almost a million visits a day – 95 times its usual capacity. It kept functioning.

NHS Digital has also delivered additional functionality into the 111 service to enable the online creation of Isolation Notes – announced in the Budget by the Chancellor – and this was turned around in less than a fortnight. It offered people suffering from suspected COVID-19 the opportunity to generate their own such notes, meaning GPs weren’t overwhelmed with demand for them. Over a million Isolation Notes have now been issued.

Prioritising patients, protecting resources

The second area where work has been ongoing is around the use of data. A good example is the Shielded Patient List. When the government announced it would be asking the country’s most vulnerable groups of people to stay at home completely to shield themselves from the virus, NHS Digital worked with the Chief Medical Officer to develop, in just days, a clinical algorithm to identify patients who were classified as high risk.

This was critical, since being able to focus care where it’s needed most makes the most efficient use of already stretched resources.

The baseline work identified an initial 900,000 people. Now that GPs, acute Trusts and specialist colleges have had an opportunity to additionally flag patients who might not have been detected through the original algorithm, the list has grown to over 1.3m people.

Keeping key systems working

At a time of acute pressure on the NHS, it is of course imperative that key systems can continue to operate.

One of the critical risks to such systems, of course, is cyber attack – a risk I also see close-up in my role at Reliance acsn, as they defend health and social care institutions in the UK from such attacks (NHS England, West London NHS Hospital Trusts, regional , and others).

Read the final instalment of this blog to learn about how NHS Digital is working with NHSX, NCSC and security teams across the NHS to defend key systems during the COVID19 crisis.

Read part 3


John Noble is an experienced senior leader with a strong track record for operational delivery and strategic business change, formerly the Director of Incident Management at the National Cyber Security Centre (NCSC), where he led on nearly 800 major cyber incidents; This work has given him unrivalled experience in dealing with and understanding the causes of cyber issues. Prior to that, John spent four years at the British Embassy in Washington, USA.

During more than 40 years of government service, John has built collaborative, diverse and high performing teams and has excelled at creating effective partnerships.. For his work in creating effective partnerships in the run up to the London Olympics, he was awarded a CBE in 2012.

John Noble CBE Reliance acsn Advisory Board member

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