The NHS - TechNology is important, but people make it happen

    By James Storr, Lead Architect at BJSS

    James Storr

    The goal of digital transformation in the NHS is to efficiently scale the UK healthcare system so that citizens attain the quality of life they are entitled too. The monumental scale and complexity of digital transformation in the NHS is well understood. Still, the recent National Audit office report on NHS Digital Transformation, in my opinion, has missed an opportunity to highlight a primary ingredient to a successful digital transformation.

    It is concerning that there is little focus on just how crucial ways of working, culture, and skills are to driving digital transformation. It’s not possible to deliver the demand for quality and timely healthcare that our citizens need without integrated digital services. Building digital services our citizens need will only accelerate if transformation teams have the right working conditions in place. Just a workforce plan is not enough.

    In 1998 the NHS identified the importance of sharing data between IT systems. In 2017 only 16% of trusts reported their digital capability as ‘low’. The audit report does highlight a lot has been learned from the days of NPFiT (National Program For IT), but the statistics make it clear progress is not fast enough.

    In the 90s, the Hospital Information Support Systems (HISS) projects had capable technology available. There have also always been suppliers promising a magic bullet that will make it all easier, and some of these technologies truly did. Modern technology can rapidly release value, but those same technologies in many organisations almost have the opposite effect when the focus of the organisation is wrong.

    Far too often we see organisations buy DevOps tools, build some CI/CD pipelines all in the public cloud, maybe even some Kubernetes microservices. However, these technology magic bullets will fail to solve everything alone. Undoubtedly these technologies can be essential tools to deliver excellent digital services. When technology is focused on, it can distract from the goal, creating ideological battles over which cloud, tool, or technology burn energy and time.

    Technology and complexity are the challenges to be met by high performing teams. The technology will always have awesome new features. Still, gaps will exist and will always need teams to integrate and fix it. The variety of technology available today and the myriad of ways digital organisations use it highlights it is not just the technology they use. What differentiates successful digital organisations is the people, teams, and culture in which they operate.

    1. Have you got the right ways of working? Does the culture, skills, leadership and practices within the IT team promote innovation and release value rapidly while helping to manage the ever-present clinical risk challenge?
    1. Will your IT operating model support digital transformation? Is your current IT operating model fit for the patients, the organisation, and are your teams delivering the right technology services?
    1. Do you have the right suppliers? - Is the supplier ecosystem healthy and appropriate for your needs? Are the supplier’s partners who leave your organisation with residual value for the future?

    Digital transformation is hard but knowing what your baseline is makes things a lot easier. The old strategies and practices are not fit for purpose. People and teams without the right skills and practices operating in the right culture, with an optimal operating model will not be successful, irrelevant of the technology. Now more than ever before, a strategic workforce plan is just not enough, this is a fundamental change to how technology is delivered.

    At BJSS Technology Consulting, we recognise that large-scale transformations rarely deliver the vision that is sold. Our approach is to start small, operate iteratively and collaboratively to identify the incremental changes needed. We can help by quickly bringing our experience to bear in these areas by assessing where you are today against your aspirations, providing practical and realistic recommendations. This will leave lasting value in NHS IT teams and ultimately deliver the health care we all need. Find out more about how we help healthcare organisations with their digital transformation by visiting our health & social care page.