The digital revolution remains a challenge for the NHS but one it needs to embrace head on. Here Hazel Jones, head of health at Made Tech, explores how building a different mind set will revolutionise health services.
In my recent experience working as a digital leader within the NHS, I’ve experienced first hand the struggle with digital adoption. This isn’t unique to the NHS, many of the big corporates have been, and in some cases, are still on that journey. I have observed a drive to recruit more Chief Digital roles, but the risk with this is that the Digital Officers will also struggle with resistance to change that appears endemic in big parts of the NHS.
The ‘hearts and minds’ element of change is still relevant if they are to inspire their peers and workforce to consider moving from ways of working that are safe and comfortable in order to adopt new digital approaches that are unfamiliar. John Kotter has written much about the psychology of change and resistance to change that applies to any large organisation – but data and evidence enabled and tracked through digital pilots or beta services speak for themselves.
At NHS Blood & Transplant, we were in the middle of the pandemic and had to find a way to identify potential donors with high grade Covid-19 antibodies so that we could use their plasma in the treatment of vulnerable Covid-19 patients. This was in support of the RECOVERY clinical trial.
Traditional methods had been set up to recruit potential donors via webforms, book them in via a call centre, and obtain a blood sample in one of a range of pop up donation centres. This traditional way of working led to scaling concerns and an openness to look at other options. Postal sampling is already used by the NHS for Covid-19 testing, so why not consider a similar approach to identify patients with high grade antibodies.
In a matter of weeks, we had launched a digital journey to collect blood samples via postal kits so that we could quickly identify and prioritise donations from those with the highest antibody levels.
Implementing a digital solution enabled us to provide an efficient and scalable digital service with valuable insights from the data used to track the end-to-end journey. Tracking conversion from invite right through to the sampling and donation results provided vital insights into the efficiencies and scalability, enabling speedy refinement and optimisation of the service. Without a digital mind set, we wouldn’t have gained a scalable service or the insights to inform future donor experience activities.
A digital mindset and agile ways of working enables the work to speak for itself. Taking a small, focussed team to build and launch a beta or pilot service gleans quick insights. Quick insights gained from pilots or beta services enable the team to test and refine the service much more quickly than traditional heavyweight methodologies. Moreover, the overall benefits can be achieved more quickly, and extended through further iterations.
We have started to see more of a shift in the NHS’s approach to transformation, with COVID-19 accelerating digital solutions to ensure it could still treat patients and remain functional during the pandemic. However, that’s not to say there weren’t seeds of innovation that were already in place. Organisations such as NHSX and Health Data Research UK have been doing great work in helping to nurture and grow digital innovation. However, if the NHS is going to continue its upward technological trajectory and further embrace transformation, it needs to look internally and change how it thinks about digital.
To do this, it needs to not just transform digitally, but also change mindsets, particularly those of decision makers and senior staff. In some cases, the word ‘digital’ has negative connotations amongst officials who may have been hurt in the past by previous large scale transformation projects that have not delivered the results expected, cost fears or simply being comfortable with the legacy solution in place and not wanting to rock the boat. While this can be understandable, a lack of willingness to embrace change is holding back potential new solutions coming in place, hindering staff and patients in the process.
At the same time, more senior staff members who have worked in the NHS for a long time may have been taught to run projects in a certain way that, while effective when they learnt them, are not suited for digital transformation. For example, rolling out a new digital solution using traditional waterfall methodologies, manual processes and a ream of excel project trackers may provide the project lead with a feeling of comfort and control but come at the cost of speed and efficiency. This will lead to a long, drawn out process that could lead to errors occuring, only going to reinforce the fear of digital that I referred to previously.
So, if we are going to change the pace of the adoption of digital approaches and help the NHS embrace best practices when it comes to digital transformation, providers need to be helping to create trust. When a digital partner is brought in to implement a new solution, they should see this as an opportunity to demonstrate ways of working by showing results early. NHS needs to see very quickly how new approaches will benefit their trust or body, rather than just installing new technologies and then leaving. This will help demonstrate the value to senior officials and decision makers and provide them with more confidence that a digital approach is the right one. Digital lends itself so well to pilots and iterative development, feeding back results quickly, and enabling decisions to be made based on actual results.
As well as this, we need to help the NHS with its recruitment and training processes if mindsets are to truly change. As digital transformation accelerates, the NHS needs to have the workforce in place that understands how to fully utilise its potential. This requires upskilling current staff while ensuring new positions are created and filled by the right people. Digital partners have vast experience in both these areas and should be looking to share this knowledge with decision makers to ensure the best workforce possible is available. Joint working is an approach to upskilling that I have seen work in two major NHS organisations, enabling NHS employees to learn through experience and develop into digital roles.
The NHS has the potential to be at the centre of digital innovation, implementing solutions that could revolutionise healthcare for both patients and staff. If it is going to unlock this potential, it needs to fully shake off this reputation of digital hesitancy and change the way it thinks about digital transformation. Through education, guidance and collaboration, our health service will become a technological source for good now and in the years to come.