The NHS response to COVID-19 has accelerated digital transformation everywhere, underlining the importance of every trust having a strong understanding of the topic. This guide is designed to help boards build on this momentum. The five standalone chapters cover: 

  • the definition of digital
  • why digital transformation matters
  • pre-conditions for success
  • factors that help or hinder digital delivery
  • lessons from other sectors


We have suggested a short list of questions that board members - both executives and non-executives - may find helpful as a check on progress. The answers should help prompt board level discussions about areas for improvement or celebration. 

  • Does the trust have a shared understanding of what digital means that goes beyond IT?
  • Can you explain which areas you chose not to focus on in your digital strategy, and how you made these decisions?
  • Has the board experienced what users of the trust’s digital services experience, rather than just read a description on paper?
  • Does the trust's leadership take collective responsibility for the digital agenda, as it does for quality and finance?
  • Is the board sufficiently technologically informed to hold digital leaders to account, especially on major contractual arrangements with suppliers?
  • Does the board have the confidence and knowledge of digital working practices, processes and technologies to take a proportionate approach to digital risks and opportunities?
  • Does the trust have a shared commitment and vision for digitally enabled health and care across its sustainability transformation partnership (STP) or integrated care system (ICS)? Is the trust clear on the system’s investment priorities?
  • Is the trust taking opportunities to copy and adapt learning and work from other trusts, the centre (NHS Digital/NHSX) and other industries? Is it sharing its work?
  • Are teams in the trust empowered to experiment with new ways of working, and is the organisation well placed to scale up innovation when it succeeds?