Trusts need to set digital strategies that will give their teams a north star to aim for, and principles that will help them make decisions in an ever changing environment.

Creating a meaningful digital strategy takes time. As with any strategy, it must speak to the real and unique challenges facing your organisation, your system and the population you serve.


Trust strategy

Your digital strategy should be closely aligned with your trust’s core strategy, including your clinical strategies.

In fact, the best digital strategies are the ones that are embedded in the strategy of the organisation, its teams and staff. Many 'digitally native' organisations don’t have a separate digital strategy or digital team - it is simply how they operate.

Depending on a trust's digital maturity, it could make sense to start with a standalone digital strategy - it is often the best way of focusing organisations on this agenda. However, it is critical to keep a close connection with the trust strategy.

Boards will want to reflect on how well integrated digital transformation is within your corporate strategy and plans.


Absent Siloed Embedded
No mention of digital in business strategy or plans

Tokenistic mention of digital in business strategies and plans

Digital at heart of business strategy


Separate strategy, projects, budgets and objectives for digital

Digital transformation plays a key role in delivering corporate objectives 


Weak link between digital and overall trust objectives 



Trust performance 

Before embarking on your digital strategy, it is worth reflecting on the current performance of the trust, both in terms of digital but also more generally. Your performance data can tell you a lot about the services most in need of redesign and the biggest opportunities to use digital to improve the patient experience.

For example, an audit at Sherwood Forest Hospitals NHS trust found significant error rates in paper based early warning scores. The trust used these findings as a case for change to introduce e-observations, which has since reduced the error rate to zero.

There is no standardised way to measure the performance of your digital services. However, it is worthwhile thinking about some metrics that you could start to track, set goals and report on.

For example:

  • percentage of digital take up
  • cost per transaction/per user
  • user satisfaction
  • failure demand e.g. time to respond to patient contacts

These types of metrics can be useful as leading indicators of success, but they are a means to an end, not an end in themselves. Close alignment between your digital and core strategy should ensure success is measured in terms of quality of care, patient outcomes and staff satisfaction. The Northern Lincolnshire and Goole NHS Foundation Trust digital strategy sets out how they are combining these metrics to articulate their vision for 2025.



Your strategy should take into account the constraints you’re working within that may have a significant impact on your digital transformation approach. It should be recognised that trusts will have very different starting points:


This is often the main barrier to digital transformation and can feel insurmountable for some trusts. The scope of your strategy should align with your reality.


Digital skills
Digital transformation necessitates a new set of skills and an empowered, empowering culture. This is explored in more detail in our previous guide.


Physical infrastructure
You may have a hospital estate that makes the installation of reliable WiFi impractical, or an outdated data centre and network that requires urgent investment. This may take first priority.


Data infrastructure
Without reliable, standardised data and ways to share data between systems, the task of digital transformation in healthcare becomes even more difficult. Understanding your interoperability needs and ensuring your suppliers can support them is critical.



A key part of the context for any digital strategy refresh will be taking stock of the enormous changes brought about by COVID-19. Across the NHS, the pandemic fuelled years worth of progress on digital transformation in a few weeks. Trusts have rapidly delivered digital alternatives to face-to-face interactions, improved data sharing and new ways of working.

The sector's response to the pandemic has provided boards with greater clarity about what it means to be digital. COVID-19 has accelerated three emerging trends:

  • Pace: autonomy and authority has been delegated to teams delivering change
  • Purpose: the NHS rallied around a clear, unifying goal that has focused minds and generated greater willingness to do things differently
  • Priority: digital has been thrust into a central role supporting the trust's activities

All of this has underlined how much digital transformation is not fundamentally about technology: it requires an environment where people have the freedom and support to innovate across the usual professional and organisational silos. Board leaders will want to reflect on the profound cultural changes that have occurred within their organisations and ensure their digital strategy builds on this momentum.


Fairly early on during the pandemic, the board recognised the trust had historically viewed “IM&T” as an overhead that needed to be managed. But now they saw “digital” as a key enabler for service provision. We collectively agreed to signal a line in the sand through our Digital Strategy. Our approach to digital transformation has fundamentally changed for good.

Chris Bird    Executive Director of Partnerships, Strategy and Digital, North Staffordshire Combined Healthcare NHS Trust