Foreword from Caroline Clarke, Group Chief Executive, the Royal Free London NHS Foundation Trust:
All chief executives should have digital on their agenda. It should just be what we do now, it's your business, not just your chief clinical information officer's (CCIO) or your chief digital officer's (CDO). Life has changed – now most transformation investments are underpinned by digital. Chief executives and their boards can set a tone for an organisation, that technology is taken seriously and talked about at all levels of the organisation.
Digital can't just be discussed when a business case is submitted to the board. As leaders, we must understand how digital is delivered:
Be proactive. You must create the case and environment for change, and then go out and actively find the resources to make it happen. In my experience, it works best when you have a board that is assertive, dynamic, and willing to take some risks and iterate on what they learn.
Take the long view on digital transformation. The journey to digital transformation is a long one, but it is one well worth doing. There will often be bumps and bruises along the way, but you have to keep a robust mentality and know that the discomforts of change will be temporary, but the impact of having a truly digital organisation will be transformative and long-lasting.
Capitalise on opportunities to collaborate with others. Understand the limited latitude you have as one organisation. When it comes to scaling technologies and your commercials, you may get better value from working with others in your system, rather than trying to go at it alone. Even a large group of hospitals like the Royal Free isn't big enough to do this on our own. Understand what the national team is doing, find things that you can do at scale with partners, such as pooling digital skillsets, and pursue these together.
Plan for proper resourcing. We know that good health systems are clinically led and data driven. Invest in good infrastructure to take advantage of the data, train clinicians and encourage them to be curious and ask the right questions. It costs a lot to curate data and turn it into something useful. Digital initiatives can go wrong when boards undercook the resourcing and try to cut corners.
Most importantly, go out and learn from others. There are opportunities for peer learning all around you and it is critical that leaders take the time to learn from the successes and challenges of others. To be successful, you need to understand digital in a level of detail you might be surprised about. Just as with finance or quality, sometimes it will require you to understand a bit 'under the bonnet'. Therefore, it is worth visiting others who have done things well. If you really want to accelerate the pace of digital progress, you have got to have a board who doesn't mind standing on the shoulders of others.