Successful digital transformation requires digital and clinical practitioners – doers – on the ground who can deliver. It's critical that these teams are:
- Multi-disciplinary – not just staffed by the IT team.
- Hands on, with skills that go deeper than strategy and project management.
- Not wholly dependent on outside consultants or contractors.
Digital is part of the NHS workforce challenge
Digital talent is in short supply across the NHS and the wider economy. As trusts become more reliant on digital transformation to achieve their aims, these shortages can put delivery at risk. Given the need for joined-up digital transformation and the scarcity of skills, we recommend that trusts work together to build shared digital teams with system partners. While technology suppliers play an important role across the NHS, they can't take the place of in-house digital teams entirely. Retaining at least a 'minimum viable digital team' is critical to get the most from technology suppliers and ensure that digital transformation is anchored in the needs of your users, clinical outcomes and local context.
There is no point in undertaking digital transformation unless you are prepared to totally change the culture of your organisation.
Group Chief Executive, the Royal Free London NHS Foundation Trust
Digital transformation can't be done as a hobby
Clinical input is critical to successful digital transformation. Digital services with limited or late clinical involvement are unlikely to deliver good clinical outcomes, or be adopted widely by staff. However, clinicians can't make significant contributions to digital transformation on top of a full-time day job. Trusts need to find ways to fund clinical time to support digital transformation – not just senior leaders but those close to the details too. And those involved need to reflect your wider workforce and the population you serve because it will lead to safer, more efficient and inclusive services. Trust leaders need to actively review recruitment practices, find new networks and consider the impact on equality and diversity when negotiating with commercial partners.
Don't expect transformation just to be led by the IT team
Successful transformation is about much more than technology, it usually involves changing the way people work and communicate. Trusts should be prepared for the scale of change required here; transformation will involve changing processes, culture and mindsets, not just kit. IT teams are experts in technology; but you will also need experts in user-centred design, healthcare and organisational change. Sometimes these skills sit in other teams. That's why a diverse, multi-disciplinary digital delivery team, supported by senior leaders across the trust, is a critical condition of digital transformation.
Key questions for boards:
- Do you have a 'minimum viable digital team' in place?
- Are clinicians supporting digital initiatives as part of their job, or as a favour?
- How dependent are you on technology suppliers and contractors?