On a day to day basis NHS board leaders are making difficult choices. It's fundamental to their leadership role. Leaders should feel comfortable making decisions across a range of areas, including digital and technology. But they also need to ensure change is then delivered.
Digital transformation is hard in any sector. That's why NHS Providers and their partners Public Digital, as part of the Digital Boards programme, have published eight simple principles to help boards realise the opportunities of digital transformation.
Not all board leaders need to be digital or technology experts. Just as not all board leaders need medical or financial qualifications. But they need to take collective responsibility of the agenda, and that means understanding what digital transformation involves and building their confidence and capability in assuring that their trust is harnessing the opportunities digital provides.
Realising benefits isn't just a reporting exercise
From the get-go, whether it's at project initiation, contract signing or formulating a team, the board must focus on outcomes not outputs. It sounds obvious, but too often organisations find themselves hitting targets and missing the point. All board members have a role in empowering and enabling teams to focus on what matters.
For example, Tim Welch, chief executive at Cheshire and Wirral Partnership NHS Foundation Trust and a former director of business and value, says "the role of a finance director is ultimately to enable change. Our job is to make [the case for digital transformation] simple and accessible to all."
Crucially, board leaders shouldn't wait until the end of the programme to look for these benefits. They should seek assurance that digital teams are constantly testing, measuring and learning how change is working.
Know how to get the best out of technology suppliers
Regardless of whether your organisation primarily builds or buys technology, you will always need to maintain relationships with technology suppliers. Obviously board members can't be across all supplier relationships. These will be managed at different levels within the organisation. It might be the chief executive who leads on the top two or three key relationships, such as your electronic patient record supplier. Your chief information officer may hold the relationship with other large suppliers your organisation works with.
Therefore as a board, you should know what in house commercial skills you have and what contracting methods the trust deploys. And most importantly, what would happen if your relationship with your most important technology suppliers went wrong. What are the most serious consequences and how will you mitigate against these? These are the questions boards should seek answers to.
Be prepared and remain flexible
Boards should avoid analysis paralysis and get comfortable with not knowing everything at the start. The nature of digital transformation is that change leads to more change. You can't predict the future, but you can prepare to be agile and flexible.
Success measure four of the What good looks like framework encourages organisations to support people by creating and encouraging a digital first approach. This will require you to make sure the trust is responsive to change and encourage a culture of openness and honesty about digital risks. Unfortunately things will go wrong but as a board you have to be able to reprioritise and create an enabling environment so teams can adapt. This is a sign of true digital maturity.
Digital is part of the workforce challenge
Ultimately it is the teams on the ground who will then deliver digital change. As a board, you should be looking to retain at least a "minimal viable digital team" that includes technical, user research and change management skillsets. This will ensure digital change is anchored in the needs of your users, clinical outcomes and local context.
We at NHS England and NHS Improvement recognise the challenge of recruiting digital, data, technology and informatics professionals. That's why this year we have launched the year of the digital profession. We're laying the foundations upon which the professions can grow, and building a pipeline for the future so that the NHS has the right capacity and capability to deliver digital.
We'll soon be launching a five-year strategy and roadmap that builds a sustainable digital and data workforce, so watch this space.
In the meantime, as board leaders of your organisations, make sure you get involved in the Digital Boards programme, and if you haven't done so already, please consider booking a bespoke board development session.
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