10 Quick Reflections on…

Digital leadership in the NHS

Shanti Vijayaraghavan profile picture

23 July 2019

Shanti Vijayaraghavan
Consultant physician
Newham University Hospital, Barts Health NHS Trust


Joe Harrison profile picture

Joe Harrison
Chief Executive
Milton Keynes University Hospital NHS Foundation Trust


The NHS long term plan sets out an ambitious vision for the digital development of the service. Investing in technology offers significant opportunities to meet the developing needs of patients and the future population.

To help deliver this NHS organisations have been trying to define what makes a good digital leader. NHS Providers, working with NHS Confederation and NHS Clinical Commissioners, hosted a webinar discussion in May, which brought together leaders to discuss how effective digital leadership will turn this vision into reality. 

Here, two of the panellists from that discussion, Milton Keynes University Hospital NHS Foundation Trust chief executive Joe Harrison and Shanti Vijayaraghavan, a consultant physician at Newham University Hospital, Barts Health NHS Trust share reflections from the discussion and their advice on making digital leadership work:

  1. Risk – Joe Harrison argues that the ability and appetite for leaders to take risks on technology is critical. There will be failures along the way but leaders must accept them, learn from them and move on. He argues that having strong senior level sponsorship, supported by capable enthusiasts, not just in IT but across operational departments, increases ownership and the opportunity for success.
  2. Support- Use formal and informal networks within organisations, rather than just relying on one avenue or individual to get the support you need. Share great ideas and develop them. Joe adds that leaders will need to be prepared to put some effort and persistence in to get things moving.
  3. Skills – Joe tells us that good organisations blend the technical skills and operational skills to give projects the best chance of success. It is important to bring clinical teams on board by helping them understand the technology available, how it can help solve problems, and the benefits it can bring.
  4. Clinicians – Shanti Vijayaraghavan argues that digital leaders should work with early adopters to bring clinicians on board. She cites the example of greater use of keyhole or robotic-assisted surgery. She also argues that making sure work is evaluated, including through patient feedback, and shown to improve outcomes can win valuable support.  
  5. Pilot – and if it works, roll it out. Joe Harrison suggests that it is vital to maintain momentum in the rollout phase as with the development and pilot periods. Think about how to remove blockages when those who are less enthusiastic or knowledgeable highlight real or potential issues.
  6. Software – The considerations when choosing software are vital when embarking on a digital project argues Shanti Vijayaraghavan. Consider the ease of use, reliability of the system and a flexible approach. Shanti adds that flexibility is critical given current outpatient structures which are rigid, not user-friendly and tend to operate in silos, e.g. booking systems/ clinical pathways/ diagnostics and ICT which are all large separate structures.
  7. Roles – will need to change but may not be lost. Shanti’s own experience with online care shows that technology is changing the way we use some roles, e.g. clinic nursing and admin roles in a more patient focussed manner. Often roles will not be lost or reduced in numbers anticipated by some.
  8. Nurses – Shanti argues that nurses probably engage with patients far more than most, but how best do we engage them with digital change? As this group also use technology often, it is vital that software is not too complex and the systems and support are in place, and properly integrated, to help them recognise the value of the digital transformation programme.
  9. Governance – Joe Harrison argues that information governance (IG) is there for a reason so use it to your advantage. Governance helps to protect the organisation and individuals from doing the wrong thing, as well as ensuring our patients are protected. Include the IG function early and engage in finding ways through problems, don't ignore them, or there are likely to be problems further down the line.
  10. Incentives – Shanti flagged that the move to virtual consultations hasn't been supported by competitive tariff incentive. She explains that any proposed tariff must consider the initial costs of setting up and staff training required, along with patient uptake, to produce a critical volume to deliver efficiencies.


For more information or to re-watch the full webinar discussion, including an exclusive video interview with health and social secretary Matt Hancock, visit our website.

 

About the authors

Shanti Vijayaraghavan profile picture

Shanti Vijayaraghavan
Consultant physician

Shanti Vijayaraghavan is a consultant physician with special interest in diabetes and endocrinology at Barts Health NHS Trust where she leads the young adult and transitional diabetes service. Her research interests include access to care, particularly among minority ethnic groups.

She has been exploring the role of online care since 2011 and she is currently leading a Health Foundation-funded project exploring national scaling up of online consultations. This follows a recently concluded NIHR-funded project examining clinican-patient dynamics and organisational impact of online care.

Joe Harrison profile picture

Joe Harrison
Chief Executive

Joe joined Milton Keynes University Hospital NHS Foundation Trust as chief executive over five years ago. He has 30 years' experience working in acute hospitals, and has a passion for education and research, sitting on a number of committees and the council at the University of Buckingham. Joe’s particular focus is on improving patient safety, experience and clinical effectiveness, supported by technology.

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