Fusion Teams at Surrey and Borders Partnership NHS Foundation Trust

Toby Avery profile picture

03 November 2020

Toby Avery
Chief Digital and Information Officer
Surrey and Borders Partnership NHS Foundation Trust


What the heck is a fusion team? You may ask…

I would have probably asked the same thing not so long ago, in fact some of our fusion teams would probably ask the same question.

If I am honest we aren't great at communicating the exciting names we come up with, however I do think we have come up with, or come across, some great concepts that we need to build on and one of these is the idea of fusion teams.

This is not really a new idea, it is the extension of the multidisciplinary team to include digital thinkers, but turning a good idea into reality is not always easy.

For us, a fusion team is the bringing together of diverse competencies to design for the outcome. Historically we have often designed solutions to meet a need, but we have done it based on the preferences, interests or bias of those designing it.

The result has been either a solution that is not fit for purpose or one that people do not use.

A fusion team aims to mitigate these natural biases that we all have by bringing the right people into the entire design, build and implementation cycle. This very much includes people from outside technology and data teams, we need the expertise from the frontline not just the 'backoffice'.

For us, a fusion team is the bringing together of diverse competencies to design for the outcome. Historically we have often designed solutions to meet a need, but we have done it based on the preferences, interests or bias of those designing it.

Toby Avery    Chief Digital and Information Officer

We have taken several approaches to achieve this.


Digital clinicians

We have recruited clinicians into Digital to lead and influence the entire product lifecycle.

For instance, asking a nurse to lead on our electronic patient record development, pathway design, adoption, learning or anything else forces designers, developers, techies, trainers, and analysts into a different way of thinking. It challenges the 'why' of what we are doing and forces a narrative around usability, safety, and experience.

This was not an overnight success, it required a significant mind shift, but as the approach has matured and been applied to developing products, pathways, and adoption the benefits have been significant.

This was not an overnight success, it required a significant mind shift, but as the approach has matured and been applied to developing products, pathways, and adoption the benefits have been significant.

Toby Avery    Chief Digital and Information Officer

 

Embedded leadership

We have stopped designing and building solutions for clinicians and operational teams. This simply does not work!

Instead we design, build, and implement with those that will use the solution. This brings in the differing competencies needed for success, hierarchy goes out of the window and everyone’s views, skills and experiences are given a place.

We still battle the expectation that a 10-minute conversation equals engagement and that requirements can be defined in a single exercise, but the dial is turning, and ongoing involvement is becoming more commonplace and easier to achieve.


Design teams

If I'm honest we took a punt with this one, we knew from looking outside the NHS that we needed to adopt human-centred design thinking practices, but this wasn't something we were really hearing about inside the NHS (not to say they didn't exist but we hadn't heard about them). We reworked some of our team, brought in and developed new competencies and put clinicians in charge. 

If I'm honest we took a punt with this one, we knew from looking outside the NHS that we needed to adopt human-centred design thinking practices, but this wasn't something we were really hearing about inside the NHS (not to say they didn't exist but we hadn't heard about them).

Toby Avery    Chief Digital and Information Officer

Who knew what a user researcher or a product manager was? Trying to explain this internally remains a challenge but the outcomes with solutions built around need are becoming more and more powerful.

Within six months of our first design team being in place we started turning the corner from slow and painful waterfall-based project delivery to agile, experience led developments with iterative improvements.

The results spoke for themselves and now we have several design teams and have just created a fusion team for learning and adoption.

 

In conclusion

We are on a journey, an evolution if you like, of the way digital enables and transforms clinical models and pathways, this evolution must involve clinical professions and digital thinkers.

The board has supported us throughout this journey. We have been given the freedom to act which has allowed us to take a few punts. We regularly keep the board up to date on risks but also try to demonstrate the quality and value of what we’re doing. 

It is not easy, funding products rather than projects, finding the right competencies, creating momentum are all challenges we face. We will not get there overnight, I am not even sure there is a clear destination to get to, however I know that we can make life a bit better today and tomorrow and the next day.

For us fusion teams are part of this journey and I am glad that we have taken a few steps in the right direction.

About the author

Toby Avery profile picture

Toby Avery
Chief Digital and Information Officer

Surrey and Borders Partnership NHS Foundation Trust

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