How collaboration holds the key to digital improvement

Julian Hartley profile picture

19 February 2024

Julian Hartley
Chief Executive


NHS providers are navigating a challenging environment right now with significant pressures on workforce, funding resources and operational demands, much of which was exacerbated by the backlog of elective and urgent care due to the impact of Covid-19.

Given this backdrop, there is a critical need for robust collaboration and partnerships, especially now that integrated care systems (ICS) are fully embedded. One of the key facets of this collaboration is centred around digital transformation to improve data flow, make the most out of electronic patient record (EPR) systems, and facilitate shared care records.

Better use of the data we have can help inform improvements in inpatient care, such as more timely treatments and improved access for patients through virtual outpatient services. Robust data sharing and analytics aid strategic data-driven decision making and allows partners to understand the pressure points across the system and react accordingly. Each of these elements contributes to tangible improvements in patient care and presents widespread opportunities for ICSs and NHS trusts.


How culture plays a part in digital transformation

Every system is different and has its own unique set of challenges and opportunities. Often, achieving a truly digital organisation necessitates a fundamental reconsideration of core processes and culture. This transformation involves the cultivation of a digital culture founded on trust and collaborative relationships.

Digital solutions are only enablers for achieving wider strategic priorities and are not an end in itself. At the crux of digital transformation lies the establishment of robust relationships and collaborative behaviours both within and between trusts and systems. Some people say ICSs will move at the pace of trust; the reciprocity and the collaboration that is central to the digital agenda cannot be overstated.

At a trust and system level, success follows where there is engaged board-level leadership that collectively own the agenda for driving forward transformation. Leaders must create the right conditions for successful transformation, provide assurance, set the strategic direction, and make sure that collaboration is the default mode.


The interoperability conundrum

Overcoming the challenge of interoperability is crucial across health and social care where partner organisations operate from different technical systems. Interoperability is about joining technology, people and processes to allow the sharing and receiving of data. Practically it's about staff having access to the right data at the right time, enabling them to do their jobs better and reducing unnecessary duplication of data collection in an overburdened environment.

NHS trusts have been working together for years to try and solve these issues and many providers are making headway through shared care records. These enable joined up working and information sharing across organisational boundaries – my own experience of the Leeds Care Record is a great example of that. Partner organisations all contribute to build the record and make it richer, which then helps support greater understanding of health needs and enables real-time health and care information across care providers and between different systems.


Maximising the opportunities of digital transformation

Beyond this, there are currently some big challenges to digital transformation, including ensuring adequate funding and recruiting and retaining the right digital data and technology skill sets. That's been a challenge for some time and it's vital that we think about the investment that we can leverage to really drive the potential of digital transformation. Digital is an enabler for safer, more effective and efficient care, but many trusts have not been able to use digital investment strategically/most effectively because of funding being awarded late in the year or the lack of multi-year commitments.

Crucially, recruitment and retention are a key overarching challenge within the NHS and the same strain is being felt in the digital workforce too. Trusts and systems are struggling to build the capacity and digital skills they need to implement large-scale transformation projects and support continuous improvement. This is another area where collaborating to pool resources and expertise across a system can really help system partners.

We've seen many success stories and examples of cutting-edge digital transformation work within the NHS, however there is still the need to focus on getting the basics right, for example, investing in strong digital and data infrastructure, Wi-Fi and building a digital workforce. This is the foundation that will underpin the exciting new advancements that are on the horizon. It's only by sustainably investing in digital transformation that NHS trusts and systems can maximise the opportunities that the latest technology and innovation offer.

This opinion piece was first published by Healthcare Leader.



At NHS Providers, our Digital ICS programme, delivered in partnership with NHS Confederation and Public Digital, is helping ICS leaders to better harness digital transformation to enable delivery of system ambitions. In the first year of programme delivery, we have engaged 89% of ICSs through our bespoke development support and peer learning events. This free programme is supported by NHS England as part of their NHS Digital Academy and focuses on strengthening collaboration and understanding for digital transformation through dedicated board development, peer learning and insights sharing. Get in touch to learn more about how we can support your system.

About the author

Julian Hartley profile picture

Julian Hartley
Chief Executive

Sir Julian Hartley joined as chief executive in February 2023, having been chief executive of Leeds Teaching Hospitals since 2013, where he led a major programme of culture change and staff engagement to deliver improved quality, operational and financial performance.

Julian’s career in the NHS began as a general management trainee and he worked in a number of posts before progressing to a board director appointment at North Tees and Hartlepool NHS Trust.

In 2019 Julian was asked to be the executive lead for the interim NHS People Plan, having previously worked as managing director of NHS Improving Quality, and in 2022 he was awarded Knight Bachelor for services to healthcare in the Queen’s Birthday Honours.

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