Learning from digital successes and failures

Dan Sheldon profile picture

03 May 2022

Dan Sheldon
Health Technology Specialist
Public Digital Network


Digital transformation is hard. Digital transformation in healthcare is even harder. And it seems to have a habit of going wrong: clunky new systems that get in the way of clinical care, technology supplier relationships that go sour, or transformation programmes that promise lots but deliver little.

It's little wonder that many NHS staff – who use intuitive, real-time and reliable technologies in their home lives – have to lower their expectations when they're at work. And some senior leaders – burnt by previous bad experiences – have retreated, putting digital transformation in the 'too difficult' box, leaving it to the IT team to make progress where they can. It doesn't have to be like this.

Over the past two years, NHS Providers and Public Digital have engaged with over 750 NHS board members at 195 trusts as part of the Digital Boards programme, supported by Health Education England and NHS England and NHS Improvement. We've seen trusts like Alder Hey, or Milton Keynes Hospitals, who are leading the way. Not just implementing new technology systems, but changing how their organisations work and how care is delivered.

We've also seen trusts who are struggling to make progress on digital. Some organisations have backed themselves into corners with some bad technology decisions, and lack the in-house skills to change course. Many are struggling to invest the money and time required to do digital transformation properly. And some lack focus: a long shopping list of projects with no coherent strategy.

Even for those trusts with funding and a good digital strategy, some come unstuck when trying to turn that strategy into reality. We've heard from senior leaders grappling with the messy reality of digital delivery. This is often wrapped up in the language of 'programme management', 'change management' and 'benefits realisation', but really it's about delivering things that solve real problems for staff and patients. It's also about building an organisation that can deliver this: bringing together clinical and digital expertise, focusing on user needs and adopting an agile, iterative approach to delivery. This also usually means updating how you do procurement, governance and communications to ensure they are fit for purpose in the digital era.

That's why we've published our latest digital transformation guide, setting out eight principles to help NHS organisations realise the opportunities of digital transformation and avoid common mistakes. We've based these principles on some hard-learned lessons from digital successes and failures across the NHS and other sectors.

The principles are:

  1. Deliver things that patients and staff need

  2. Set clear, realistic goals

  3. Test, measure and learn how it's working

  4. Think long term, deliver in the short term

  5. Invest in a dedicated, cross-functional in-house digital team

  6. Get the best out of technology suppliers

  7. Build trust, not barriers

  8. Don't stick to the wrong plan.


These principles and how to achieve them are explained in more detail in the guide, along with case studies. We've also provided some questions for boards, to help them assess how their organisation shapes up against these principles. There's no shortcut to successful digital transformation, but these principles are designed as practical and pragmatic pointers for NHS organisations, regardless of their digital maturity.

Digital is not the answer to every problem in the NHS. But it can be part of how we deliver better health and better care at lower cost. We hope these principles can play a role in this.

This blog was first published by the National Health Executive.

About the author

Dan Sheldon profile picture

Dan Sheldon
Health Technology Specialist

Dan Sheldon is part of Public Digital network, and the author of several digital transformation guides for NHS Providers. Dan was a member of the UK government's Health Tech Advisory Board and has experience of digital transformation in the NHS, pharmacy and central government.

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