Ten key lessons for embedding digital in your trust

Cate McLaurin profile picture

06 April 2023

Cate McLaurin
Public Digital

Three years ago, we partnered with NHS Providers to launch the Digital Boards programme. Commissioned by Health Education England as part of their Digital Academy, and supported by NHS England, it was designed to support boards leading the digital transformation agenda.

This week, we have launched a summary guide for leaders capturing our learnings since the programme launched. Over 2,000 leaders from more than 200 trusts have participated in this programme, giving us a unique insight into the state of board digital leadership in the NHS.

We've already published several guides for NHS boards on leading digital transformation, but as we come to the end of our third year, we can see that there's a need for a short but comprehensive version – one that outlines the basics and helps board leaders navigate the information quickly to find what's relevant to where they are now.

So, what are the 10 key lessons we've identified?

  1. There must be visible collective responsibility for digital at board level
    Digital is sometimes seen as a separate issue, or an "add-on" to other strategies. However, it is when all leaders recognise and champion digital as a core priority, firmly integrated within clinical, strategic and business considerations that trusts make the most progress.

  2. There is (still) a need to build confidence and capability in digital among board leaders
    We've been helping boards develop greater assurance of their digital decisions and link digital investment to their quality improvement and patient safety agendas. Many board members recognise the importance of digital, but don't feel equipped to contribute to the conversation. Trusts benefit when the whole board is confident to engage with digital, so we've focused on building that confidence and capability for everyone.

  3. Having an EPR in place is the start, not the end of the journey
    Electronic patient records (EPRs) are now in place in almost every trust – and there's a concerted effort to support those that haven't got one. Having an EPR is a first step to becoming a digital organisation – but implementation is not the end of the journey. Good boards are focused on optimising their EPRs, working to improve the usability and adoption of these systems continuously so that they can better enable more efficient and safer care.

  4. Services need to be designed to meet the needs of users
    One of the core messages of the Digital Boards programme is the importance of really understanding your users – both staff and patients. We've seen some fantastic services on our travels, which are a direct result of trusts getting closer to the digital user experience by adopting a user focussed approach to service design.

  5. Badly designed services exclude people
    Boards leaders are, rightly, worried about digital inclusion. During Covid-19 we saw that trusts all over the country were able to stand up new digital services quickly. The challenge now is to not revert to older ways of thinking and doing, and instead ensure that we build on that progress by designing for the whole service, and the end-to-end user journey. It is not digital that excludes people; it is badly designed services.

  6. There are lots of competing requests for time
    Increasingly, trusts are appointing clinical digital leaders. The momentum continues to build for further professionalisation of digital clinicians. This will start to build much needed capacity and skills in clinical digital leadership, but for as long as digital is seen as an add-on, there will be limited bandwidth across the workforce as a whole, with clinicians struggling to carve out time from their day job.

  7. Digital investment is lumpy and unpredictable
    Good digital investment is sustained and focused and enables a trust to deliver against their strategy. But the current funding model means that trusts can end up chasing pots of money for technology or priorities that don't fit with their wider strategy. More advanced trusts are working to flatten those funding lumps to give stability to digital services and teams. Equally, insufficient funds make it harder to replace core infrastructure or legacy systems, or delay EPR implementation.

  8. The big opportunity for digital transformation lies in quality improvement
    Trust leaders are seeing the potential to merge existing expertise in digital and quality improvement to drive the transformation of care delivery, for example with virtual wards that use new technologies to provide more care at home rather than in hospital. We think this is where the opportunity for transformation truly lies.

  9. Fixing the basics isn't sexy, but it's necessary
    WiFi that works, devices that are usable and removing multiple logins to systems are all fundamental enablers of a successful digital health care organisation. It's the sort of investment and work that sometimes gets overlooked, but when it's not there it prevents real valuable change from happening.

  10. Digital is the lever for achieving alignment and collaboration
    Alignment and collaboration are the two main organising challenges for integrated care systems. Digital will be the most effective lever in addressing those challenges because technology allows dispersed individuals to come together in a way that was never possible before the internet. However, this also requires a shift in mindset from competition to collaboration. Adopting a digital way of working will enable that shift.


Want to know more?

The Digital Boards programme is an initiative run by NHS Providers in partnership with Public Digital. Since its launch in March 2020, the programme has helped NHS leaders grow their confidence in digital and make digital a priority on their trust agendas. The programme is funded by Health Education England and NHS England and has recently been extended to include integrated care boards with a specific Digital ICS programme offer.

This blog was first published by Digital Health.

About the author

Cate McLaurin profile picture

Cate McLaurin

Cate is a globally renowned digital transformation leader with deep experience of delivering agile, user-centred services and capabilities in public services. She has designed and led digital programmes from scratch, and worked with senior leadership teams to rethink and reimagine delivery culture and ways of working.

Cate has senior experience across both local and central government, including as Head of Delivery at the London Borough of Hackney, a role she held through both the pandemic and responding to a cyber attack. As Director of Digital Innovation at Acas, she built their first digital team, helping the conciliation service adopt user centred, agile ways of working.

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