High-value, low-risk digital transformation – the importance of collaborative technology in the NHS
Health IT leader and Silverlink non-executive director, Stephen Hopkins, explains how a blended technology strategy, using multiple supplier solutions, can offer NHS boards the best return with the least risk.
Having spent over 30 years in technology and transformation within the NHS, in roles spanning Director of Finance and IT through to Chief Executive, I’ve visited numerous trusts and have always looked for evidence to show that the IT systems were working as intended, and that people were getting the benefits they expected. Yet, at times, I’ve witnessed as much as 40% of a procured (single) system going unused.
Why such waste? From my experience, having worked in trusts that use single system suppliers, there is less scope to change and adapt the technology once it’s been implemented. Business cases are rightly focused on key metrics for the NHS, such as cash releasing benefits, reductions in length of stay and opportunities for cost savings. However, the methods for measurement and evaluation aren’t always captured and reviewed in the right way to ensure there is a return on these multi-million pound investments.
Systems without compromise
An integrated, blended approach that uses multiple solutions from specialist suppliers can counter these issues, enabling NHS organisations to choose systems that best meet their needs, without the compromise of unused technology. The suppliers are experts in their field – they provide knowledge and support that takes into account the needs of each speciality, and they are responsive to those specific user requests. For a single supplier, these requests could often be considered too niche or specialist, and therefore, not a priority in the overall pool of change requests amongst the user community.
The best of breed (BoB) software also develops strong ownership amongst its users (a common challenge with IT projects that I’ve been involved in), as functionality is designed for specific purposes, rather than a one-size-fits-all solution.
This type of strategy also gives greater flexibility around implementation and investment. Trusts can put systems such as electronic observations in early, to show clinicians the positive impact of technology on care. Future enhancements can come later as investment becomes available, without the high upfront costs of a single supplier.
As a result, the technology delivers tangible benefits from systems that work as they’re intended, and people get the benefits they expected. The return on investment is there for everyone to see.
Why is this more important now?
With everyone working under ‘new normal’ conditions due to the pandemic, the phased and flexible implementation and investment made possible by this blended approach will be essential. It can help support the NHS through these uncertain times, ensuring digital continues to play its part in helping manage the current demand, whilst also enabling future transformation ambitions.
The references to the complexity of the approach – as described by NHSX in the recent National Audit Office report into digital transformation – are valid in certain instances, but not all. Trusts can leverage interoperability to underpin robust system integration from multiple suppliers, minimising the impact of working with numerous solutions. And the continued work on interoperability standards and open APIs from NHS Digital, and action groups like INTEROPen, means progress can continue in earnest to manage the concerns about complexity.
Admittedly, I used to support the single supplier approach when I was a financial director in the NHS, primarily because it gave me the reassurance of having a single point of contact and a single line of accountability. But I soon learnt that the compromises around functionality outweighed the benefits of supplier relationship management. And, if the IT team can create a collaborative approach amongst the suppliers, and establish sub-owners across the trusts – for example, the pharmacy team ‘owning’ ePrescribing – it’s possible to overcome this hurdle.
NHS boards want the best return for the least risk. The integrated, collaborative model means boards are more empowered to be digital leaders – the organisation can own solutions that align to the way they want to do business, both clinically and commercially. They can embrace a flexible approach that copes with change, and that works with responsive and adaptable organisations that specialise in each field.
IT leads and CIOs also have an important role to play, by presenting the vision of what will happen after implementation, with clear tangible metrics. They can show what technology means for patients and staff on a hospital ward, to make it real, and have simple yet effective tools to monitor and measure these benefits.
To achieve this, business cases can’t become tick-box exercises – they need to be attuned to the aims of the organisation. We need to ask clinicians what they want, rather than what they should have, and be realistic about what can be achieved.
Ultimately, this is not the time for 10-year plans; it is time for an approach that will be sustained in the NHS for decades. With BoB, the NHS can embrace flexible approaches to digital transformation that will stand the test of time.