NHS digital transformation works best alongside cultural change

The ‘back end’ that holds the NHS together has altered beyond recognition: technology has taken a central role in the collection, organisation, storage, processing and management of information.

Arguably the biggest challenges the NHS faces today are around its working culture: outdated processes, staff teams working in silos, a lack of joined up thinking, and even a loss of focus on the top priority – meeting the needs of service users.

Digital transformation can refocus the NHS. It should be predicated on putting patient needs front and centre, while at the same time making the most of all NHS resources – from skilled staff to equipment to buildings and budgets. Looked at in this way digital transformation isn’t the computerised equivalent of finding new ways to shuffle paper. It is right at the heart of the NHS’s focus on its people, culture, mindset, process and attitude.

>See also: Top 5 biggest challenges for digital transformation in the NHS

With this focus, digital transformation is not just ‘yet another technology change programme’ but an honest attempt to change the way work gets done, supported by technology but driven by cultural change that puts users and their needs at the heart of the process.

Achieving this isn’t always easy. The NHS is a huge organisation employing over 1.3 million people. There can be resistance to change, and even when it is completely supported there can be difficulties unravelling ways of working that have developed slowly over time. But the price of inaction is likely to be increasing complexity and decreasing efficiency – at the same time as need is growing. Inaction isn’t an option.

The challenge here is not primarily technological. It is cultural, and is bound up in the way the organisation structures itself, makes decisions and goes about its work. Digital transformation can be used to implement more streamlined, user focused ways of working, but it is people that need to define what’s needed and ultimately put it to good use, using technology to make work less complex, less costly and more focused on users.

Importantly, digital transformation isn’t about implementing ‘fit and forget’ projects. Rather, digital programmes need to develop alongside cultural changes within the organisation. The two should move in a sort of symbiosis where changes in one support (and where appropriate drive) changes in the other.

>See also: Why GDPR is an opportunity for digital transformation in the NHS

For example, dxw has been working with NHS England on its web presence since it was set up in 2003 to replace the NHS Commissioning Board. As NHS England has evolved, so has the website, so that it accurately reflects an organisation that is about people by ensuring both engaging stories (blogs) and NHS news are easily accessible to both the public and anyone within the NHS.

In another example, the Department of Health asked dxw to create a new intranet for them. It was to be a more responsive, mobile first site that could be accessed from anywhere. The aim was to increase staff usage and connect the many different systems the NHS used for expenses, procurement and document storage. Instead of tinkering with multiple discrete systems, the aim was to create unity.

This site is now live. Its running costs are about 15% those of running the old intranet. By introducing better core processes on the intranet, tasks such as publishing posts, searching for team members and documents and filling in forms take much less time. The intranet saves each staff member around 30 minutes of time per week – well over £1m of efficiency savings a year.

These are startling figures, but it isn’t just about the money. The most streamlined, cost efficient system in the world is valueless if it is not used. Developing the system involved supporting wider organisational change, while the skills needed to run an agile product team were transferred to DoH comms staff.

>See also: Healthcare efficiency through technology

In another example, dxw designed a new recruitment web site for NHS Jobs. This vital service handles 300,000 vacancies and over 4.5 million jobs every year, and is used by all 154 NHS trusts and other NHS funded healthcare providers.

By mapping user journeys to understand their needs at different stages of the recruitment process, dxw discovered how to make the journey easier for both candidates and recruiters. They also identified that reducing time to hire could save significant amounts of money.

Digital transformation like these examples, which embrace, inform and even drive cultural change, is vital for the NHS if we want it to survive for another 70 years. If all digital projects do is drop a new solution onto an existing process problem, they are simply rearranging its digital deck chairs.


Sourced by Harry Metcalfe, managing director, dxw

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Nick Ismail

Nick Ismail is a former editor for Information Age (from 2018 to 2022) before moving on to become Global Head of Brand Journalism at HCLTech. He has a particular interest in smart technologies, AI and...

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