DigitalHealth.London – the collaboration between the capital’s Academic Health Science Networks, Academic Health Science Centres and London Mayor to pioneer the development, commercialisation and adoption of digital technologies – has talked to people involved in NHS digital innovation to identify key factors behind successful projects.
This is an extract from their report Digital Leadership in London’s NHS.
1 Who is in charge?
A central message was that digital transformation is far too central to our future healthcare to leave to the technologists. The board, chief information officer, chief operating officer and others need to lead this work as part of their core clinical strategy and transformation plans.
This is echoed in the movement to create a chief clinical information officer (CCIO) in every organisation.
2 Be agile and brave
Speed and agility is critical. Successful organisations have trusted their clinical and managerial leadership and backed them to make rapid progress. These trusts haven’t made the mistake that we see regularly within the NHS that IT projects have to follow highly bureaucratic, long-winded processes for approval, no matter what their size.
3 Pragmatism, not waiting for perfection
Successful projects have not let ‘the best be the enemy of the good’. A neat digital tool could be the tactical solution you need for now and be heaps better than the current process or bit of paper trying to do the job.
If it is 80 per cent right, go for it; don’t wait for perfection
You don’t need to transform outpatients or put in your new electronic patient record or integrate everything first. If it is 80 per cent right, go for it; don’t wait for perfection. Everything doesn’t need to interoperate immediately, you can test and try things.
4 Role of clinical leaders and patient involvement
Interviewees cite the importance of clinical leadership in identifying, achieving support for and then delivery of digital healthcare solutions. The engagement of patients, parents and service users, as well as clinicians, in product selection has also been highlighted.
A number of the digital health solutions have invested a huge amount of time in user-led co-design to ensure their products work as well as possible for those using them, particularly where user uptake and ongoing adherence is a key part of the success of their programmes.
5 Restless for improvement
The pressure on operational NHS services is so severe that it can be difficult to carve out thinking time for innovation and changing the way services are delivered. But that discipline is well rewarded when solutions help support an entirely new way of working.
Never being ‘too busy to improve’, despite intense pressure from patient demand, regulators and others has been an important aspect of the progress we have seen. Boards have also supported the implementation well and encouraged pace, which has helped the clinicians and operational managers charged with delivery.
6 System-level change
Sustainability and transformation partnerships (STPs) present the opportunity to use digital products at scale across an STP geography. In south west London, the iPlato product is going in across all GP practices in Wandsworth, Richmond, Kingston, Merton, Sutton and Croydon, a population of 1.6 million Londoners. This will support STP commitments to improve population health such as increasing health check and screening rates, targeting people for appropriate interventions and reminding them of key appointments.
Likewise, in north west London, proven digital tools that support behaviour change and weight-loss including OurPath and Oviva are being made available to patients across the STP. By linking STP goals to evidenced digital solutions, STPs are able to move into delivery mode more rapidly.
7 Support matters
As well as enthusiastic clinical and operational support within the organisation, each of those referenced has had dedicated support from a digital health navigator to help them review potential solutions, decide to proceed and then implement.
8 Inspiration and skills
We are now past the point of ‘digital dabbling’ being acceptable within the NHS, and need to develop the confidence and skills of leaders at all levels. We see boards recruiting non-executive directors to add ballast at board level and it is important that senior leaders are accessing inspiring examples of what is possible in their work.
However, there is no need for everyone to turn into geeks, simply that we should support colleagues to become more confident and digital savvy to ensure that the NHS makes the most of the possibilities of the third industrial revolution to improve care, the working life of our clinicians, and to make every pound go as far as it can.