Maintaining the digital momentum

COVID-19 has forced rapid change across the NHS – nowhere more so than in digital technology. How can NHS boards maintain the momentum on digital innovation?

Before the pandemic, it is fair to say that the NHS did not have the best track record on the implementation of digital interventions at scale. In 2013, the then Secretary of State for Health, Jeremy Hunt promised a fully digital health service by 2018, arguing that:

“The NHS cannot be the last man standing as the rest of the economy embraces the technology revolution. It is crazy that paramedics cannot access a full medical history of someone they are picking up in an emergency – and that GPs and hospitals still struggle to share digital records.”

Sound familiar? Research by Parliament Street suggests that as recently as October 2019, 94% of trusts were still using handwritten notes.

Then the pandemic hit and, out of necessity as much as anything, everything changed. Suddenly, we saw a spate of digital innovation and improvement across the NHS.

Within the first two months of lockdown alone, the average monthly number of remote meetings rose from 13,521 to 90,253, while video consultations within primary care are said to have risen by c.85%. Understandably, NHSE/I is keen that this momentum is built on.

Focus areas for digital improvement

This is made clear in the recently published NHS 2021/22 priorities and operational planning guidance, which highlights several digital improvements it expects systems and individual institutions to focus on in the course of the next year, including:

• the use of technology enhanced learning and the option of staff digital passports to support more flexible working
• using digital solutions to support out-of-hospital care
• ensuring that digitally-enabled models of therapy are rolled out in specific mental health pathways
• using shared care records to facilitate greater connectivity between health and care services and to improve patient experience and care
• the increased use of data to support population-based interventions.

A September deadline has been set for systems to implement a ‘minimum viable product’ for shared care records. For those behind the curve, this could present a significant challenge.

Lessons should be learned from previous initiatives such as the failed Care.data programme. Equally, it will be important that systems also look at best practice examples from across the country. NHS Digital’s website hosts several case studies. One such intervention is University Hospitals Plymouth’s introduction of GP Connect, which has helped to link GP and trust patient records, improving clinical effectiveness.

The role of boards

As ever, NHS boards will play a critical role in the success of such programmes. Boards are the ‘controlling mind’ of any organisation and have key accountabilities for setting strategy and delivering plans.

There are several things boards can do to ensure that they are well placed to execute digital transformation plans:

1. Ensure that all board members understand the issues: digital transformation should not be delegated to one individual on the board. It needs to be an issue on which the whole board is engaged and accountable for.

2. Lead by example: board members should, wherever possible, utilise and promote the use of relevant technologies.

3. Put in place a culture that supports digital adoption: Sonia Patel, the National Chief Information Officer, has argued that “‘good digital teams’ are identifiable by three main characteristics: user centred design, agile ways of working and a knowledge of how to build and operate modern technology and data services.” Boards need to be thinking about how they develop a culture that supports and promotes the use of digital solutions across roles and grades.

Finally, it has also been highlighted that there is often a digital deficit at board level. While digital transformation is a whole-board responsibility, there may be benefit in NHS organisations recruiting specific board-level expertise in this area. This is something we are increasingly seeing being considered and introduced to the organisations we are working with.

Illuminations

• The NHS does not have a glittering track record when it comes to digital transformation but since the onset of COVID-19 digital adoption has accelerated dramatically.
• To capitalise on this momentum, the recently published NHS Planning Guidance outlines a number of digital priorities for the year ahead.
• Boards will have a crucial role in the success of these interventions and will need to both reflect on the lessons from previous initiatives as well as think strategically in order to effectively implement them.

If you have any questions or comments about this briefing, please call us on 07732 681120 or email advice@good-governance.org.uk.

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