How to effectively embed digital in your trust

A guide to support board members in embedding digital ways of working and lead digital transformation within their organisations

CREDIT: This is an edited version of an article that originally appeared on NHS Providers

Three years ago, the Digital Boards programme was launched. 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.

Over 2,000 leaders from more than 200 trusts have participated in this programme, providing a unique insight into the state of board digital leadership in the NHS.

Here are 10 key lessons that were identified:

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.

There is (still) a need to build confidence and capability in digital among board leaders

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 there’s been a focus on building that confidence and capability for everyone.

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.

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. 

Trusts need to get closer to the digital user experience by adopting a user focussed approach to service design.

Badly designed services exclude people

Boards leaders are, rightly, worried about digital inclusion. During Covid-19, 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.

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.

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.

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. 

Fixing the basics is 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.

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.