The digital transformation of the NHS promises multiple benefits. For patients, it means better personalisation of, and remote access to, services, as well as greatly reduced waiting times and better self-care. For staff – and the healthcare system more broadly – it stands to reduce burnout while simultaneously increasing workforce productivity, as well as lowering operating costs and improving data sharing and analysis.
But while transformation has, in some areas, been fast, it has been patchy. Compared with other industries in Britain, which have been quick to integrate new digital tools into operations, public healthcare is lagging in its digitisation journey.
Many factors have contributed to this: legacy IT systems, the vast and complex array of stakeholders within the NHS, inadequate digital skills and decision gaps, funding constraints, lack of ownership, and a lack of authoritative decision-making.
On top of that, suppliers have faced several problems. Key among them are a lack of knowledge of the many different NHS organisations and how they work and overlap, and lack of deployment expertise.
The upshot is frustrated NHS staff and frustrated patients, wasted resources, and inequality in access to digital healthcare, with parts of the UK population given more efficient services than others.
Mapping the landscape
Too often, the same mistakes are made in integrating digital services into the NHS. At the same time, patients and staff aren’t fully informed of the benefits of digitisation, which means they may be less invested in the process. Without that buy-in, successful integration is harder.
“We’ve got to take people on the journey; we’ve got to help them understand what transformation means for them,” says Kay Kadel, owner and founder of KCL Digital, which specialises in guiding organisations through the digital transformation process.
KCL Digital has been delivering healthcare transformation services for more than two decades, and now runs a consultancy of healthcare delivery specialists that have already achieved measurable success in transformation with several NHS Trusts across the UK.
Kadel says that a key part of the process is understanding the gaps.
“It’s really important to understand what technical maturity is already in existence for end-users and beneficiaries of digitisation, as well as what’s missing,” she says. “This is key to mapping out a holistic view of where trusts are on their journey, including local infrastructure, local dependencies and the local appetite for change.”
Doing so, she adds, helps an NHS organisation to consider economies of scale and the success criteria before embarking on a transformation journey.
KCL Digital undertakes business analysis and service user research prior to designing a transformation journey. Norfolk and Waveney’s Integrated Care Boards (ICBs), for instance, already made effective use of technology and digital tools, but the Covid pandemic brought exponential digital growth that transformed the Trust’s digital agenda.
Among other areas, it wanted to improve IT capability in primary care networks, in part by enhancing digital support for care pathways across primary and community care, mental health and social care, and with care homes.
KCL Digital’s first step was to provide Norfolk and Waveney ICBs with two senior consultants who together held deep experience in strategy development, culture change and stakeholder engagement.
They could listen to, and analyse, the arc of previous journeys undertaken by the ICBs, and feed this back to KCL to inform the creation of the client’s strategy, as well as the setting of achievable goals – all via close collaboration with the client, and all in line with local, regional and national healthcare agendas.
Weeks of desktop research, engagement with stakeholders at all levels, the planning and management of engagement, collaboration with key contributors and senior digital leaders – these aspects of the process enabled KCL to deliver a forward-thinking digital primary care strategy that was co-created, and fully owned, by Norfolk and Waveney ICB staff.
Digital transformation can’t be an add-on, says Kadel: “We’ve got to embed, we’ve got to make it the norm.”
But fear is often an impediment to real transformation, and the work of KCL Digital is therefore closely concerned with finding ways to address and remove the fear of change. A key part of KCL’s strategy centres on clear communication of a simple message: that change should be incremental.
“We can do that by bringing in steps of change, [and] quick wins,” says Kadel. “That could be anything from improving their connectivity so they can access records from anywhere [to] automating part of a pathway that hasn’t been automated before.
“Helping to not add additional burdens, especially on those clinical facing teams, while taking them on the journey, is going to be a challenge, but it’s massively important.”
Navigating complex webs
So much of digital transformation rests on gaining the trust of those affected, and ensuring they understand the benefits it will bring.
Prioritising proper planning and readiness assessments, as well as collaborating to ensure that whichever healthcare provider in question feels they own the process, are all key to securing that trust.
But there’s a final message that KCL Digital always seeks to communicate: that digital transformation eventually pays for itself – not just in terms of the financial cost/benefit, but also the quality of healthcare for patients and the easing of the burden on healthcare staff that such a transformation delivers.