Rodolphe Malaguti, Product Strategy and Transformation at Conga, tells us about the ambitions of leaders for digital change within the NHS and the diffcult reality of delivering effective change in the healthcare sector.
In his 2024 spring budget, chancellor of the exchequer Jeremy Hunt announced £3.4 billion in additional funding for the NHS to accelerate its Digital Transformation plans with the aim of boosting productivity across the healthcare service.
The plan included updating legacy IT, to ‘lay the groundwork’ for greater use of Artificial Intelligence (AI) and other new technologies, as well as ensuring that all NHS trusts are using electronic patient records (EPR) by March 2026.
However, considering the healthcare sector’s Digital Transformation legacy, reactions have been mixed. Hunt himself, when secretary of state for health in 2013, offered £4.2 billion to deliver a ‘paperless NHS’ by 2018 and five years have passed since the original deadline.
Whilst 90% of trusts in NHS England have now adopted EPR, the majority are still reliant on paper notes or legacy systems. Despite leaders’ ambitions, there has been a real challenge in delivering effective digital change in the healthcare sector.
Why transformation programmes fail
Firstly, it starts with how senior leaders approach Digital Transformation in the first place. Too often, project leaders focus on the technology, rather than establishing clear objectives and what they are trying to achieve. Without taking a step back and reviewing the current situation, that is, how teams are functioning, the current operational model or data cycle, IT teams will not be able to identify areas where technology would be best suited. For example, there could be issues with a certain trust’s data architecture or how data is shared between different practices or ERP systems.
According to a report conducted by the National Audit Office (NAO), the healthcare sector’s reliance on multiple ‘legacy’ systems has led to a lack of interoperability. NAO has highlighted that the various systems for storing data cannot communicate with one another effectively. Any data that is collected is often not readily available. Therefore, implementing or integrating new solutions or automation technologies may further complicate this.
Secondly, there’s been a ‘stop-start’ approach to the healthcare sector’s long-term digital goals. There have been multiple delays to the paperless project, with a second deadline extended to 2020, followed by 2023. It appears that leaders have underestimated the size and complexity of this kind of transformation programme. Given the sheer scale of the NHS itself – which is made up of hundreds of practices and trusts, all of which have their own methods and ways of working – this project is extremely complex.
If leaders continuously pause or stop-start their Digital Transformation programmes, it often leads to more inefficiencies. In this case, if technology is implemented at the wrong time – for example, when data and processes are scattered or systems are not fully integrated – it leads to further operational complexity. Successive project leaders have likely had to back-track, to try to undo the previous team’s work – once they have figured out what it is that they need to undo.
Delivering effective digital change
Naturally, there are temporary setbacks, but approaching Digital Transformation in this way will only make matters worse and complicate existing operational issues. When implementing a new solution or system for a large organisation like the NHS, it needs to be approached in a phased manner.
Ideally, introduced across one department at a time, so project leaders can identify any concerns and ensure all data is accounted for and shared easily between teams.
Also, project leaders forget that Digital Transformation is ultimately about people. Most programmes fail because they are treated as ‘technology change’ projects, rather than ‘people change’ projects. Too often, change is made without consulting the relevant departments or staff who will be affected, despite employees being key stakeholders when it comes to implementing change or identifying further areas of improvement.
For example, project leaders may be unaware of current processes or inefficiencies and healthcare staff can offer valuable insight into how communication or data-sharing could be improved across teams. The relevant stakeholders need to be involved from the offset to help inform and guide the strategy and ensure that all staff understand what they’re trying to achieve.
Future healthcare delivery
Digital Transformation offers many advantages, but that does not mean it is easy to define, plan or execute. Despite senior leaders’ ambitions, there are a number of obstacles that the healthcare sector has to overcome before it can deliver effective digital change. When it comes to tackling issues of the paperless plan, it is important that project leaders take stock of the situation and work towards establishing a more unified system.
To improve operational efficiency, IT teams and project leaders need to establish each healthcare practice’s or trust’s digital maturity – where it stands with regards to its own Digital Transformation journey. By doing so, teams will be able to identify key areas of improvement and deliver its long-term digital plan far more effectively; rolling out new innovations and improving outcomes across one healthcare unit at a time.
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