The Transformation Directorate at NHS England has published “Guidance for designing, delivering and sustaining Robotic Process Automation (RPA) within the NHS”, calling it a “national ‘how to guide’ to support effective and safe adoption of RPA [which] will present good practice on planning, delivering and sustaining RPA solutions and will highlight the key considerations including where RPA cannot be used.”
The guidance is split into seven chapters, the first of which is “Understanding RPA“. In the context of operational and business process improvement, it states that technologies that reduce human intervention “can be clustered into three distinct groups based on actions they enable, and the level of sophistication and degree of complexity of technical solutions used”: Robotic Progress Automation (RPA), Intelligent Automation (IA) and Artificial Intelligence (AI).
Robotic Process Automation (RPA) is “a technology that enables the build, deployment, and management of software (robots) that can be programmed to emulate human actions and interact with digital systems in order to automate basic manual and repetitive tasks.” It can automate high volume, rule-based and repeatable tasks, and can only handle structured, digitised data.
Getting started with RPA
The next chapter sets out the key questions that teams should consider, along with identifying the key roles, skills and technologies required, making relevant recommendations for each category. Questions are split in terms of where in the process they should be asked, for example, design (“What are the key drivers for automation? What are the specific pain points we are trying to address?”, delivery (“Have we engaged stakeholders from clinical and non-clinical teams? Do they have the bandwidth to support the programme?”) and sustaining (“How will ongoing bot monitoring and performance optimisation work? Do we have operational governance and patient safety controls in place?”).
NHS Transformation Directorate go on to list the types of licenses that organisations can purchase for RPA use, providing a brief overview for each.
For those looking to get started with RPA, the guidance identifies multiple entry points, depending on the priorities, tools and resources of the team in question. The guidance provides details on three approaches with pros and cons for each: ICS Supported, RPA Hub Supported and Commercial Partner Supported. It notes that “a hybrid approach encourages flexibility and provides the opportunity to adopt one, or multiple approaches, depending on your organisational needs and local priorities.”
It states an organisation should build a benefits case, the guidance advises, which should include operational benefits such as increased operational capacity and speed along with patient and treatment backlog reduction. Additionally, patient safety outcomes and experience can benefit from improved patient journey and experience, and a better, faster and seamless delivery of care. For staff, suggested benefits could include improved engagement, reduced attrition and less burnout. Finally, implementing RPA could lead to process efficiency benefits such as reduced human error and reduced process variability.
The guidance then provides support on making the transition from RPA programme delivery to RPA service, noting that “the service wrapper needs to carefully consider business as usual requirements and business criticality. Fall back options and service level agreements should be planned by engaging the right business, clinical, frontline and/or support staff to ensure they are in line with how the bot will be used.”
When it comes to running and managing RPA bots, NHS Transformation Directorate provide suggested options: to engage an external partner, to commission from third party within the NHS, or to establish your own. A list of benefits and potential barriers is supplied with each option to help teams come to an informed decision.
The final part of this chapter focuses on procuring RPA. The guidance lists six procurement category pillars and their minimum standards. “Organisations will first need to determine the procurement category pillar the requirements fall under,” the guidance advises, and “any product within these pillars must meet the minimum standards defined”. Click here for full information on the pillars and their standards.
Next, the guidance covers how RPA solutions can be designed and delivered, divided into four stages.
The first stage, demand generation, focuses on identifying opportunities for RPA. Three approaches to identification are highlighted: comprehensive analysis, staff engagement and design thinking workshops.
The second stage, demand triage, is about shortlisting RPA opportunities. The guidance advises that teams develop “an effective triage framework” to ensure that “limited resources and investment can be focused on best value opportunities driving the best ROI for communities, NHS service users and staff.”
Moving on to the third stage, building and development, the guidance states that a lean approach to process development will support the optimisation of processes before they are built and automated. The PRE-ACT model is suggested, which focuses on Purpose (ensuring that the purpose of process is clear with focus on operational efficiency and business value), Reduce (reducing exceptions, variants and workarounds through lean thinking), Eliminate (removing wasteful or unnecessary activity), Automate (using RPA or task application), Combine (combining manual and automated tasks into larger chunks and reducing over-specialism), and Transfer (move tasks to the right people in terms of capacity, skills and cost).
Stage four focuses on releasing, embedding and running managed services. “Just as the human workforce requires facilities, training and line management support,” the guidance notes, “the digital workforce needs platform and oversight in the form of bot managers or controllers.” There needs to be a strategy in place to manage and support the automated solution, and it needs to be agreed during the design process so that it can be implemented in parallel to development.
The guidance goes on to supply examples of processes which have been previously automated, identified by respondents to the NHS National RPA Survey 2020.
Technology for RPA
In this section, the fundamental elements of RPA are outlined such as development tools, robotic control centre and run time.
Technical requirements are highlighted: namely, ease of use, the ability to scale, reliability, fast implementation, and smart working – to “support simple, task-based activities, read and write to any data source, and utilise advanced learning to improve future automations.”
Next, the guidance lays out key attributes that RPA tools must include, from the overarching requirements for the tool as a whole to requirements for compatibility with existing estate, automation process, security, scalability, exception handling, implementation, centralised control and analytics, audit trail, cognitive capabilities, training and support, and pricing.
NHS-specific compliance requirements that need to be considered for any RPA implementation are included, including medical device regulation, clinical risk management, and NHS digital technology assessment criteria.
For more information on the requirements, the guidance can be read here.
Standards and guidelines
Chapter six of the guidance comprises of a checklist of standards and guidelines for teams to ensure that they are compliant with before going live. Clinical safety standards, cyber security, data security, interoperability usability and accessibility, use of RPA as a medical device and ‘screen scraping’ are all covered. Click here to access the checklist in full.
Finally, the guidance concludes with extra information which could be useful to teams planning to design and implement RPA in their work, from global trends in RPA to insights from the national survey to learn from the positive and negative experiences of other NHS teams.
The additional information section can be read here.