A guide to embedding digital in organisations has been developed and shared by NHS Providers and Public Digital as part of the Digital Boards programme, which aims to build board understanding of the potential and implications of the digital agenda, ultimately increasing confidence and capability to harness opportunities.
The guide covers six main areas for boards to focus on: digital leadership and understanding of the board; building and enabling digital teams; creating an effective digital strategy; making technology decisions; digital delivery; and optimising your EPR. It highlights important information with regards to each section along with sharing a list of common pitfalls and questions for boards to ask themselves.
Digital leadership and understanding the role of the board
A number of key points are made in this section. Firstly, the guide points out, digital is much more than IT; it also means applying the culture, processes, business models and technologies of the internet era in response to raised expectations. As such, digital transformation relies on all leaders, not just IT and digital leaders, and trusts should demonstrate collective responsibility for digital transformation at board level.
All board members need to be confident talking about digital and curious about implications, it adds, though technical expertise in specialist areas is not required.
“Successful organisations really understand their users’ needs,” the guide states, noting that digital transformation is ultimately rooted in deep understanding of needs, behaviours and experience of service users.
It notes that digital innovation is not invention, with collaboration and building on others’ success encouraged, and acknowledges that empowered, multidisciplinary teams are vital.
Building and enabling digital teams
Picking up on the above point, the guidance emphasises that “digital teams are the cornerstone of building a truly digital organisation”, and emphasises the importance of multidisciplinary teams in bringing together operational, clinical and digital staff.
To be effective, it says, digital teams must “work together in a stable and sustained way”, which “means each member of the team having sufficient capacity to really engage in the work and for teams to be funded long-term – not just as project teams that end at go-live.”
Digital teams require a different kind of governance and leadership, the guidance states; digital should be given the same attention as finance or quality, and should focus on outcomes rather than deliverables.
“Digital teams need a mandate and the space to work differently,” it adds, “particularly when they’re just starting out. It is the board’s role to create these conditions so that teams can deliver.”
Creating an effective digital strategy
All board members should take responsibility for the digital strategy, the guidance states.
It highlights the importance of the strategy integrating with the rest of the organisation; in addition it should be user-centred, realistic, focused and selective, and should be “mainstream – something that people can digest, remember and understand how to contribute to.”
Making technology decisions
The guide acknowledges: “We know from our work that trust leaders find themselves ill-equipped to make the right technology decisions that will enable their organisations and systems to collaborate and innovate.”
It recommends that boards start by asking what the trust is looking to achieve before considering technology solutions. “You need a clear vision that flows from your overall strategy,” it says. “Start these conversations early, before the business case stage is reached.”
In addition, boards should focus on data – what is it, how will it be used and shared, how can it be kept safe? On that note, the guide also warns to take the threat of cybersecurity seriously. “No technology has a monopoly on security, it’s down to how it is set up, the controls around it and – ultimately – how it is used by staff and patients,” it states. “Doing nothing carries its own risk, for example not investing in new technology, relying on outdated legacy systems.”
Finally, the guide encourages boards to ensure that honest conversations about risk, failure and realistic mitigations are had early and often. To avoid sunk cost fallacy or projects that “become too big to fail”, it recommends implementing smaller technology projects at an incremental pace. “Start small where possible, solving real problems, and test and learn before committing. Make sure your commercial teams are well briefed and understand the sorts of things you want to guard against in any longer-term contracts, and the consequences of not having that flexibility.”
Digital delivery
Here, the guide makes a number of further recommendations for boards with regards to delivering digital transformation throughout their organisation.
Be proactive, it says, and plan for the long-term with sustained resourcing. Building in regular prioritisation exercises is also key, with the guide emphasising the need for a culture and operational model and governance processes that allow you to stop when something no longer adds value.
Having a clear strategy is also a key part of this, along with developing an organisation set on delivering iterative improvements.
“The only digital service of value is one that is being used by staff and patients,” the guide says. “Delivering and demonstrating progress on a weekly basis is a good habit to build and will not only speed-up the realisation of benefits, but also reduce risks by helping to spot problems early on.”
Finally, it notes that boards should become expert customers: “Working with suppliers effectively requires your technical, clinical and commercial experts to work together, with a clear idea of the outcomes you want to achieve and the ability to build trusted, honest relationships.”
Access the guide in full here.
