In order to transform digital delivery in healthcare and achieve better patient outcomes, we need to learn the lessons from the COVID-19 response and the ongoing digital transformation occurring within trusts.
This requires us to keep users at the heart of the services we build and to utilise the full potential of the cloud, as well as developing the digital skills and capabilities that are needed at Trust level.
What does success look like?
During our talk at the Digital Leaders summit, Andy Callow and I discussed three key enablers for achieving ‘better patient outcomes’ within Trusts:
User-first: Employing a user-first approach means being driven by patient needs and measuring success through clinical outcomes. We worked with Andy and his team to rapidly develop the NHS Book a virtual visit service precisely because there was a clear patient need and have facilitated over 1,000 calls with an average call duration of over an hour so it is measurably having a positive impact on the lives of Kettering General Hospital’s patients.
Interoperable: Without interoperability between systems you will struggle to pick the right tool for the job and to have the right data at the right time. When systems refuse to talk with other systems outside of a particular vendor’s own ecosystem, Trusts’ hands are effectively tied when it comes to picking products or building their own services to deliver better patient outcomes. This vendor lock-in is stifling for innovation and is one of the drivers for NHS staff members having to remember up to 15 logins to do their job.
Collaboration: To digitally innovate, Trusts need to develop new capabilities and the best way to achieve this is by collaborating and sharing ideas with other Trusts, suppliers and organisations undergoing similar transformations. I personally feel that open source software presents a massive opportunity as a collaboration mechanism between Trusts. The open source NHS Design System enabled us to rapidly prototype the book a virtual visit service in just 48 hours and have it tested on wards within a week.
How to achieve better patient outcomes
During our talk, we discussed a number of ways Trusts can iteratively and incrementally work towards better patient outcomes. This certainly isn’t an overnight process and, in my opinion, it’s not even a process with an end. It’s a continuous improvement process. You have to start somewhere though and we shared a few ideas on how and where you might start.
Build a pipeline of candidate services: Developing a roadmap that includes all your candidate digital improvements and services which focus on better patient outcomes is a great way to keep track, prioritise and communicate what you have in the pipeline.
Secure proper funding: You should aim to secure specific funding for your digital programme, so you can ring fence delivery teams to work on it. This will allow you to ensure your funding is directed towards continuous improvement of software. You should also try to help your entire Trust become more comfortable with the transition from capital to revenue, as you move towards subscription services in the cloud.
Build momentum through early success: However small your early successes might be, they can really help you to build momentum. Invest in your teams, expose them to new ways of working and make sure the organisation knows about it. A tool for helping the discharge process was one early success at Kettering General Hospital.
Work in the open: Keeping your successes to yourself wastes time for you and others looking to learn from it. Also, with more remote work taking place, documenting your work helps others and helps you to ensure your explanation of the detail is as clear as possible.
Commission open source alternatives: Ideally, if individual Trusts can develop small amounts of technology themselves, these can be shared with others for everyone’s benefit. This will ensure patients aren’t paying for services twice and drive down costs over the long term. It also means more digital services can be built transparently, in the open and to the NHS Service Standard.
Require suppliers to develop skills: Suppliers should not just be building services for Trusts, they should also be helping them to develop skills. While delivering the NHS Book a virtual visit service for Kettering General Hospital, I’m proud that we were able to work with their developers and eventually handed the service over to them.
Accelerating a Trust’s digital journey
Crucially, this is a path that any NHS Trust can plot should they choose to do so. Andy freely admits that, not long ago, Kettering General Hospital was a digital lagard.
However, by implementing a user-first, interoperability and collaboration strategy, it is demonstrating how the NHS as a whole can be radically transformed and achieve better patient outcomes.
