An end to pulling the rope at each end: agile DevOps and digital-savvy leadership are driving the NHS’s approach to healthcare technology


Barry Corless, ITSM & DevOps Global Product Director for Global Knowledge believes collaborative software practices and strong leadership can turn things around for the NHS. Here, he explains why


The NHS has always been at the forefront of cutting-edge medical technology, from the world’s first IVF baby to the first heart, liver and lungs transplant. As the original provider of universal healthcare, free at source since 1948, the institution is rightly a source of national pride for its level of care, but there’s also been a long, less illustrious tradition of frustration with the implementation of new technologies and systems. As digital innovation advances become more integrated into everyday life, there’s an expectation from both patients and doctors that healthcare should be able to exploit this technical progress as well.

Previously, the scale involved in managing and integrating vast amounts of data has created its own problems for the NHS – from bureaucratic snarl-ups like 2013’s costly abandoned patient database project to 2017’s missing documents controversy. And then there’s bad actors/hackers, who cost the NHS £92m in follow-up measures in 2017. Funding and skill shortages, not to mention the increased demands on services from an ageing population, have added additional pressure to the smooth running of the NHS. It’s going to take more than going paperless (although that is an initiative on course to complete in 2020) to help the NHS address the increased administration requirements and escalation in the volume and complexity of patient demands. The whole of the healthcare sector and in particular the NHS must adapt to take advantage of exponential technological change. It’s going to take an across-the-board upgrade – not just of the technology – but also to ensure the people implementing and using that technology have the training and information they need.

Entrenched ways

Healthcare organisations, in common with many large corporations, can suffer from the ‘silo mentality’ – where there is a lack of communication and understanding of the singular capabilities and challenges between departments. Evidence often points to a lack of appreciation of each other’s issues at all levels, so the solution needs to be top down. Government-imposed constraints, knowledge gaps and a failure to recruit expertise from outside the sector have led to good ideas going unimplemented. With a mission to change that, the NHS Digital Academy was born.

According to the Academy’s CEO, Rachel Dunscombe, ‘Technology is the only option for the NHS to make significant gains in productivity and safety. All other avenues will give marginal gains but not the major impact our health and care systems need.’

The NHS Digital Academy is an organisation created to develop a new generation of healthcare digital leaders who can drive the information and technology transformation of the NHS. The NHS Digital Academy, through a partnership with Imperial College London, the University of Edinburgh and Harvard Medical School, provides a year-long fully accredited learning programme (Post Graduate Diploma in Digital Health Leadership) for digital change leaders. Global Knowledge became involved when we were asked to leverage our expertise to produce the module on Programme and Project Management.

Preaching to the non-converted

Dunscombe also recognises the importance in creating buy-in for the new technological processes across the organisation: ‘Leadership is essential in this space as digital is the platform for reimagining how we deliver health and removing geographical constraints and changing the skills mixes we need. This journey needs people who can tell the story of how we will revolutionise the way we work. This will have an impact for almost all the NHS workforce and so strong leaders who can build trust and seek win-win situations are essential to the momentum. Traditionally in healthcare, the gap between technology and delivery has been wide – the best leaders are now bridging this gap – getting everyone pulling on the same end of the rope for positive change.’

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To minimise the chances of making the mistakes of the past – and pulling on different ends of that rope – our healthcare sector needs to move away from unilateral experimental innovations that don’t involve all stakeholders before they become operational. This is not simply a technology ‘fix.’ Any innovation needs to be supported by both board and staff to really embrace the potential of AI, Cloud and digital whilst, crucially, retaining focus on patient outcomes. Healthcare could learn a lot from practices such as DevOps, Agile and ITIL 4 where the co-creation of value through collaboration of all stakeholders is at the heart of what is delivered. That means leveraging the best solution through collaboration between patients, healthcare technology organisations and clinicians. It is encouraging to note that a significant percentage of the NHS Digital Academy cohorts 1 and 2 are from clinical and non-IT backgrounds. The CIO of the future must not be blinded by the dazzle of new technology, but rather apply technology solutions to healthcare in ways that co-create value for all stakeholders.

Be it the surgeon reviewing new techniques through YouTube, cancer research using AI or the patient checking into the surgery on a touchscreen, expectations of new healthcare technology are sky high. If it is to succeed it must overcome the traditional challenges related to legacy systems, beginning with system integration – choosing the right architecture to bring together what is often a patchwork quilt of diverse systems. Stakeholder buy-in can require education and experience of the benefits of any new system – there’s a marked difference between being alerted to the value of technology and actually realising that value. Prudence is needed when deciding where to focus efforts. It is easy to be dazzled by the potential capabilities of exciting new technology like AI or RPA projects at the expense of value in areas like patient outcomes and the sheer volume of data provided by modern tools and medical techniques needs to be recognised, structured and utilised.

Technology can help address increased administration and an escalation in the volume and complexity of patient demands. A focus on adaptability is key, rather than hoping for a ‘miraculous’ technical solution. Every healthcare provider must be led by people who understand and can execute this. The NHS Digital Academy is trying to augment the abilities of those leading change, and hopefully equipping them with the additional skills to help everyone working towards the NHS’s Digital Transformation to make this great leap forward together.

About the author

Journalist and editor Kathryn Reilly has worked in consumer, contract and medical writing for more than 20 years.

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