3 Lessons from the Frontline of NHS Digitalisation.

To make progress towards the NHS Long Term Plan and public cloud first principle, NHS Digital has partnered with Nordcloud and IBM to help define and execute the NHS’ road to cloud. 

As we enter a new phase, it’s time to reflect on our experiences so far – and what lessons NHS Digital stakeholders and trusts can use to drive digitalisation effectively and sustainably.

 

Lesson 1: Don’t spend too long on strategy – benchmark a quarter

This lesson is about avoiding analysis paralysis and driving fast results. 

With NHS Digital, we set a target of formulating a strategy and being ready to start Stage 1 execution within 3 months. We achieved this by defining exactly what was needed to start focused, iterative execution. 

What didn’t we do? Define a detailed, multi-year plan that would end up needing to change anyway.

To define the strategy, we conducted framework-driven assessment of 3 areas:

  • Capability readiness – to inform change management, capability development  and upskilling requirements
  • Workloads and applications – to understand the complex IT estate and outline the remaining cloud migration journey
  • Business case – to understand return on investment (ROI) and total cost of ownership (TCO) improvements

The resulting strategy then contained key elements to focus the cloud journey around measurable, achievable outcomes:

  • Cloud vision – to define what NHS Digital wanted to achieve with cloud
  • Cloud mission – linking that vision to overall NHS objectives
  • Themes for change – highlighting key areas where public cloud can deliver benefits aligned with the NHS Long Term Plan
  • High-level goals – for what a successful NHS Digital cloud journey looks like in practice
  • Outcomes – quantifying those goals in terms of savings and sustainability
  • High-level 5-year roadmap – with the focus areas for each year
  • Cost and effort – what’s required to make those outcomes a reality
  • Achievements for the last fiscal year – what success looks like for the first year after the period impacted by pandemic 

Everyone aligned around this strategic framework, so we could hit the ground running in working towards those first-year achievements.

 

Lesson 2: Think about incremental innovation and waves of cloud transformation

Complex transformation and digitalisation projects don’t work well in large public sector organisations. They may look nice on paper, but they tend to end up in media headlines decrying wasted taxpayer money and demoralised staff.

Our approach with NHS Digital is about defining the big goals – but translating them into small, achievable and accountable steps. For example, a modernisation is split into 15 projects instead of one big one. 

This means there’s a big focus on incremental delivery. With NHS Digital, we all embraced agile ways of working, with short stand-ups 3 times per week. This meant we could quickly identify and solve challenges so as to deliver faster results.

These experiences show that an incremental approach enables you to:

  • Start innovating immediately – after all, pandemics don’t wait for you to have your perfect technical foundation and delivery model for fast service delivery
  • Enable elasticity and scaling – because unpredictable demands and peak volumes require elasticity and right-sizing capabilities
  • Build a community around digitalisation and cloud – so you drive engagement with transformation
  • Do more with less – because we all know about NHS budget pressures

A prime example is the work we’ve done around the NHS Directory of Services (DOS), a database that underpins a range of patient-facing services like 111. Pandemic pressures demonstrated that DOS needed innovation to support spikes in use and new requirements. Now, we’re executing a progressive cloud migration and modernisation so DOS can better support changing demand and underpin a more effective citizen experience. The project delivers rapid savings and benefits – while minimising risk to an essential service.

 

Lesson 3: Focus on scaling pockets of excellence 

Covid-19 proved that the NHS can be exceptionally agile in deploying new services and capabilities. What would have previously taken 6 months had to be done in 6 weeks. In days, platforms had to handle 10 times the volume. 

The right digitalisation approach harnesses these capabilities and expands them outwards – using cloud technologies and operating models to make them comfortably business-as-usual instead of all-hands-to-the-pump crisis operations.

We therefore framed the NHS Digital cloud strategy and delivery model around 3 themes:

  • Repeatability
  • Reusability
  • Scalability

It’s all about driving digitalisation through pockets of excellence that we can progressively expand within the NHS ecosystem, repeating proven processes and reusing tried-and-tested models instead of reinventing the wheel each time.

 

What should be next on your digitalisation agenda?

Let’s discuss how you can balance quick wins and sustainable value in the digitalisation projects you’re part of.

Contact Giacomo Corsini, Nordcloud’s NHS Engagement Director.

 

NHS organisations: Want to learn what support NHS Digital offers? Learn about the Cloud Centre of Excellence and contact them for more information.