24 Oct 2022

  • Public Services

Challenges around transformation in Healthcare

I recently attended the Healthcare Excellence Through Technology (HETT) conference at ExCeL in London and enjoyed attending the numerous talks and chatting with exhibitors.

  • James Chudley

    Experience Director

    James Chudley

It was fascinating to hear more from leading healthcare professionals about themes that have emerged from much of our work in the healthcare sector, such as challenges around interoperability, digital maturity, skills shortages and making digital transformation happen within the sector.

A panel of leading healthcare professionals sat around a table in front of a pink background.

The challenge of making innovation happen in the NHS

Matt Whitty, Director at NHS England and NHS Improvement, gave examples where innovative approaches had been taken to solve problems within the NHS. A stand-out example was the use of drones to deliver Chemotherapy medicine between sites, significantly reducing transportation times.

There is a clear need to get innovations to patients faster.

One approach to help make this happen comes from focussing on priority areas as defined within the Core20PLUS5 strategy. This is an approach to reduce health inequalities within the most deprived 20% of the population who are members of specific minority groups.  It focuses on improving 5 key clinical areas; Maternity, Severe Mental Illness, Chronic Respiratory Disease, Early Cancer diagnosis and Hypertension.

The NHS had also invested in making it easier for external innovators to bring their ideas into the NHS. It’s a process that currently takes too long, up to 10 years for some suppliers.

To help address this, the AHSN Network supports innovators by helping to match their innovations with the parts of the NHS that are most likely to benefit from them. Their role is to accelerate the spread of promising and impactful innovations in the NHS. This helps to shortcut the process, and they help to refine and improve the innovators’ ideas, acting a bit like a medical version of Dragon’s Den.

The challenge of building effective teams to make transformation happen

The question of how to build effective teams to do digital health transformation was explored in a session with James Freed, Anne Marie Cunningham, Joanna Fox and John O’Connell.The panel explored the question ‘What is a digital team?’ and explained the importance of adopting a ‘digital mindset’ where teams focussed on small, incremental delivery of work based on learnings from user research. They emphasised the  importance of teams having flat non-hierarchical structures,along with teams being self-organising to allow them to make decisions quickly.

A useful tip came from a discussion about helping a new team to settle and navigate the usual forming, storming and norming cycles.

By simply asking your new team members ‘what can you do?’ you help build the boundaries of what people can and can’t do and get a quick understanding of skills gaps within your team.

One key skill was the ability to hack bureaucracy. You need people who can navigate the bureaucracy of the organisation to help to make change happen.

Transformation skills are in short supply, and the panel highlighted that everyone was short of staff and finding recruitment challenging. One solution to this was to be brave when tackling skills gaps, to deliberately map out career development pathways for internal staff to bring them on and to develop from within.

The panel discussed the interesting trend of clinical staff moving into digital jobs due to clinicians realising that the way to make changes is to move into digital roles. This reminded me of the UX Healthcare workshop we ran earlier this year which explored the question of ‘How might we help clinicians to think like service designers?’ – perhaps one approach to address skills shortages in this area?

Building effective teams is clearly challenging. One resource the panel recommended as ‘the bible’ was Digital Transformation at Scale: Why the Strategy Is Delivery which they often turned to for both advice and guidance.

The challenge of driving the adoption of change

Finding people with the right skills to do transformation work is one issue, but a more significant challenge I heard about was how to get people to adopt and embrace change within the system. It’s a critical point that can get lost in the heads of people doing the transformation work. What would be the point in redesigning things to make them better if you can’t make them land?

Clear communication and change management is of critical importance to help with this. This issue was highlighted in a panel who discussed mental health pathways across Integrated Care Systems.

Bringing in change within a mental health setting is particularly high risk; this presents huge difficulties around the adoption of change and new technologies. The panel shared how they had managed to make change happen by sharing success stories from different parts of the system. They talked about how they had seen actors being used to enable clinicians to practice using new tools and having new conversations that represented different ways of doing things. This low risk environment allowed them to practice without the risk of harm. A fascinating example  of service prototyping in action!

The final learning from this thought provoking day was that what is transformative to one person, is an everyday thing to another.It’s easy to assume that transformation is all about cutting-edge innovation, but in some parts of the healthcare system, such as mental health services, having seemingly simple things like good wifi to enable video conferencing can be transformative.

A quote from one of the panellists summed it up nicely for me:

‘Transformation should be based on patient needs that results in things that work for everyone. We need to be realistic and not let perfection be the enemy of good.’

So what can we learn from this?

I’ve found doing transformation-based service design work in the healthcare sector to be incredibly rewarding but also incredibly challenging for many of the reasons that were discussed during the day.

It’s a hugely complex domain filled with wicked problems. Much of what seems to make it work are superheroes within the system who perform miracles on a daily basis that help to keep services running.

The widespread adoption of service design and user centred methods is hugely encouraging. It has helped to identify the right problems to be working on as well as the right solutions to solve them.

There are so many examples of best practice within the system that become invisible due to organisational silos. Many people have the same problems yet are unable to find one another to share potential solutions.

The adoption of digital solutions is often the focus of transformation initiatives, but digital skills shortages, lack of digital maturity, and digital poverty feel like massive barriers to transformation success for both patients and staff.

We need to be careful not to focus solely on digital as always being the answer. So many potential solutions to problems we’ve seen have concentrated on better policy, better processes, and better communication – all of which may have nothing to do with digital or technology at all.

What is heartening is the impact that service design practices are having on ways of working that are really helping to identify, communicate and prioritise problems within the system and test potential solutions to them.

Learn more about Challenges around transformation in Healthcare

Reach out to James Chudley

Experience Director

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