Simon Bolton, Interim Chief Executive of NHS Digital (pictured above speaking at the PPP annual conference), outlines how the organisation is building on its Covid response to help foster innovation across the NHS.

The pandemic permanently changed the way in which care is delivered. The changes NHS Digital made in response to Covid-19 have now become essential and embedded. Collaboration using digital tools, such as consultations using new channels, and new data collections to inform critical forecasting and planning, and ensure the NHS wasn’t overwhelmed, are just a few examples among many.

While these are the most visible steps, they might not be the most significant to the long-term future of digitally enabled transformation. We also had to change the way we think about building technology for the NHS and the people it serves, and the way we work with our colleagues in other organisations throughout the health and care system.

The pandemic forced the system together. Newfound collaboration was seen between NHS England and NHS Improvement, NHSX, NHS Test and Trace, and the Department of Health and Social Care. This clearly demonstrated the value of working across teams and collaborating closely with both the centre and the front line.  

We left our badges at the door and delivered the vaccine roll-out, the Shielded Patient List risk stratification to identify and protect the most vulnerable, and new Covid data dashboards, to name but a few. We can’t afford to slip back now.

Listening to and understanding the needs of our customers is the foundation of delivering the right things, and although we had to move at pace over the last 18 months, I’m proud to say we never lost sight of that.

Now we must apply those lessons to supporting and driving forward the NHS priorities for transformation. We’ll continue to be guided by the impact of what we deliver, the outcomes that make a difference, and the clinical priorities. This means embedding a permanent change in the relationship between NHS Digital and the organisations around us.

“Listening to and understanding the needs of our customers is the foundation of delivering the right things”

Building the right architecture

We can only build the right architecture for the solution by having a dialogue with all its users and coming to an agreement about where we as a central organisation can provide value.

As a collective of organisations at the centre of the NHS, we need to be clear to the people delivering care and at the point of care about what we do, how we work together, and how we can serve and support them as part of the same team, to achieve the same outcomes. Working closely with integrated care systems (ICSs) and providers will ensure we are designing the right solutions and getting the right technology and data architecture in place to support the NHS.

Innovation can happen in a much richer way if we can get closer to the problem and closer to the real needs of the customer, collaborating and co-creating with them. For example, the power of data is unarguable; it is a fundamental foundation on which managing and transforming the NHS is built. But we must ask, when is it critical or valuable to have data in the centre, and when should it be held by ICSs or trusts locally to meet their needs? And if it delivers real benefits by being held centrally, then what data do we need from our provider partners, and how can we collect it in a way that minimises the burden?

We can only build the right architecture for the solution by having a dialogue with all its users and coming to an agreement about where we, as a central organisation, can provide value. NHS Digital can support providers to do a better job by providing direction, setting the standards, and identifying and spreading innovation.

This principle of becoming customer-centric also needs to apply to the way we build and run the things we create together. Products need to evolve and improve continuously to deliver outcomes for the system more efficiently and effectively and to offer an ever-better experience for their users.

During the pandemic, many of our services have evolved at pace. For example, by scaling up massively to meet demand, NHS login has been able to go from one million users to 25 million in a year. Others have successfully faced unprecedented new pressures or a steady stream of new ‘asks’ for new features and capabilities, like facilitating access to the NHS COVID pass in the NHS app. But there is still a huge opportunity to improve the citizen experience where it makes the most impact.

“Innovation can happen in a much richer way if we can get closer to the problem and closer to the real needs of the customer, collaborating and co-creating with them”

Striving for impact

In the past, transformation programmes have focused on deliverables and timelines. During the pandemic, the timeline has always been ‘as soon as possible’ and the deliverable ‘by any means necessary’.

By switching the spotlight onto outcomes and impact instead, we are forced to think more about why we are building these tools. What difference are they going to make to frontline staff under pressure or vulnerable patients? Why are we developing this service rather than another with our limited resources? What’s the right thing to do?

Our portfolio of improvement and transformation projects needs to directly reflect the priorities of NHS England and the broader system as we look beyond the pandemic – for example addressing the crisis in urgent and emergency care, supporting elective recovery and removing inequalities in health outcomes. We must dedicate our time as digital technologists to the things that matter for the whole system and make a critical difference to the people that rely on it.

If there’s one thing above all that we learned in the pandemic it is that together we must be bold and ambitious. Our aim has to be to change the world, to dramatically improve the NHS for its staff and the people it serves at the time they are most in need. Working closely alongside our colleagues and partners as one team, we will shape and deliver the digitally enabled transformation of the NHS, where data and technology supports its people in a service fit for the future.