NHS England and Improvement (NHSEI) should set up a Transformation Factory and teams consisting of leaders from digital, data, clinical, management and operational functions, according to the newly published Wade-Gery Review.
It recommends the moves along with the shake-up of the structure of organisations, announced earlier this week, that will involve NHSX and NHS Digital moving to within a new Transformation Directorate in NHSEI.
Laura Wade-Gery, chair NHS Digital and non-executive director of NHSEI, has carried out the review – Putting data, digital and tech at the heart of transforming the NHS – for the Department of Health and Social Care (DHSC) to establish an approach to transforming the sector and supporting integrated care systems. It says that data, digital and technology should be at the heart of transforming health services.
This includes a need for NHSEI to “transform the way it transforms”, which leads to the case for a Transformation Factory to have oversight of the teams drawn from the various functions of the health service.
This would be aimed at maintaining a focus on rapid deployments in improvements in outcomes rather than large scale traditional programmes. The document cites examples of initiatives such as advances in digital triage and at-home remote monitoring of frail and elderly people.
It says that building the Transformation Factory will need investment in skills and capabilities and the NHSEI will have to create a rewarding environment to make it happen. It would also involve the use of common components and tools, the creation of a coherent data architecture and infrastructure, and the design of core infrastructure standards to scale solutions across the NHS.
The function would sit inside the new directorate and be accompanied by the creation of a new role of chief data and information officers for the NHS.
Need for clarity
The review explains the need for the reorganisation as deriving from a lack of clarity due to the current separation of digital strategy under NHSX and technology architecture under NHS Digital. It says this also creates friction in the sharing of data.
This leads to the recommendation for a more joined up centre to drive transformation, with the new operating model announced earlier this week, along with making digital integral to transforming care. Under this, NHSEI should provide leadership for trusts and other healthcare organisations in their own transformations.
Other recommendations include building patient trust in the use of data, recruiting leaders for integrated teams, carrying out a skills audit and capability mapping of existing teams, developing more agile and flexible workplaces, and assessing the level of technical debt across the NHS.
The latter point should lead to an update of the estimates on the technology spend required and a case for increased funding.
There is also a call to mitigate digital inequality by expanding the role of the senior responsible owner for the issue, and developing national frameworks, guidance and best practice in implementing solutions to reduce inequalities.
Enablers crucial
In the concluding remarks says Wade-Gery says: “It will be tempting to focus on the organisational consequences. However, implementation will fail unless the accompanying enablers for change are followed through.
“As such, the change management effort is significant and will require full time resource and the determined sponsorship and commitment of the new CEO of NHSEI and the CEO of NHS Digital and their wider executive team and boards.
“Engagement to date has revealed strong support for the proposed changes.”
Image from iStock, ipopba
