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The steps towards end-to-end transformation


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Avoiding ‘rip and replace’, being technology agnostic and building self-sufficiency are among the crucial features in making a success of digital change, writes Gareth Handley, head of product development at NDL Software

It has become common wisdom in the public sector that the digital transformation of its processes needs to run end-to-end, going as far as possible in removing the manual elements for greater efficiency and effectiveness.

But it can be a complex challenge and organisations are asking questions about how to manage the changes successfully and build the momentum for a broader transformation.

This provided the background to a recent UKA Live discussion, bringing together myself and UKAuthority publisher Helen Olsen Bedford with Dan Smith, head of operations at Circle Integrated Care, Liam McLaughlin, CIO of West Suffolk NHS Foundation Trust, and Andy Adam, senior IT officer at Moray Council.

A key point to emerge was that there is no clear rule about the starting place; it depends very much on the priorities of the organisation and details of a process. McLaughlin said that West Suffolk’s development of a mobile app for the sharing of digital images for clinical functions such as opthalmology was initially prompted by the need to improve the recording of patient consent, but that the team quickly began to see further benefits in making it easier to take photos and make them visible on the patient record to support clinicians, then to extend it fields such as dermatoscopy and endoscopy.

It can be a case of starting on something for specific purpose then seeing a broader solution evolve.

Why and how?

This has to be accompanied by a clear understanding of why and how you need to change a specific process. It involves looking at the human process, what causes problems or demands that people spend time on mundane tasks, and what could be gained from digitisation and/or automation?

Circle Integrated Care showed this in its project to improve patient flows in community musculoskeletal pathways by using NDL e-form and robotic process automation technology.

The forms were designed to provide information that could be assessed by a clinically derived algorithm to establish the treatment needed by the patient, where it was available and how this related to waiting times and travel distances. It made it possible to quickly provide a patient and their GP message giving them information on where they could go to.

Crucially, it then included the clinical information from the e-form in a referral pack that could be transferred to the provider through their preferred channel, such as a system-to-system link, the e-Referral Service or email. This reduced the time needed for the process from days to about 10 minutes.

Similarly, Moray Council identified a need to change the way it carried out and processed housing repair jobs. Moving to a digital solution allowed repairs to processed electronically.

Workers were directed to jobs based on bookings, areas and priority rather than manually selecting a paper based job sheet which transformed the efficiency of the repairs service, increasing worker output. It did this using the NDL low code toolkit, connected to the scheduling and other relevant systems, and soon provided significant savings.

It is also important to realise that the ‘rip and replace’ approach is seldom the best, and that when possible it is better to build on the existing platforms with which people are familiar, with a ‘technology agnostic’ approach to transformation. This underlies much of NDL’s work with public authorities, the company providing tools that make it possible to bridge the gaps between systems already in use to build processes.


Equally important is the self-sufficiency factor, enabling in-house teams to develop the skills to build services and make changes when needed. It may not be possible on every occasion – sometimes customers with a strong capability still need to call on our expertise – but it makes it easier to change quickly and provides the scope for digital services to evolve as the organisation identifies further potential.

This is reflected in the use of low code platforms, which make it possible to configure many services without the need for in-depth coding skills, and in turn give an organisation more flexibility to do things for itself. Again, it may not work for every digitisation or system integration project, but we are always working to keep up-to-date with changes in operating systems and various platforms to make it possible to do more in a low code environment.

Another feature is in finding the right balance in the use of application programme interfaces (APIs) for sharing data and robotic process automation (RPA) for specific tasks.

The former has often been held up as the way forward for transformation, but it has proved a complex and often costly approach as vendors of legacy systems often demand a high price for providing an API. In addition, an API might be promised for the future but the organisation has to show some urgency in modernising a process.

This is where RPA can be valuable in copying and transferring data from one application or database to another, making a small transformation possible much more quickly than when waiting for an API. It comes back to looking at a specific approach with an agnostic mind, and there is a view that there will never be 100% availability of APIs, which will leave a significant role for RPAs.

Hearts and minds

In turn, this comes with its own challenges, as in many organisations people have feared that more robots means fewer jobs. The discussion highlighted the need to include a ‘hearts and minds’ element within the design approach to overcome this, showing people that an automation can take away the mundane tasks and free them up for the more satisfying elements of their work. Engaging with people in advance about what could help them is the key element in this.

No-one will claim that any of this is easy, but the discussion brought out the key lessons for end-to-end transformation that can be summed up as follows: decide what you want to do; break it down to manageable tasks; don’t go too big too soon; when one process has been transformed move on to the next; allow the overall ambition to evolve; and continuously challenge your own thinking and look to improve things further.

It involves a lot of individual steps but can take an organisation much further than it originally thought possible.

This year NDL marks 40 years in public sector innovation. Designing technologies for the public good, NDL has helped many public sector organisations on their digital transformation journey. Read some of the success stories here


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