Published on September 29th, 2021 📆 | 3299 Views ⚑
0Accelerating health information technology capabilities across England’s National Health Service
Digital transformation, such as implementing and optimising electronic health records and electronic prescribing, has been achieved through organisation-wide engagement and alignment of efforts around a future-oriented vision, while still allowing space for more organic development supported by nationally orchestrated knowledge sharing initiatives. However, there is a paucity of clarity about how these success factors (those associated with successful digitally enabled transformation in the GDE programme) are incorporated into the national digitisation strategy going forward.
- Sheikh A
- Cornford T
- Barber N
- et al.
,
Review of the final benefits statement for programmes previously managed under the National Programme for IT in the NHS.
In the aftermath of the National Programme for IT, hospitals were left to their own devices to procure and implement systems, with little central guidance or funding.
Making IT work: harnessing the power of health information technology to improve care in England. Report of the National Advisory Group on Health Information Technology in England.
of NHS England's health information technology strategy led by Professor Robert Wachter sought to learn lessons from the disappointing outcomes of the National Programme for IT and the US$38 billion Health Information Technology for Economic and Clinical Health Act programme in the USA.
- Sheikh A
- Jha A
- Cresswell K
- Greaves F
- Bates DW
Given that the investment required to digitally transform all NHS hospitals greatly exceeded available resources, the Wachter review proposed a phased approach, starting with the most digitally advanced hospitals, coupled with a national programme to build digitisation leadership.
Making IT work: harnessing the power of health information technology to improve care in England. Report of the National Advisory Group on Health Information Technology in England.
The GDE Programme was accordingly designed to create a select cohort of digitally advanced GDE hospitals that would pass on their learnings to a second cohort of less digitally mature, so-called Fast Follower hospitals and catalyse large-scale digitally enabled transformation of the wider English NHS.
The GDE Programme also put into place mechanisms for sharing learning (including GDE–Fast Follower partnerships and the circulation of Blueprints [formal documents designed to capture implementation experience]) that have fostered the informal networking needed to create the foundations for a dynamic learning ecosystem.
- Williams R
- Sheikh A
- Franklin BD
- et al.
Digital transformation in the NHS. Twenty-second report of session 2019–20.
,
- Apathy NC
- Holmgren AJ
- Adler-Milstein J
As the GDE Programme ends, there is now a need to build on the momentum created and carry forward key lessons to promote digital transformation more broadly across the NHS. However, strategy will need to be carefully considered. The transformational impetus resulting from the synergy of three key drivers—dedicated funding, a degree of local control over implementation pathways, and reputational benefits—might be weakened as the focus shifts towards promoting digital transformation in less digitally mature organisations. This consideration is especially relevant if available resources are spread thinly across organisations that might require higher levels of support.
- Krasuska M
- Williams R
- Sheikh A
- et al.
Second, it is not necessary or desirable for followers to replicate the journey, involving many false turns, made by current leaders. Levelling-up strategy needs to now focus on creating opportunities for leapfrogging through local partnerships, sharing learning and capabilities. Although successfully promoting digital transformation in digitally advanced sites, the short timeframe of the GDE Programme encouraged tried and tested solutions. Longer term interventions are required to promote innovation, including organisational, service, social, and product innovation. Otherwise, there is a risk that the growing digital maturity divide between organisations will inhibit both the delivery of integrated digital environments for care pathways and also the establishment of a dynamic learning ecosystem with innovation at its core.
The authors received funding from NHS England for the independent evaluation that this Comment is based on. The views expressed in this Comment are those of the authors and not necessarily those of the NHS, NHSX, NHS England, or NHS Digital. An independent academic advisory group provided clear and supportive guidance during the entire duration of the GDE Programme. The academic advisory group included Anthony Avery (the chair), Gordon Schiff, and Philip Scott. We thank the individuals and provider organisations who took part in this research.
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Published: September 28, 2021
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