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National Programme for IT
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June Parry explores how taking the wider view on NHS modernisation places the correct emphasis on this national IT initiative from a service perspective. As someone who has been a NHS clinician, IT Director and change management consultant, she strives for a balanced view of the issues.
The National Programme for IT (NPfIT) continues to be both complex and controversial. This £6 billion investment to bring NHS information systems into the 21st century is the world's largest project of its kind. There can be very few within the NHS, if any, who would not support full exploitation of developing technology. Who amongst us would not acknowledge that technology can give us the tools to improve healthcare delivery and improve the way we work. Yet, in spite of this, why is there an apparent reluctance to embrace technology in ways that that will change the way we work, the way we deliver healthcare and the way we interact with patients?
Digital Expectations
Health care is becoming more and more complex, with extensive integrated activities supporting service delivery. In developing improved services, clinical research focuses on new approaches to diagnosis and treatment. The digital age is here to stay and citizens increasingly use IT and expect IT to support their needs. Their healthcare is no different to their other digital expectations.
The strategic vision presented within NPfIT faces the challenge of a wide range of legacy systems and an inherent lack of standardisation across all elements of information management and IT within the NHS.
Whilst focussing on technological innovation and operational processes, it is now more important than ever that the implementation and practical application of NPfIT is seen as an integral part of a greater programme of change involving people, process, technology and other local initiatives, delivering a profound change to the whole healthcare delivery system, a service transformation, so as to provide more choice, more personalised care and real empowerment of people to improve their health.
In this way technology investment can be assessed and evaluated as one part of NHS service transformation, alongside workforce modernisation, process improvement and new models of service delivery. This necessitates a greater synergy between existing silo'd NHS initiatives and incorporating other care partners, including the independent sector.
In the past, the NHS has received significant criticism for pursuing IT implementation in isolation. NPfIT began to address this by presenting a strategic vision aligned with NHS business strategy and objectives, although still within the relative boundaries of an 'IT project'.
IT to Enable Change in the NHS
But IT is only an enabler, part of the 'toolkit' for change to occur. If change doesn't happen then applying technology just reinforces the old ways of working. To translate the deliverables of NPfIT into benefits it is essential that we develop an effective and relevant service framework to operate in.
I believe that previous benefits frameworks have focussed too much on justifying cost and not enough on enabling change. Perhaps this is the reason why our clinical colleagues seem reluctant to embrace IT solutions. The endoscopes, the CAT scanner, autoclaves, dialysis machines are all examples of technology embraced enthusiastically by NHS staff. Why? Because each supports and enables change, clinical users are very aware of the benefits to their day-to-day practice and service delivery.
NPfIT to date has been presented to clinicians with few "what's in it for me" messages; more "just take it and be thankful". Existing benefits frameworks have failed to identify and support broad transformational change. Each NHS initiative has been introduced very much in isolation, i.e. Ten High Impact Changes, Agenda for Change, Access and Choice, NPfIT. As a consequence, such initiatives have been viewed and implemented separately rather than an integrated 'package' of enablers for change.
NPfIT presents a significant financial investment and level of complexity that can cause us to lose focus on the transformation we are seeking, and the time it will take to achieve. Getting this wrong will only result in implementation fatigue and disengagement.
Can We Fully Envision the Benefits?
Benefits rarely turn out in the way they were first envisaged as they are based on what we think will happen, based on what we think we know. Think back to your very first mobile telephone, you wanted to make and receive telephone calls, conveniently and 'on the move'.
Could any of us have possibly identified text, e-mail, internet access, photography, television, etc. as benefits at that time? However, over the last fifteen years or so we have embraced the mobile phone for a very specific purpose, and exploited its use to support changes, over time, with regard to the way we function or work.
Developing improved understanding and ownership of agreed and broad transformational change is infinitely more powerful in securing the results we seek. There are benefits to be realised from NPfIT solutions but only if the focus is on changing the way we think and work and recognising that this is but one part of the change process. NPfIT is only one part of the routemap, not the destination for the NHS.
If you have any questions about the subjects covered in this white paper or you would like to find out more about how Oakleigh Consulting could help your organisation, please contact us on 0161 835 4100 or email us.
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