Transformation Directorate

The power of alignment - bringing together the worlds of improvement and digital

Thanks to our regional scale programme, supported by our national innovation collaborative, more than 125,000 people are now being supported at home using digital technology. It has also enabled a real focus on partnerships with patients and service users, alongside opportunities for clinical staff to deliver care in a different way. To hear more about this journey, we’ve recorded six great podcasts where both patients and staff share their experiences. As we move forward and look to maximise the benefits this work can bring, I’ve been reflecting on where our greatest opportunities lie.

The COVID-19 pandemic has put digital firmly in the spotlight as an inherent part of how we now deliver care. However, it is also clear that non-face-to-face care isn't ideal for everyone: it is definitely not a one-size-fits-all-model. What it has demonstrated to me is that there is a significant number of people who want to be more actively involved in a technology-enabled self-care model. They want the digital tools to enable them to do this at home, whilst knowing that their clinical teams are keeping an eye on them in the background and will intervene when there’s a clinical need. You can read some of these patient and staff stories in our regional case studies and event recordings on our innovation collaborative workspace on the FutureNHS platform (if you’re not already a member, email us at innovationcollaborative-manager@future.nhs.uk).

There are also many people who can and want to leave hospital earlier, reassured in the knowledge that they can still be monitored by their clinical team in their own home. We are seeing the emergence of technology-enabled virtual wards across the country which enable patients to do exactly that. One patient described the virtual ward that looked after them in Norwich as “groundbreaking” and “priceless”. For me, this is all about a blended model of care that helps people manage their care in a way that is most suitable for them personally and which their clinician feels is appropriate and safe.

Digital technology has allowed us to start this journey, which in many cases has been driven by necessity during the pandemic. But this is about so much more than the technology itself. It’s about trusting relationships, clarity of accountability, appropriate training and support for patients and clinical/care teams, and a real step away from what has been a traditionally paternalistic model of care. This is about a large-scale change to codesign a new model of care where patients, service users and clinical teams are all central to the conversation. All this needs to happen against a backdrop of recovery from the pandemic in terms of backlogs in demand, whilst also facing one of the biggest workforce challenges we have had in my career in the NHS.

To rise to this huge challenge, and capitalise on the opportunity that digital technology offers, we need to use all the resources available to us, especially improvement expertise. This is not about using a particular improvement or digital transformation methodology, it's about conversations between the right people to help them do the right thing. We need to ensure our new technology-enabled models of care are safe, that we can measure whether they are delivering benefits, that we can test and iterate to get this right and, most importantly, that the user voice is placed firmly at the centre of this work. Improvement teams have been supporting this approach for many years and I believe closer alignment between the worlds of digital and improvement will add huge momentum to our digital journey in health and care.

We have some great examples of where this alignment is happening and our latest podcast is one of those: two people, telling their real world story. Kevin and Bob take us through their journey of aligning digital and improvement at Imperial College Healthcare NHS Trust. So, if you're thinking about how you can do the same in your organisation, grab a cuppa, plug in your headphones and listen to them chat through their learning so far!