As a result, a number of NHS innovations are being built on archaic foundations with new system functionality limited by the old, often crumbling infrastructure below it. Connecting the old to the new can also be unexpectedly difficult for some. Integrating a patchwork of currently disparate clinical systems is essential for NHS to fully adopt digital. A complicating factor is that local NHS IT departments often do not control or maintain all the technology needs within the Trust, making the management of change very difficult. Local NHS IT departments sometimes face challenges from clinical departments wedded to their stand-alone systems and often paper-heavy workflows. Whether legacy COTS black boxes or award winning in-house developments, these technology islands pose an obstacle to digitally connecting the NHS. They are also often ferociously defended by people (often high-ranking clinicians) who are used to working with them, have little appetite for change and see re-training as wasting time that could otherwise be spent caring for patients.
Against this complex and challenging backdrop, IT organisations are asked to deliver core digital platforms that enable significant enhancements to patient care. In our experience, those NHS Trusts most successful at advancing their digital agenda are taking a holistic view of their IT function. Rather than undertaking discrete initiatives they are taking a broad, comprehensive view of how best to meet the needs of all core clinical functions. Streamlining day-to-day IT operations to release the scarce resources (both people and financial) required to build the digital future is essential.
A number of the NHS Trusts we work with have outsourced their IT functions. Typically this is a decision taken many years ago, and primarily one taken for reasons of cost savings. To their credit, most service providers work hard to deliver value to the Trusts. However, all service providers come with one fatal flaw: a congenital inability to recommend any service or solution they cannot provide. There are, we believe, a lot of good reasons for Trusts that outsource their IT to review their current sourcing arrangements. We know this because our recent studies at a number of Trusts identified significant savings opportunities within existing sourcing contracts. Equally, those Trusts that kept their IT in-house don’t always employ the most efficient methods to manage their resources, and often lag behind best-in-class techniques. What was a good price a few years ago is not necessarily a good price today. The difference between what you are paying and what you should be paying can be a very useful contribution to the digital transformation budget.