If the health and care sector is to safely and securely use and expand digital services, with clinicians becoming ever more dependent on it for the delivery of care, then we must get the basics of digital service delivery right and enable a digitally safe culture. Rob Ludman, Director of Ludman Consulting Ltd, shares the three priorities he feels is needed to tackle this.
Recent stories in the press (Whole health system’s IT goes down; Critical incident cyber attack; NHS computer issues linked to patient harm) underline again that digital service delivery in healthcare organisations is fundamental for clinicians to deliver safe care. When not done right (or if disrupted by bad actors), it can cause significant harm to patients and risk clinicians' careers.
Following the Post Office Horizon scandal, there is also growing concern that a horizon-sized iceberg is just waiting to be discovered under the waterline in digital health.[1],[2]
If we are to safely gain value from further digital transformation, including the coming AI wave, and manage existing digital services and infrastructure safely, we need to tackle some fundamental challenges in health. These are my three priorities as a conversation starter:
1. Shaping the investment in digital health services
Modern digital service delivery requires a higher ratio of overall revenue to capital funding. For example, a shift to Cloud-based services and setting up digital product or service-aligned teams isn’t supported well by business case models that focus on discreet programme investments with capital-dominated thinking and language. A holistic service-based approach is required for business case development, for modelling digital service benefits and value, which then shapes the overall digital investment required for the full life of a new digital service.
2. A modern digital workforce and profession
The NHS job role profiles[3] and skills for digital professionals are not working for us. They are still based fundamentally on an information management and technology model (over 20 years old), whereas other sectors have long ago updated their workforce profiles (e.g. the Government Digital and Data Profession Capability Framework). This is achieved by referencing wider-industry frameworks (e.g. SFIAplus, ITIL, IT4IT, DevOps), which provide structure as the (albeit messy) process of industry practice innovation occurs.
Although efforts are underway in health, which I applaud, such as the FED-IP role database,[4] the digital world evolves fast, so reactive approaches to reviewing the NHS job profiles and aligned job descriptions isn’t going to cut it. The NHS won’t be able to adopt modern and safe digital management practices across the whole system, if the digital workforce is shaped by role profiles that are not modern or proactively managed.
3. Use of frameworks and standards
Frameworks and standards strategically shape how organisations deliver their services. They act as foundations ensuring that individuals, teams and organisations remain aligned to evolving professional practice, helping to assure supply chains, maximise service value and lower risk. Individuals, teams and organisations that use frameworks and standards (e.g. for digital delivery, such as ITIL, IT4IT, GAMP, ISO20000, ISO27001, etc.) are never perfect, but they are better placed to get the basics right and to learn, which has to be where a digitally safe culture starts.
References
Dafydd Vaughan. Horizon IT scandal: repeating patterns. 14 January 2024.
Digital Health. The Post Office scandal has a hard lesson for the NHS. 16 January 2024.
NHS Employer. National job profiles. 20 December 2023.
DFederation for Informatics Professionals. FEDIP Job roles
Further reading on the hub
Engaging patients to improve the safety of digital health innovation
NHS England warns electronic patient record could pose ‘serious risks to patient safety’: what can we learn?
If the health and care sector is to safely and securely use and expand digital services, with clinicians becoming ever more dependent on it for the delivery of care, then we must get the basics of digital service delivery right and enable a digitally safe culture. Rob Ludman, Director of Ludman Consulting Ltd, shares the three priorities he feels is needed to tackle this. Recent stories in the press (Whole health system’s IT goes down; Critical incident cyber attack; NHS computer issues linked to patient harm) underline again that digital service delivery in healthcare organisations is fundamental for clinicians to deliver safe care. When not done right (or if disrupted by bad actors), it can cause significant harm to patients and risk clinicians' careers. Following the Post Office Horizon scandal, there is also growing concern that a horizon-sized iceberg is just waiting to be discovered under the waterline in digital health.[1],[2] If we are to safely gain value from further digital transformation, including the coming AI wave, and manage existing digital services and infrastructure safely, we need to tackle some fundamental challenges in health. These are my three priorities as a conversation starter: 1. Shaping the investment in digital health services Modern digital service delivery requires a higher ratio of overall revenue to capital funding. For example, a shift to Cloud-based services and setting up digital product or service-aligned teams isn’t supported well by business case models that focus on discreet programme investments with capital-dominated thinking and language. A holistic service-based approach is required for business case development, for modelling digital service benefits and value, which then shapes the overall digital investment required for the full life of a new digital service. 2. A modern digital workforce and profession The NHS job role profiles[3] and skills for digital professionals are not working for us. They are still based fundamentally on an information management and technology model (over 20 years old), whereas other sectors have long ago updated their workforce profiles (e.g. the Government Digital and Data Profession Capability Framework). This is achieved by referencing wider-industry frameworks (e.g. SFIAplus, ITIL, IT4IT, DevOps), which provide structure as the (albeit messy) process of industry practice innovation occurs. Although efforts are underway in health, which I applaud, such as the FED-IP role database,[4] the digital world evolves fast, so reactive approaches to reviewing the NHS job profiles and aligned job descriptions isn’t going to cut it. The NHS won’t be able to adopt modern and safe digital management practices across the whole system, if the digital workforce is shaped by role profiles that are not modern or proactively managed. 3. Use of frameworks and standards Frameworks and standards strategically shape how organisations deliver their services. They act as foundations ensuring that individuals, teams and organisations remain aligned to evolving professional practice, helping to assure supply chains, maximise service value and lower risk. Individuals, teams and organisations that use frameworks and standards (e.g. for digital delivery, such as ITIL, IT4IT, GAMP, ISO20000, ISO27001, etc.) are never perfect, but they are better placed to get the basics right and to learn, which has to be where a digitally safe culture starts. References Dafydd Vaughan. Horizon IT scandal: repeating patterns. 14 January 2024. Digital Health. The Post Office scandal has a hard lesson for the NHS. 16 January 2024. NHS Employer. National job profiles. 20 December 2023. DFederation for Informatics Professionals. FEDIP Job roles Further reading on the hub Engaging patients to improve the safety of digital health innovation NHS England warns electronic patient record could pose ‘serious risks to patient safety’: what can we learn?
