Within healthcare, we are seeing a rapid race towards digital, with NHS trusts and organisations leaving paper, pull cords and legacy systems behind one by one. What we must remember, however, is that going digital is not that simple, and it costs. Being fully digital does not mean that it leads to becoming an Outstanding NHS trust but it does help along the journey.
The pace of technological change in recent years has been frantic. Creating a health service that responds to these changes and stays ahead of them can at times seem impossible. Yet, in the face of budget constraints and a set of pressures unique to every trust, the NHS is making a continuous effort to do so. When I came to work at The Christie, I saw it as my chance to get a digital service right. Of course, The Christie is a trust with its own individual challenges, so how will it be possible to achieve digital excellence? One reason is its smaller size than some other trusts, serving 3.2 million people across Great Manchester and Cheshire; around 25% of our patients are referred from other parts of the country. Another is its specialist organisation for cancer care
As I discussed at the recent Healthcare Partnership Network, transforming the culture of the organisation can be equally important as transforming the technology. Digital change alters the way that staff interact with patients, alters the way they work as clinicians, and this shift can be intimidating. A trust must unite the staff body in its working methods, putting every person on the same page.
In recognition of this, it has been of utmost importance to me to build the operational resilience within my teams. Much of the time, money will get thrown at a digital transformation, to be delivered by the IT department without forethought. A certain amount of time and investment needs to be put into training and developing the culture within the staff body as well as revolutionising the way we work. At the same time, the digital service itself needs to consider everyone involved – from the patients to their families, from the clinicians, nurses to the administrators.
The will, the recognition that investment is needed, and the ambition must all be there for a transformation to work. At The Christie, we have taken strides towards achieving a digital trust, and my hope is that eventually we may be used as a blueprint for other organisations.
Preparing for the power outage
One aspect a trust must be careful of is assessing the risk of making digital changes without a change in culture. Staff must know what to do in the face of a power outage, equipment failure, unexpected hiccups. Many organisations in the NHS, through lack of investment, do not run smoothly in these instances and struggle with introducing digital – they can be too busy trying to keep the lights on to begin the change.
Reacting to disaster is not enough; we must be proactive in our digital approach as trusts. With targets, cuts, and a whole host of other stressors, it’s easy to bow under the pressure and reject the notion of pre-emptive, pro-active approaches. We have started to be successful at transforming on a small scale, but there is something to be learned from what we have been able to do here – something that can be applied to larger organisations.
A cultural foundation for change
Now that we have a cultural foundation for change, our plans for 2019 are large but achievable with help from the magic ingredients of investment and resilience. In no way are we perfect, and we are always striving to improve, with several ambitious projects in the pipeline for the coming year.
Advancing our home-grown EPR is a priority, as it will lead to many other positive changes within The Christie. Improvement in the EPR gives us a platform to conduct more research as an organisation, as a specialist cancer centre. It will help advance the beginnings of a project that will gather patients’ reported outcomes and patient experiences, and combine them with the EPR to compile a complete picture of a person’s treatment and how they are coping with it. This will help us respond better to other patients about to embark on the same treatments, while working with pharma to improve treatments. Beyond this, we are looking to construct a research centre adjacent to the hospital, in collaboration with Cancer Research UK and the University of Manchester. This will allow researchers and our clinicians to have the opportunity to work together under the same roof. These are all steps towards being able to improve research data for clinical trials. In addition to being a leading cancer centre in the UK, these strides will help The Christie to stand at the side of other world-leading cancer centres.
This is an incredibly exciting time for The Christie, and these things could not happen without the precise focus on cultural change before complete digital transformation. Our ambition as a trust is to become completely digital.
The crux of some of the projects we are working up at The Christie is setting as many fires alight as we can, and then seeing which ones will burn the brightest. It is essential for a trust to get the basics right, to make the building blocks that can then create a world-class digital service to go alongside a world-class clinical service. As a trust, you simply need the will to do so.
By Eileen Jessop, CIO of The Christie NHS Foundation Trust, speaking at the Healthcare Partnership Network event