We literally cheered when we heard that the NHS – our nation’s most-loved 70 year old institution – was going to receive a £487million technology investment to improve productivity and patient care. No one is more deserving of having excellent technology to help them do their jobs than our heroic NHS staff.
We envisage a paperless NHS where the front-line community of doctors, nurses and carers manage patient treatment and the logistics of their healthcare, via apps on a mobile while on the go. This would also enable patients to quickly and easily consult with a doctor online from the comfort of their home. And, these apps would seamlessly integrate into a real-time centralised system for back-office, authorised users to access and manage the administration.
But, for the NHS to get its staff to cheer on a digital nirvana, its stakeholders will have to overcome some significant cultural challenges:
- Mistrust: this is due to a history of badly managed technology change. Do you remember the disastrous £10bn NHS patient record system project that kicked off in the early 2000s? Also, on-going patient data breaches has resulted in NHS staff being wary of technology that supports administration.
- Disengagement: most front-line staff don’t care for technology unless it can help to treat and cure a patient. As said by one of our NHS clients ‘you don’t go into nursing if you like computers’! Additionally, there is a concern that if you use technology whilst with a patient you’re not giving the patient your full attention.
- Sufficing poor technology: NHS staff are masters at problem solving and work-arounds to make patients better; and this is their approach to technology. One client told us how their community nurses hold team meetings – those present in person hold up multiple mobiles with remote colleagues on FaceTime! Genius, but don’t they merit something better?
- Fear: we’ve had NHS client experiences where healthcare assistants and nurses have gone sick or wept, as they’ve been fearful of the new technology as they’ve not been shown how to use it.
- Hierarchical behaviour: the NHS is known for this, which is good as successful change needs to be led from the top. However, the culture of world-class surgeons and executives is to ‘do as I say, not as I do’. This is a problem as digital sign-off requires them signing off more and delegating less. Also, they’re having to learn new technology, which means they’ll be exposing their lack of skill; and as the knowledge experts this just isn’t acceptable.
So, what initiatives should the NHS consider building into its technology change management programme to address these cultural challenges?
- Set up a VIP programme: provide senior consultants and executives with training on the new technology in a closed-circle environment, so any challenges they have aren’t exposed to a wider audience. Additionally, they should be coached on how change is led from the top and that staff seek permission to change from their line-managers, so they get why they must adapt their behaviour.
- Provide managers’ tool kits: equip line managers with one of these for each new technology work-stream. Tool kits are like an encyclopaedia – they provide a wealth of facts and reference points that inform and guide managers on what they should be saying to their teams and when. They’re a critical part of the management cascade model and can ensure the correct message is communicated.
- Create a champions’ network: identify and recruit front-line and back-office staff who have an interest in technology and are positive about the change. Then equip them with the skills and the message you want them to spread, so they have the knowledge and capability to support their colleagues on the new technology. Recognise that this is a job itself and remove some of their other daily responsibilities, so they’re not overwhelmed and see the role as burden.
- Equip staff with the skills: remove their fear by providing blended learning on the technology. Think classroom, floor walkers, drop-in sessions, online videos and guides. Create customised and flexible training packages to suit the different working patterns of front-line and back-office staff; and most importantly, ensure they’re given the opportunity to learn away from their day job. Beyond IT skills training, show how they can use the technology in their job. For example, front-line staff will be mindful of using the technology in front of patients. So, give examples of how they could achieve a balance.
- Engage staff to excite them: understanding ‘what’s in it for me’ is a critical component of technology adoption, so take the time to create NHS staff personas, map the benefits of the change to each persona, and promote how the technology will transform the life of each persona for the better. Time-saving and making life easier benefits always ignite an interest. Also, by understanding how people work you can ensure you set up their IT environment correctly.
- Make policy a focal point: by highlighting the importance of data governance, trust will be built with the staff. Weave policy guidance into the training programme so staff understand the technology rules and best-practice. A lack of knowledge creates a lack of trust, so by giving staff the information they will begin to trust the technology more.
- Showcase real life stories: by speaking with NHS trusts or public-sector organisations who are ahead of the curve, stakeholders can collate positive real-life stories to share with their staff about how working, modern technology can make a change to your day. If staff understand how integral technology can be to getting stuff done quickly and easily, they’ll be less complacent about reporting devices that aren’t working and sufficing technology that doesn’t do the job.
We all know there is a huge potential for the NHS to transform how they deliver patient care, so they execute more timely interventions with less reliance on paper. But, that involves embracing technology, so we hope the cash boost is spent wisely!