2020: The year NHS IT leaders made the frontline

On any normal year, The Digital Health state of the nation survey (NHS IT Leadership Survey) is a brilliant overview of how attitudes to Digital Health have evolved and how colleagues throughout the system are relating to the demands of being the driving force for transformation.

But this year, it makes for startling reading about how much can be achieved with not quite enough through sheer grit, determination and amazing skill in the most unprecedented situation the NHS has ever faced.

Proof that perception has changed

The survey highlights the positivity of what has been delivered – 83% said it had resulted in a more positive attitude to digital among board members, and 60% are optimistic this change will be sustained. Meanwhile, over three quarters felt it had improved staff members’ perceptions of digital but whilst it gives a focus on outcomes that have been achieved, it’s also clear that there is a desire to get more from what has been done.

Many believe, at last, that digital transformation is the key to managing the wave of demand that will sweep into the NHS over the coming months to support the desperate need to build capacity and offer ways to satisfy the insurmountable demand being directed to it in 2021 and far beyond.

The success that was made of systems already available to the NHS almost at the start of the pandemic can be seen as themes running through the survey, the leverage of systems that were at the fingertips of the NHS so quickly and the ability to forget old reasons why things weren’t permissible. Telehealth and distributed work capability have gone from nice to have to a must have and that has been a key success story of 2020.

The greatest fight the system ever had

Digital leaders of the system were able to step up to a place where a light could be pointed at them and they could finally deliver on the promises that they had wanted to make for some years, whether that be the ability to empower vast parts of the health system to be delivered remotely or to offer the skills and learnings that agents of transformation have at other parts of the system. The people of digital health clearly feel somewhat more valuable to health care delivery in 2020 than ever before, after all they have been on the front line of the greatest fight the system has ever had.

Sadly though, the role of CIO or IT Director seems to be waning and the ownership of the IT agenda at a board level still hasn’t become this ubiquitous ‘thing’ across all healthcare. IT is still not ‘the business’ of the executive but a back off service, such a shame and something that I desperately hope starts to change in 2021.

The most stubborn statistic

The stubborn statistic remains constant in the survey, despite the success of 2020 there is little confidence that the budget to truly achieve digital change is there or going to be made available – just 14% say they have enough budget for business priorities. There is still a fear that IT can be done against a back-drop of more for less.

When will the NHS leadership realise that there is no plan for change until there is funding to make it so, a plan without funds is simply a well described hope for the future. IT is not free and can’t be delivered on a shoe string. For too long health systems have not invested in the right way, with a

strategic view of the future, an end in mind – but funding has also not reflected this need – instead it’s often annual or given in dribs and drabs around specific initiatives.

Stop with the dribs and drabs

There is a positive light though going into 2021, removal of decades long barriers to digital transformation is now possible and a further description of how long-term transformation of health systems is now an accepted goal of large proportions of the digital health leadership, shows the level of maturity achieved in leadership in 2020 and how the effort can pay off in changing mindsets.