Creating the conditions for success: the board’s duties

Understand the board’s strategic role - To give “clarity of purpose, freedom to act”

The lessons from major programmes like NPfIT (the early 2000s National Programme for IT) are clear. Digital transformation is a collective board responsibility. It cannot be handed off to a single person, department or outsourced supplier. The entire board must own the strategy, understand the risks and be accountable for the outcomes. Supplier relationships, technology investment decisions and digital risk are strategic, board-level priorities.

This doesn’t mean that the whole board needs to become specialists in technology. But it does mean that the whole board should be informed, and be able to ask questions, challenge, assure and participate in conversations and decisions related to digital transformation at your trust.

Setting the vision and strategy

Digital strategy mustn’t exist in isolation from your wider strategy, it has to be woven into the fabric of the trust strategy. The board’s role is to be explicit about the most important challenges and outcomes. An important and surprisingly simple change that board leaders can make is to avoid leading with specific technological solutions in the strategy and instead focus on the change and outcomes you want to achieve for patients and staff. 

Establishing a digital committee can provide the focussed governance and assurance needed to keep this work on track. This works best when it is made up of a multi-disciplinary and cross-functional team that represents the areas of the trust that need to work together to deliver your vision and outcomes. The knowledge and experience of the team should represent all areas of expertise and have a clear remit to ensure the improvement of patient and staff outcomes, safety and experience - enabled through digital change. 

Cultivating a transformation-ready culture

A successful digital leader needs a receptive culture. Boards should champion digital teams as strategic partners whose work is core to delivering front-line services, not just an internal service provider. Don’t allow policy, process and culture to become disconnected from technology and data change. 

Psychological safety is another key factor in successful transformation. Where teams can learn and adapt as they deliver, the likelihood of reducing risk increases significantly. Crucially this requires building trust over time. It must be safe to fail, with lessons learnt quickly, and leadership engaged in course correcting based on the learning before risks and challenges grow to an unacceptable level. Organisations that don’t provide safe pathways to escalate early are much more likely to suffer delays or fail to deliver.

Crucially some of that trust also comes from delivering the basics - and committing the investment needed to do that. There is little point in expecting staff to embrace an AI-powered transformation if the Wi-Fi doesn’t work or equipment on the ground is out of date, slow and hard to use. Attempting to rush ahead without addressing these will only serve to increase the truth gap between the board and the teams delivering, building frustrations that will distract from the organisation's goals.

Building a transformation-ready culture requires creating teams from across the organisation, who will be users of your digital systems, to design and deliver. This will include your clinical, administrative and operational staff and crucial to the success of this is those team members with a clinical and digital role, such as your CNIO, CCIO or AHP digital leads. 

Funding the change, not just the tech

The board must lead a shift in perspective, viewing digital not as a capital cost that can be made once and then forgotten. It is a strategic investment in sustainability, efficiency and effectiveness and the technology is only part of that change.

There is no such thing as a technology solution. Boards must insist that business cases are holistic and account for the entire lifecycle costs. This is more than just the technical implementation and needs to include the skills and capacity needed to understand user needs and design, test and iterate new ways of delivering services, as well as comprehensive training and support. Critically, boards must ensure to provide the sustained investment needed for the ongoing optimisation and continued improvement required to realise the full benefits of your investments and keep pace with the changing needs of patients and staff.