Public Services > Healthcare

NHS Digital ‘capability review’ questions its role and clarity of offer

David Bicknell Published 20 July 2017

Critical feedback asks serious questions of organisation, saying ambiguous expectations and blurred operational boundaries across the health and care ecosystem have adversely affected NHS Digital’s delivery performance


A critical capability review of NHS Digital has asked serious questions of the organisation’s ability to meet the delivery commitments set out in the National Information Board’s Personalised Health and Care 2020 ambitions.

The review, carried out between October 2016 and March 2017, which has since prompted the creation of an NHS Digital report “Fit for 2020” responding to the review,  asked what steps would be needed to further transform NHS Digital into a modern, agile organisation capable of meeting the delivery commitments made in Personalised Health and Care 2020.

It found that few people are aware of NHS Digital’s role and functions in their entirety, especially its statutory role. The Executive Summary for the “Fit for 2020” report suggested NHS Digital is recognised for its expertise in delivering large scale infrastructure and technology live services, but there is frustration about its handling of data services.

It said its national partners recognise the criticality of "our role" but are also concerned about its ability to step up to the delivery of the strategic requirements of Personalised Health and Care 2020.

And its local stakeholders said it is distant from the front-line, an issue exacerbated by the way it communicates with other organisations, which is experienced as ‘transmitting’ information rather than ‘engaging’ with organisations.

There were also concerns about a lack of clarity about the roles of national organisations involved in data and technology, including the system-level leadership and governance, approvals, assurance and governance processes as well as roles and functions.

As a result of the capability review, NHS Digital said it had set out a clear suite of recommendations to ensure it is ‘fit for 2020’. All of the actions, it said, would be started in first quarter of 2017/18, with most completed by April 2018.

The headlines from the capability review indicated the following concerns:

National role and clarity of service offer

Ambiguous expectations and blurred operational boundaries across the health and care ecosystem adversely affect NHS Digital’s delivery performance. This has resulted in an inability to articulate a clear service offer with confidence. This creates confusion, undermines organisational credibility and limits customer satisfaction.

Customer needs and front line engagement

NHS Digital does not currently maximise the value of every customer interaction by working collaboratively at the “front line” to capture intelligence and insight that focusses delivery on what matters.

Fostering innovation

There is no industrialised organisational process for distilling insight into valuable solutions and introducing new ideas, products and services – through collaboration with customers and the supplier market – that address the fundamental challenges of the business.

Modernising data service

The data services offered by NHS Digital have a large and varied audience. Feedback from customers was that these services were below expectations. Delivering better here will have the largest impact on brand and reputation.

Assurance and ownership alignment

Inconsistent governance and assurance arrangements across critical internal and external stakeholder groups lead to uncoordinated management of portfolio level risk and delivery.

Strengthening cyber capability

Although there has been a rapid foundational capability roll-out for cyber security, there is still opportunity to enhance and mature both internal and external cyber services.

Strengthening commercial capability

Commercial capability is assessed as basic to average, with particular challenges around market data and insight, category management and corporate strategic supplier management. New digitally-networked market complexities need to be reflected in the speed and agility of commercial and procurement vehicles.

Workforce skills and agility

An articulation of the impact of the future strategy on the workforce is limited. Capability imperatives have not been mapped against emerging delivery requirements, and limited use of alternative resourcing channels damages NHS Digital’s ability to flex to meet changing workforce demands

Digital culture and behaviours

Historic skills requirements and established ways of working have too much influence on the organisation’s behaviours. This impacts NHS Digital’s ability to drive change at scale.

Modernising the internal technology landscape

The business is using out-of-date technology in key areas and the adoption of innovative digital solutions and automation is often too slow.

Industrialising the delivery model

NHS Digital has not defined its “business architecture” clearly enough – from high level system interoperability to the delivery models and technology blueprints which underpin them. Current operating structures are too isolated, compartmentalised and rigid for delivery across a multi-speed IT environment. Any new initiatives must be considered as part of an end-to-end, top-to-bottom value chain of interdependent activities.

In a covering letter to stakeholders , chairman Noel Gordon said, “As an organisation committed to continuous improvement we recently commissioned an independent capability review which has informed our response in Fit for 2020.

“Fit for 2020 re-enforces NHS Digital’s vision of providing IT and data to improve health and care for patients and describes what we need to do to improve what we do and outlines our ambitions for the future.

“Just over a week ago we published our annual report which brought into focus what we’ve achieved over the past year and provided an opportunity to celebrate successes like the new NHSmail2 programme, the Electronic Prescription Service and the 100% reliability of NHS Spine – saving more than £21million in running costs in the process.”

Gordon continued, “We are rightly proud of these achievements but there’s still much more to do.

“We are reinventing the culture of NHS Digital to become more flexible and responsive to the very dynamic environment in which we operate and to help this organisation meet the high expectations of the professionals and public we serve.

"Our vision is to harness the power of information and technology to make health and care better for patients and the people who work in the service and I believe Fit for 2020 clearly describes how we are going to be true to our ambition through this bold statement of intent."

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