I was very privileged recently, to be asked to speak at the Healthcare Excellence Through Technology (HETT) conference back in September, where I joined James Freed (Chief Digital and Information Officer at Health Education England) on the Culture Excellence panel. This also included fellow speakers Anne Marie Cunningham (Associate Medical Director for Primary Care, Digital Health and Care Wales) and Joanna Fox (Managing Director at Medi-hr Ltd).

Although my Apple Watch didn’t appear to think so, buzzing on my wrist. 'You appear to be resting but your heart rate has risen!' Don’t get me wrong, I’m a big fan of technology and the use of health alerts but not when I’m about to address a live audience on stage...

Thankfully my heart rate quickly recovered. I guess seeing an audience live rather than via Teams on a PC must have been a shock after so long away from live engagements. James kicked off the session by asking us ‘what is a Digital team?’ but before I share with you what I think helps answer this, let’s first understand why this question is so important to the NHS transformation efforts. 

Gartner¹ research states that ‘the single greatest factor that will drive organisational success through the decade will be our ability to pair continuing technological advances with talent strategies coupled with every significant business initiative will have a Digital underpinning’. It is what Gartner calls ‘workforce digital dexterity’ - the ambition and ability to use technology for improving business and patient outcomes, along with an agile and open mindset. This should be our call to arms, to create this future workforce.

What is a digital team?

Digital teams are responsible for developing, testing, and implementing a strategy to reach and engage target audiences through digital channels such as the web, mobile, and social to improve the consumer experience. 

In the NHS’s case, digital teams work to improve and support clinicians at work, help patients get the best care, and use data that is captured to improve health and care. An example of this is to improve and optimise workflow such as a patient cancer pathway.

I believe digital teams are identifiable by what NHS Providers² highlight as the extent to which they demonstrate a 'Digital Mindset’ and the set of operational traits they apply.

The five cornerstones of a ‘Digital Mindset’ – Agile, Together, Open, Flat, User-centric (ATOFU)

Imbuing the healthy working practices outlined by Andrew Greenway³ and using ATOFU as a simple aide-memoire, a digital mindset:  

1. needs to be agile. What really matters is that teams are focused on the user’s needs, delivering relatively small, incremental improvements, failing fast, but constantly learning.
2. have teams working together, creating a collaborative working space. As you can’t see agility, the working space is where that culture takes shape. 
3. needs to be open. Teams must have a strong bias towards working in the open. Publishing code on Github (a code hosting platform for version control and collaboration) or similar is essential. This encourages collaboration and avoids duplication and waste.
4. have a flat structure. Agile digital teams are at their best when they are small (7 to 11 members). They should be autonomous and self-organising units, who are really trusted to get on with delivery. So as a leader, I recommend empowering everyone to make decisions within their field of expertise.
5. lead with user-centred design. The role of design in delivering great products and services, how the design process and user research works. I recommend making sure services you are digitising are accessible for people with disabilities.

Addressing your WIGs

So, what is the big driver of a digital team?

Simply put, I believe it is addressing your end-users WIGs (Wildly Important Goals), and we (the NHS) have so many.  

One big driver people miss is the scalable benefits, the network effects digital offers us. The underlying value of a digital product or service increases as the number of users utilising the service increases. 

The three Ds for digital success

One final area that I feel is vital for digital success is what I call the 3 Ds

1. Diversity – research reports that diverse and inclusive organisations outperform their peers. However, you need diversity both in the workforce but also in the approach to recruitment. Especially after 87% of global senior executives surveyed by McKinsey⁴ said their companies were unprepared to address the skills gap in digital skills – and that was before the pandemic caused a dramatic shift towards remote work and e-commerce. Mckinsey recommends opening up the field (such as job opportunities and the removing of restrictive and risk-averse recruiting practices) to all employees, especially people who want to reinvent themselves. This is an opportunity most individuals miss. This is what I call ‘internal mobility’ which enables employees to add new skills and change course and can keep them energised and stem attrition. 
2. Delivery – an Agile/Scrum approach needs a high emphasis on learning, pivoting to align with the user/patient needs.
3. Distributed – there really shouldn’t be one central digital team. Gartner⁵ research reports that distributed delivery propels digital transformation. Distributed delivery is the diffusion and spread of digital delivery and technology work outside of the formal IT team. Data finds that distributed and simultaneous digital initiatives make progress two and a half times faster than that of centralised sequential digital initiatives.

Closing thoughts

James asked what our conclusions and closing thoughts were. My observations for successful digital delivery were:

• Digital delivery (both internally and for customers) cannot succeed without team members who deeply understand the organisation. You need to bring these insiders (navigators) into the process from the start. There are many stories of successful digital change that often leave out the importance of ‘bureaucratic hacking’ (those slowing processes down) that is needed in the background to ensure success. 
• Rather than focusing on making the digital development boat go faster, people inadvertently revert to throwing bureaucratic or technical anchors overboard (let’s face it, it’s easier to do). An example of these anchors is using governance process concerns to stall or slow down change. But as a leader, I would encourage you to set the tone for engagement, getting people to openly challenge where they can, constructively pulling the anchors up. This will be key to help shape a positive digital learning culture. 

Lastly, a note to self: don’t wear an Apple watch if you are presenting on stage…

For further information, contact: 

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References

1. Gartner: Future of Work Trends: A Gartner Trend Insight Report - Published 20 October 2021
2. NHS Providers: Why and how do you build brilliant digital teams
3. Book Digital Transformation at Scale: Why the strategy is delivery. By Andrew Greenway, Ben Terrett, Mike Bracken and Tom Loosemore. ISBN 139781907994784
4. Mckinsey & Company - Overcoming the fear factor in hiring tech talent
5. Gartner: Redefining Architecture’s Role in Digital Delivery - Refreshed 13 September 2022