NHS Education for Scotland, one of the core special health boards that is responsible for providing learning services to all NHS Scotland staff, is undergoing a digital transformation that seeks to dismantle ageing silos of information and to bring everything together ‘as a service’.
The organisation is making a fundamental shift to the cloud, where it is using both Office 365 and Azure. But one of the core features of its cloud strategy is through the use of ServiceNow, a platform that organises an organisation’s underlying workflows in a way that allows for more streamlined processes. It enables companies to deliver everything as a service.
ServiceNow talks about how in the consumer world we are now used to having access to whatever service we want, in real time, at the touch of a button, on our smartphones. But enterprises have failed to catch up.
This is exactly what NHS Education for Scotland (NES) is looking to address, where it is using the ServiceNow platform to better manage its risk, governance and compliance, so that it can focus on delivering business outcomes. In other words, it wants to eliminate slow and hefty processes so that it can focus on providing services to frontline NHS staff.
I got the chance to sit down with NES’s IT director, Christopher Wroath, who explained that the organisation’s problems are common amongst other organisations that have yet to become ‘digital’. He said:
Problems we were having, we like to call them issues, were fairly generic issues with regard to organisations that have had an architecture and infrastructure that has grown up over time and has moved beyond its original planned way of doing things. And also an organisation that has had a lot of management, but not a lot of technical leadership.
By which I mean, there were lots of policies and procedures in place that made sense, in the context of where the technology started. But the longer it moves away from that place, they’re not developed.
This leads to the usual or common situation where you have technologists that are wrapped in a world of technology, but they’re not necessarily wrapped in a world of service delivery. And that separation, I’ve seen it plenty of times before.
A step change
Wroath said the he was looking to undergo a “step change” in how NES operates and delivers its services. He said that the organisation previously had no visibility and no real evidential base for how decisions were made or how resources were managed.
It wasn’t awful, services were up, technology worked and people got what they wanted. But it was very difficult to plan, it was difficult to make any real meaningful decisions about what the best way forward was. We needed more evidence.
NES worked with implementation partner Fruition to roll out ServiceNow across the organisation. Wreath’s remit isn’t just to transform how NES delivers services to NHS Staff, but to also transform how services are delivered internally.
The outward facing digital transformation started to influence the way that I started to think about the internal one – let’s move away from technology, move away from technology services, let’s move to an idea that everything is a service and remodel things around what people need in the end.
Wroath explained how NES had been structured around disparate systems that didn’t allow for it to provide a holistic approach to services or education for NHS staff. He said:
As with most organisations there are verticals, silos, which are quite rigid inside NES. They’re based around professions. Information systems support their processes and their deliverables, but they’re not joined up. There is no holistic approach to informational services. What happened in 2013 is that we went out to our main stakeholders and the Scottish government and asked them for feedback on what we do – that’s what came back, that information and services were very difficult to find.
We got ourselves into the position of knowing that that was the problem was, the data was locked inside the information systems. The executive team knew we had a problem, but they didn’t know how to resolve it. They’re not information people. PA consulting came in and did a really good job of crystallising it, they told us we needed a digital transformation, that we needed to have a single unified vision, that we needed technical leadership.
For the outward facing digital transformation, the education provision, NES has been building a new technology stack, based on Microsoft, using agile methodologies. Wroath said:
We are very excited about that. We are integrating trainee and records management around that, recording of their evidence. But we are also integrating it with the replacement for the knowledge network, which is where the resources are. So, we are introducing Amazon-style push technology, where the key is that the whole data model is based around a person now. A midwife, NHS employee, 5 years in the job – we have got their training record.
We build all of the data around that. In order to make that a longitudinal aspiration, we are separating the data from the apps.
However, NES is also changing the way it operates internally, which is where ServiceNow plays a key role. Wroath said that he and the organisation spent too much time managing things like risk and governance, in order to make sure that they were playing by the rules. But this meant that the organisation was distracted from focusing on its key objectives. Wroath said:
I’m having to deal with, risk, governance, business continuity planning, resource management, operational plan. All of that stuff is holding me and the organisation back. I’m not free, I’m learning processes. It’s wasting my time. There is a huge amount of time in my working life just answering email, looking at spreadsheets, it’s not a joined up experience.
I suddenly realised that by using ServiceNow, we are getting huge potential for a single place to manage services and processes going forward. There could be a single place that risk could be tied automatically to a business continuity plan and that risk could also be automatically connected. As well as all the other stuff, like booking a hotel and travel arrangements.
An over-arching enterprise management with ServiceNow. What I’m paid to do is digital transformation, with risk managed appropriately to bring about a safe and meaningful outcome with proper governance, which provides for better training in the NHS in Scotland.