Can the user experience of someone working in the UK National Health Service be improved by taking a more proactive approach to IT—getting ahead of potential problems so as to free up the IT department to focus on more impactful problems?
If it could, then the pay-off would be worth it, surely - as it would mean the quicker NHS staff can spot problems with their IT, the quicker they can resolve them, and the more time they can save. And in healthcare, more time, of course, directly translates to more time for helping patients.
That’s the experience, at least, of one NHS organisation, a shared service hosted by East and North Herts CCG. Its Chief Digital Officer, Phil Turnock runs an IT shared service within the NHS that provides IT services to four CCGs—Clinical Commissioning Groups—and therefore the individual GP practices, plus two NHS Trusts, one a mental health trust, one a community body. Turnock’s team thus has to support 9,500 end users across two counties, and that's across 122 corporate sites and 240 GP Connect practices.
We are a shared service, owned by all six partner NHS organisations, so it's a member-led service. Everyone contributes into the partnership based on utilisation of the service, and any operating surplus we make is refunded back in technology, or can go back to the partners. Likewise, if there is an operating deficit, then the partners have to make good of that.
To me, that is a really good model because we're all in it together; we're all invested in common problems, so we're looking for enterprise solutions that benefits all of us, not just one of us. Doing IT in a more affordable way, as a collective.
He then explained the immediate problems he had to fix back when the shared service got started:
We've been going since 2015, and our biggest problem at the start was the legacy organisation had under-invested in technology, so we had an infrastructure which was falling apart. We redesigned the back-end services, all the infrastructure, and now have two data centres, one an on-premise and the other one a replica in a commercial data center, but we manage both like-for-like.
So we spent probably three years investing in the infrastructure and getting ourselves into a much better place and a much more stable environment, able to host the clinical services that our partners required from us.
The next challenge after that was about performance of our service desk and so on, and the support element, so about 12 months ago, we started on the service improvement plan to which is centred on use of RPA (robotic process automation), so all the creating new user accounts, everything like that, is now performed by a robot. That's made a massive difference to us; in the last nine months, we probably saved in the region of 1,700 hours processing time through that robot processing user accounts.
From reactive to proactive
For Turnock, the mission now is all about going from reactive resolution to proactive problem management, which can only really start if he has full understanding of what's going on in his user community and what's really happening on their devices. And that is really a user experience problem, he believes:
The next thing we want to improve is around digital experience. If you phone up a service desk that you might struggle to get through to, you'll be frustrated. But if they've resolved your problem at the end of it, you kind of lose that frustration. So that's where the digital experience for me is really important. To sustain our shared service model, that's got to be about customer experience, about what's the experience they get, and are we agile enough to be able to respond to their needs and their digital strategies.
Because we're not a supplier, we're an internal partner-led organisation, we want to focus on transforming away from service levels, which is where we were previously, and start to move into digital experience, i.e. what does it mean to the end user about the service they get?
Really knowing what’s going on—at the user device level
Turnock has started to try and crack this problem by working with a specialist tech vendor called Nexthink, employing what he describes as a combination of real-time analytics, instant remediation, automation and collection of employee feedback across all endpoints to improve IT delivery.
We're developing this, and we're not there yet, but what we’re developing is our own digital experience portal so that we can actually play back to the partners how the service is for them. We want to get away from them trying to treat us like the supplier, and they're not, but us all trying to improve that relationship more.
The software we’re using from our supplier here has enabled us to really start to talk to our end users in a better way, and in real time. Actually, that pays massive dividends for us. At the moment, we're in the process of migrating away from Windows 7 to Windows 10, and the Nexthink package has helped us engage with the users to migrate their individual machines in a much more user-friendly fashion than might have happened otherwise. Another example is we had a problem with one of our asset management clients which was over-utilising CPUs but we were able to identify where the problem was, where the time lag was, and therefore we could put in a permanent fix to resolve that.
Turnock told diginomica/government that it's hard to put specific metrics around what he’s done so far with improving the user digital experience, but he is convinced it’s leading to boosted productivity.
It's all about end user productivity, making sure our clinicians can do the job that they're paid to do and not waste time trying to log in to their IT. We don't want them to see IT as a barrier, but instead see it as an enhancement enabler. I can say our waiting times on the service desk is now reducing significantly, because people are using different channels to get to the service desk. We are also being very proactive in terms of knowing what's going on out there, we know when certain devices are not running as quickly as they could do, and we do also try to convert that into a service.
In terms of next steps, the shared service is now mapping its clinical EPR systems to see how they’re performing, he says, but even better, because the service has radically improved over the last four or five years, a seventh partner is signing up for the shared service, the Milton Keynes CCG with 29 practices.