NHS Business Services Authority (NHSBSA) has this week launched its digital strategy, which is shunning any focus on ‘hype tech' - such as AI, blockchain or robotic process automation - and is instead centering user needs, where ‘digital' means its culture, practices and processes. The strategy is cogent and a good example of how to think about ‘digital' across a large organisation.
NHSBSA is a Special Health Authority and an Arm's Length Body of the Department of Health and Social Care. It plays a critical role in the running of the NHS, where its services include processing 1 billion prescription items a year, managing the NHS Pension Scheme for 2.6 million users, managing payments to dentists, and administering the European Health Insurance Card in the UK. In other words, it carries out a lot of the ‘back end' functions, that you'd typically see in the enterprise, for the NHS.
NHSBSA kicks off its digital strategy with a quote from Tom Loosemore, who was one of the founders of the Government Digital Service (GDS), and says that this is one of the most succulent and clearest definition of what is meant by ‘digital' and forms the backbone of the strategy. Loosemore's quote is:
Digital: Applying the culture, practices, processes & technologies of the Internet-era to respond to people's raised expectations.
And as noted above, NHSBSA is not defining its strategy by the services and the products it delivers - taking particular aim at other strategies that talk up the benefits of ‘hype tech - but is instead saying that modern technologies are a by-product of the rest of its work. They may be used, but they aren't the focus. The strategy states:
We mean our culture, our practices and the processes we apply to create, manage and maintain our services. On the ground, this is ‘lived' in how we talk about our services, how we behave and interact, the values that we work by and the thinking that drives our decision making when delivering services for our users.
As a Digital Directorate, our purpose is to create an environment for our people to be their best.
Together, we'll continue to deliver quality solutions on time through innovation and collaboration, creating value for money and efficiencies. We'll be the voice of vulnerable people by focusing on user needs, designing accessible services that are easy to use.
With this in mind, NSHBSA has broken down its digital strategy into five key ‘enablers', which are as follows…
The first enabler, which NSBSA describes as its ‘greatest strength', is its people. The strategy notes that the success of digital within the organisation depends on the "skills and hard work of everyone in the team", which includes, but is not limited to, content designers, delivery managers, developers, strategists, and testers.
NHSBSA's Digital Directorate has over the last three years grown from an organisation with less than 10 people to one with over 150 permanent employees. It claims that it has spent this time creating new roles which are now established career pathways.
To support the growth of the team, NHSBSA has moved from a traditional hierarchy structure, to one it describes as ‘matrix management', which it hopes will empower people and provide the right support for their needs.
The matrix approach focuses on three key areas: professional leadership, task leadership, and personal development.
The organisation is also introducing an apprenticeship scheme and is adopting more structured learning opportunities going forward, where it says that "self development is not enough".
NHSBSA recognises that many government policies were not designed for the internet era and don't reflect the expectations of users today. As such, it is adopting an approach that puts users first.
The strategy states:
To design services which do the hard work, so our users don't have to, we must first understand the needs of our users. Not just in the Digital Directorate but across our whole organisation and beyond.
Digital transformation means designing services based on user needs, making it easier for the citizen to do what they need to do, and reducing the cost for Government to provide those services.
We'll take a holistic view and strategic approach, identifying commonalities of user needs across services. We'll work across our organisation to share insight and research, making sure that our services are aligned wherever possible - putting the user at the centre of it all.
We have good practices in place to support a user focus, to allow visibility of user insight across the Digital Directorate and to those closely involved. This includes the sharing of user research videos, participation in user research by all team members and high visibility of user feedback.
Diversity and inclusion
This one is often overlooked in many digital strategies that we see, but it should be given the same consideration as the other more practical points. This is particularly pertinent when designing government services, as those working on design and delivery should reflect the diversity of the citizen population if they want the best chance of getting this right.
In order to deliver our digital ambitions, we need diverse teams who can bring their whole selves to the workplace and who are comfortable to be bold, inquisitive, challenging and empowered to make decisions.
With teams who offer a diversity of ‘lived' experiences we'll be better placed to deliver services which meet the needs of our diverse users.
We encourage our teams to experiment and try things out. Teams that have the freedom to make decisions and are trusted to make the right one because they understand what we're aiming for.
The strategy commits to increasing the diversity of the ‘lived' experiences across teams, improving NHSBSA's recruitment process, recognising failure as a positive and allowing teams to problem solve together as a team.
Tools, processes and governance
Underpinning this ‘enabler', NHSBSA states that it has spent the last 2 years changing the mindset of how it invests in digital. It has worked with finance and commercial teams to shift the funding model from one that invests in projects, to one that invests in teams (again, this was central to the approach at GDS).
This means that it has created a funding model that establishes digital services as evolving - iterating from first release, live support, through to retirement. It now has a quarterly investment case model.
Elsewhere, NHSBSA is planning to strengthen its reporting metrics and will code in the open and open source its research insight.
Whilst NHSBSA is avoiding ‘hype tech', it also states in the strategy that ‘technology is an ally. It states that it will not be driven by technology, but will harness its application to deliver user-focused services and interactions.
The strategy states:
Any use of technology will be employed to make the user experience better and will have been identified as a result of user need.
Technology choices will be made by our cross functional teams. They will not be constrained by the boundaries of the present or past, nor will those choices be made through a desire to explore the latest hype technology.
Choices will be considered and thoughtful, with a clear understanding of the need and impact, and by sharing evidence-based decisions, a standard will be created.