Hello, and welcome to Talking digital health, a podcast by law firm Mills & Reeve, hosted by health and tech lawyers, Sophie Burton-Jones and Charlotte Lewis.
Our aim on this podcast is to discuss key topics of interest to those procuring tech in the NHS, and also those selling tech to the NHS.
I'm Sophie Burton-Jones. And I'm Charlotte Lewis, and we're your hosts for this episode.
We're delighted to be joined by Charlotte John, a digital healthcare transformation consultant who specialises in supporting teams and adapting to change.
Thank you for having me on the podcast.
We're very, very happy to have you with us.
Thank you very much. In this episode of Talking digital health, we'll be discussing with Charlotte her top tips for engaging and supporting people within an NHS organisation that are embarking on digital transformation projects.
My first question for you, Charlotte, is what role can people within an organisation play in setting the strategy for a digital transformation project?
Great question.
I think, first of all, obviously, we need to understand that digital transformation is inclusive. And although it's about technology, it's actually driven by people. And when we are talking about strategy, I think it's really important that it's not just that top-down approach, but it really comes from a people-focused or centered perspective. And when it comes to the organisation, there are so many different roles that feed into the strategy for a project.
We've got leadership and management, and they are there really to kind of look at that strategic approach and secure the buy-in. And then importantly is the frontline staff and those end users who will provide valuable insights into how this new piece of technology and innovation needs to work. And then sometimes people forget, you know, behind the scenes, we do have IT teams that really need to ensure interoperability, security, and that compliance perspective. And again, not to underestimate that project and change management teams, because they're there really to monitor and address some of those resistances that you might find to setting a new project, especially around transforming those clinical pathways, but really there to measure success. And that isn't just those quantitative benefits, it's those qualitative ones that we want to see in, you know, in the way we deliver our patients' care and improve those outcomes.
I guess digital transformation is most successful when it's collaborative, inclusive, and user-driven, and really engaging people at every level to make sure that any digital transformation project is realistic and practical and is embraced by everyone that is going to be using it.
That makes a lot of sense.
And obviously these are all busy people with lots of roles and responsibilities. So sometimes I think people think they're trying to help by not engaging them unless they really need to, but that might lead to some further issues.
I guess our follow-up question is how early in the process do you recommend engaging with various people?
You know what, before you even think about it. The earlier the better from being on the frontline. So 14 years I was on frontline of NHS secondary care. And it's all about engagement. And it's before not wanting to try to develop a new solution or a pathway and “using that square peg into a round hole”. We really need to be engaged with people right at the beginning because that's where you'll see that resistance to change and people won't want to adapt because they won't have been part of that process. So for me, even before you've procured, it's that discovery piece right at the beginning where we need to be engaging with people.
And actually, moving on from that, and we're talking about what you do before procuring a new solution, how important is it to focus on need and demand for digital transformation?
Yeah, it's absolutely fundamental to the success of any implementation.
I always say that the success of innovation is in the hands of those that use it. So we really need to address those barriers and those pain points, and that's how we will understand what the demand is.
We might have a strategic direction from a national or a regional priority, but really what we need to understand is how is this new innovation going to really enhance clinical pathways and improve patient outcomes. So for us, we really need to understand those features and those benefits that innovation and a digital transformation project needs to deliver before we even think about, as I said, that procurement.
And in your experience, are there any areas more likely than others to delay procurement or implementation of a potential pathway or new solution? And what do you recommend for mitigating against that kind of risk of things not happening very quickly?
Do you know who gets the blame for most of this? It will be clinical safety and governance.
They are the ones…
Lawyers, too.
They're the ones that go, there are roadblocks. That's why we're not seeing success. From my experience, if you engage with them early, and I'm sounding a bit like a broken record, but it is all about early engagement. If you bring those people on board, they are going to make your implementation and transformation far better. They are not there to put those roadblocks in place. They're there to help you understand and implement it successfully.
We have things like consent and data sharing. That's all things that can be running in parallel to an implementation in terms of stakeholder engagement and procurement. So really, they are the key roadblocks in terms of procurement and implementation.
Your roadblocks after that will be with people and the adoption and spread of that. But yeah, please do not blame clinical safety and governance because they are actually there to make your life a lot easier when it comes to this.
Music to our ears, Charlotte.
You've probably heard it said it on different podcast episodes before.
No, I think for me, it's really important.
And, you know, I've spoken to a lot of people. I've done a lot of digital transformation projects. And you come in at a certain stage. And if you haven't been there from the beginning, it's clinical safety saying, well, you know, why haven't you thought about this? You need to do that. And yeah, it is a block, but it doesn't have to be because you can actually help them design it into the process. So it's being addressed the whole way through rather than being thrown at them at the end.
Absolutely.
I think what you, and this is one of the reasons why we were so keen to do this podcast with you, Charlotte, because we know that the most important thing in any of these projects is people.
You can't do it without the people, but also if you don't take people along on the journey with you and bring them in and engage them and encourage and support, actually those individual people can be your blockers. But if you work with, they can also be your best supporters. So I think that that's something we were really keen to get across so that the success or fail of some of these projects can often boil down to people and relationships.
Key thing is that that is all resolvable. You've got to work on it.
So thinking about that then, and I wanted to ask you a question really about comms, because that's going to be hugely important, I would have thought. So we know effective comms can have a hugely positive impact on a change project.
What do you recommend NHS organisations do when planning their comms strategy?
I think it's an interesting one and quite difficult because you do have different stakeholders. So your comms and engagement really needs to be the same message but targeted to different people.
Engage with frontline and users of those that are going to be the success in the adoption and spread of your technology or your transformation.
And don't forget the supplier.
They need to understand when you're dealing with comms and user-centered design, bring them in because they need to be part of that picture as well.
Otherwise, they're off thinking that they know what we want and then actually, they're building something completely different. But for me, I think it's about understanding the different methods, really understanding who your target audience is to engage with, use different methods of communication, use different times to have those communications.
A nurse at an end of a 14 hour shift, if you've asked, what do I think about a new system, you're not going to get anything out of them.
A QR code in a room where I'm sitting and having a break, absolutely. I might like to click that and fill in two or three questions and you're going to get your feedback. So that's where I think we need to understand the different types of engagement we can have in terms of our comms.
People on the frontline are very different to patients, for example. So we need to make sure that we are really planning how we want to talk to people, what we want to get out of those conversations, and more importantly, always to feedback. Sometimes we underestimate the art of actually listening to the feedback that we're getting, but then feeding that back to the people to say, actually, have we understood you correctly? I think is important because again, it's part of that empowerment and that early engagement and adoption into this process of change that we can really bring people on that journey. And I guess it's also if you have asked people for their opinions and you've decided to go down a different route, again, it's that feedback and explaining why, because there might be other really good reasons that you're not going to be able to do what they've told you they'd like you to do, but they understand that you have taken the feedback on board.
As a final question, it's understandable that people might feel apprehensive about change. How can organisations support their people to adapt to change?
I think it goes back firstly to the question before is like, how are we articulating our message?
Because, you know, we can all be sat here in this room or in our groups and on this podcast and we can all talk about digital transformation and we know exactly what that means. But to someone who's on the front line, a nurse or a doctor at the end of a 14 hour shift, for them, digital transformation probably means IT change. And then with that comes a resistance, usually from fear. And that fear is from not understanding, not being part of that process, thinking that AI solutions are going to come in and take over our job, or we're not going to be able to have the patient care that's brought us into this career path.
So it's really important to understand how we articulate that message. And when we talk about adapting to change, it has been so fast paced, hasn't it, since COVID? I think they said that in the 10 years from COVID, we'll see as much change as we have done in the last 100 years. And that is just mind blowing.
There's some sort of stat generally about change. There’s been as much change in 100 years as there was in 500 years and as much change in 50 years as there was in 200 years. And it's just that that timeline is getting suppressed.
Absolutely. And it and it's relentless.
You know, in the past, I think we had time to adapt to change and some of that, especially around digital innovations. We've seen it. But since COVID, it has been wave upon wave of digital transformation, innovation and change. And that does take its toll, not just in terms of new ways of working, but in terms of upgrades and systems. So, for me, organisations can support their people adapt to change by just never assuming that people aren't understand the vision and really articulate that message to to all those that are involved in in care and and in this transformation project and engage with them early.
As we've said, it's so important to bring people on that journey to empower them so people don't want change done to them.
They want to be part of the solution and that really comes from leadership and that change and empowerment right at the beginning of a project and help them to see the benefits and listen to the fears that they're facing. Don't underestimate how much stress and burnout, for especially our frontline staff, are under right now.
It does have an impact on how resilient they are to change. So I think it's really important that we, as much as we need to innovate and we need to transform the way we give care to our patients, we really need to make sure that we are helping the frontline staff and all the support staff behind the scenes really adapt to change by empowering them to be part of this journey.
I really liked your point about “there shouldn't be things that are done to people, they should be done with people”. I think that's a really, really important method that people should have. I was going to say at the forefront of their mind, but maybe stuck on a Post-it note in front of their faces.
I go back to the point, if you can bring people along with you, you're going to have a much smoother ride, whereas people can be really, really powerful blockers if they're not happy with something.
That, that's the other thing I found that works quite well when trying to engage people is cake. That generally goes down quite well. And if you're looking to get people in a room, maybe get cake.
Is that how you attend difficult meetings, you turn up in your suit with a cake?
No, what I do is I judge what meetings I'm going to attend and what's being offered. And if you don't want people to ask questions, you just give them toffees. We all joke about our methods, but I think really, at the end of the day, what we're talking about is building trust, isn't it, with those that are part of this process and as leaders within the NHS and outside the NHS, you know, all the touch points of this digital transformation journey. If we can build that trust, and listen to each other and empower each other to really make a difference because, at the end of the day, that's what we all want when we're looking at transforming these pathways is just making it better for our patients.
Yeah, completely.
Well, thank you very much for joining us today, Charlotte. Really enjoyed our conversation with you.
At Mills & Reeve, we're really happy to discuss any legal queries you might have about health tech, including on planning for and running digital or IT procurement.
Our individual contact details are available on our website at mills-reeve.com.
Thank you for joining this episode of Talking digital health by law firm Mills & Reeve.