The inner workings of the NHS are a mystery to large portions of the general public. Surely the NHS is a massive centrally run organisation which owns and manages all of the hospitals, community centres and GP practices? Well, that’s sort of what NHS England do, but the practical reality is that each hospital trust, dentist and GP practice is its own separate entity. Generally, each of these organisations gets to decide how to deliver the subset of healthcare they provide as long as they address the needs of national goals and meet nationally mandated targets.
I’ve just started working for my 5th NHS organisation, I’ve worked closely with other local NHS organisations and I have a network of colleagues working in NHS organisations across the country. Whenever I hear someone describe the kinds of projects they’re working on and the challenges they’re trying to overcome I get Déjà vu, the sense I’ve been here before.
Up and down the country NHS organisations are in varying stages of undertaking the same projects. In informatics this could be a project: to get rid of fax machines and become paperless or at least paper-lite, to improve healthcare capabilities by adopting and implementing innovative new technologies or to join data sources from across organisational boundaries to better understand whole healthcare systems.
The problem isn’t that organisations are undertaking the same projects; it’s that organisation aren’t learning from those who’ve completed projects before them. Each project, no matter where it’s undertaken, has a consistent set of issues and challenges which arise. Rather than find out how others dealt with the challenge, organisations invest their own resource and effort into coming up with a solution from scratch.
Across the NHS there’s an understanding that this needs to change, and organisations must get better at sharing their best practice and learning from projects. NHS England are making steps in the right direction, pairing Global Digital Exemplars (organisations at the cutting edge of digital technology and information) with Fast-Followers. The idea being that the Global Digital Exemplars will spread best practice and adoption of innovative new technologies by supporting Fast-Followers.
Although things are improving, there’s a long way to go to change the culture of the NHS to be more collaborative across the organisational boundaries. And until that happens, people across the NHS will likely keep experiencing this sense of Déjà vu.