Effectively embedding digital in your trust

Trust boards are responsible for creating the conditions in which digital teams can thrive and be empowered, including designing governance and funding that supports digital teams to be their most effective.

The unit of delivery is the team. Digital teams are the cornerstone of building a truly digital organisation.

At its core, a digital team is a multidisciplinary team. They are fundamentally different to IT teams because they involve different skills, like product management, service design and agile delivery. Multidisciplinary in the digital (rather than clinical) sense means bringing together operational, clinical and digital staff to design and implement new digital solutions.

To be effective, digital teams must work together in a stable and sustained way. This means each member of the team having sufficient capacity to really engage in the work and for teams to be funded long-term – not just as project teams that end at go-live.

Digital teams require a different kind of governance and leadership. This means giving digital the same attention as finance or quality and focusing on outcomes rather than deliverables. Being able to test and learn and create short feedback loops requires leadership that creates trust and an environment where teams can learn from small experiments or changes. At board level this means thinking about the governance you put in place and how to use it to empower and enable. For example, how can you bring assurance into the team itself rather than in a distant gateway board, and empower the team to escalate to the board when risks are of strategic importance?

Common barriers to developing and sustaining digital teams are; funding, recruitment, retention, capacity. But trusts are exploring the ways they can overcome these. Digital teams need a mandate and the space to work differently, particularly when they’re just starting out. It is the board’s role to create these conditions so that teams can deliver.

Why effective digital teams are important

The concepts of multidisciplinary, empowerment, and agility are now commonplace in clinical service delivery. Digital teams are no different – just as with clinical service delivery it’s about putting the right set of diverse skills together in a team and allowing them to focus on delivering outcomes rather than outputs.

Traditionally however ‘IT projects’ have been given to the IT team or outsourced to suppliers to deliver, leading to poor patient and staff experience and decisions made that aren’t based on the needs of the user. An effective digital team will be empowered to make decisions, without going through layers of hierarchy and governance. They’ll be able to deliver at pace and easily respond to the needs of users.

A sustainably funded digital team will be able to continuously improve the services they’re providing – breaking the boom-and-bust cycle of one-off expenditure on systems and ‘solutions’, and supporting a long-term, strategic approach to the improvement of services enabled by digital technology.

Hear from a trust leader

Watch the video below for reflections on building digital teams from Dr Shera Chok, GP, Tower Hamlets; Trustee, Island Health Trust; Chair and Co-founder, The Shuri Network.

Watch the video below for reflections on enabling digital teams from Liz Davenport, chief executive, Torbay and South Devon NHS Foundation Trust

Common pitfalls

Teams that are multidisciplinary in name only – vital members of the team are too busy to really focus on the work. Digital can't just be an add-on to the already overloaded day jobs of staff.
Short-term teams that are funded as a project to deliver implementation not sustained improvement of a service.
Prioritising funding of new technology products over funding sustainable teams that
are focused on delivering improved services using digital as an enabler.

Questions to ask

When you come together as a board to discuss and debate the delivery of digital transformation in your organisation, these key questions can help you assure whether you are setting the right conditions for your digital teams to succeed:

Who is designing your services and how? Are your digital teams bridging the traditional silos between digital experts with internet era skills, and clinical, operational, and support staff?
Does your governance of digital transformation trust and empower, giving decision-making authority to teams so they can focus on delivering? Essentially does information flow to authority, or does authority flow to information?
When did you last see or use a trust digital service yourselves? Can teams show you what they're working on, instead of telling you in a report?
How are you collaborating across your system on sharing internet era skills, and enabling cross organisation multidisciplinary digital teams to solve problems for users?

To learn more, read our longer guide to building and enabling digital teams – in it you'll find more about recruitment, governance, and operating models.

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