NHSX publishes anticipated ‘What Good Looks Like’ guidance

NHSX has published new guidance outlining how NHS organisation should be driving digital transformation and what success looks like.

The much anticipated ‘What Good Looks Like’ framework sets out a “clear north star” for digital success in NHS systems and organisations in England.

Published this morning (August 31), the guidance aims to build on the strides seen in digital and data during the Covid-19 pandemic by providing local NHS leaders with digital success measures they should aim to meet.

It’s hoped the guidance will help leaders and individual organisations accelerate digital transformation across the health service.

Speaking exclusively to Digital Health News Sonia Patel, chief information officer (CIO) at NHSX, said: “We want to ensure that we have ubiquitous digital and data transformation capability across the country and without a standard, we are likely to inherit lots of variation.

“The repercussions of variation could be at the consequence of delivering better patient care and better outcomes for the population, so therefore it is really important to provide a clear north star.”

The framework sets out seven success measures including whether digital transformation is well led; ensures smart foundations; safe practice; supports people; empowers citizens; improves care; and healthy populations.

It is split into two sections: ‘What does good look like for Integrated Care Systems (ICSs)’ and ‘What does good look like for your organisation’ which both follow the same seven measures of success.

Recommendations in the guidance include patients having digital access to their care plans and test results; a call for NHS trusts to explore new ways of delivering care using digital platforms such as remote monitoring; and the improvement of care through the use of electronic prescribing systems and decision support software.

“As the national CIO, I am really delighted we are at the stage of publishing [the guidance] because I think it’s my role to provide that leadership and ensure we’re helping and inspiring local leaders and boards on their digital transformation journeys,” Patel added.

“We’re at a point in time where there’s greater appetite for using digital and data as we’ve seen through the pandemic, and a real appetite to take that forward into the future.”

Patel hopes the guidance is “supportive and meaningful”, not just for digital leaders, but for entire NHS boards and stressed there will be “room for improvement” in the coming years as NHSX works with local organisations to develop the framework.

Feedback from stakeholders during the development of the framework suggested digital transformation was often well understood by digital leaders, such as clinical information officers, but not across the board.

“If we’re going to take the digital and data journey that we need to then the full board needs to be behind it, right from the top including our CEOs and chairs,” Patel said.

The next generation Digital Maturity Assessment

Trusts and other NHS organisations will be assessed against the What Good Looks Like guidance to help “identify their gaps and prioritise areas for investment and improvement”, according to a statement from NHSX.

It’s the first confirmation NHS organisations will be assessed on their digital capabilities since the Digital Maturity Assessments were launched.

“This is the new digital maturity assessment for the NHS and later this year we will also be looking at developing a similar framework for the care sector too,” Patel told Digital Health News.

“The reason this is our next generation of the digital maturity assessment is it is a much more rounded assessment, it’s not just measuring the tech but most importantly it’s also considering the culture, the people, the skills and the processes that are required to support good digital and data transformation.

“We are largely considering peer review assessments which will take a level of subjectivity… They’re a learning experience both for the assessors and those who are being assessed so we are likely to take a peer assessment approach to this as well as taking a quantitative assessment which we could validate against the information we hold on organisations.”

The Digital Maturity Assessment (DMA) was used as part of the evaluation process for the Safer Hospitals, Safer Wards programme, as well as the Global Digital Exemplar (GDE) Programme.

The assessments were designed to rate trusts on their digital maturity, help them identify gaps where improvement was needed and provide a blueprint for GDE fast follower trusts to aim for, but in recent years the assessment has fallen by the wayside.

Instead, NHSX had turned its focus on upskilling NHS organisations that weren’t performing as well digitally through the Digital Aspirant programme, with the second cohort of the programme being announced exclusively at Digital Health Rewired 2021.

Who Pays for What?

Alongside the What Good Looks Like guidance, NHSX has published a proposal for ‘Who Pays for What’, which aims to set out a clearer division of responsibility for technology funding.

The organisation said it was “simplifying” the financial process this year by bringing together multiple existing funding pots into one application process in a bid to make it easier for local organisations to bid, and for central bodies to ensure funding is allocated fairly.

In the future it’s planned money will move away from national funding programmes, with funding for local technology spend allocated to ICSs.

“It’s really important that we go on this partnership journey together to ensure that digital and data becomes business as usual but also that we have the capacity to work together to support further innovation and drive out further benefits,” Patel said.

In early 2020, Digital Health News reported that NHSX was working with NHS providers to determine if a minimum technology spend should be mandated, and what the level of funding should be in order to achieve full use of digital technology in the NHS by 2024.

Patel confirmed NHSX was still considering the ability to define an “optimal spend” for digital and data, adding that the two frameworks published today could help “determine baseline information” for what an optimal spend might look like.

Matthew Gould, chief executive of NHSX, said: “These two documents will give frontline leaders the essential guidance they need to plan their digital transformation. They set out what they should be driving towards, and how they will need to pay for it.

“They have been produced following extensive consultations with the frontline, and will continue to change as we get more feedback. They are designed to be helpful, empowering and clear.”

In January Digital Health Unplugged published an episode exploring ‘What does good look like?’. You can listen to the podcast, and it’s expert panel, here or on Spotify, Apple Podcasts or your favourite podcast channel.