What should board members be doing to support digital transformation?

My other, non-Public Digital hat, is sitting on the University of Exeter’s Council as an independent member. One of the interesting things about being a non-executive at this incredibly strange time is not just seeing the balance of conversation shift from the physical world to the digital, but seeing everyone on the board take much more ownership of the digital agenda; from finance to teaching to communications.

Digital transformation is a team sport. If it’s going to succeed, it needs a board to take collective responsibility.

The NHS is even more on the frontline of coronavirus than further education. Since the spring we’ve been working with NHS Providers, Health Education England, and NHSX on Digital Boards, a 3-year programme to support boards of NHS trusts in delivering their digital agenda. We’re helping to produce a set of resources, and running bespoke development sessions for individual NHS trust boards. While the pandemic may have dialled up the urgency of those conversations, the messages remain similar.

Driving digital change – any change – requires diversity in every layer of an organisation, but especially board level. This is true both in terms of visible representation, and of different perspectives, experiences and incentives. Lean too hard on one part of an organisation’s executive to take responsibility for change, and you’re more likely to end up with blind spots, bias and conflict.

The trust development sessions are conversations that are designed to involve the whole board. As we say in our first guide, board members should be concerned if they perceive that conversation about progress on digital is being led entirely by one particular tribe within their organisation. Often this will be the IT team, but the over-dominance of any area, be it strategy, IT, finance or clinical – should be good grounds for asking questions. If any one senior executive sees digital as someone else’s problem, it very quickly becomes a problem for everyone else.

Every board member has a role to play in driving transformation, but what specifically should each be doing? To support board level conversations, we have worked with NHS Providers to produce a reference guide for the questions we think board members should be asking themselves. This isn’t a complete list. But we hope it gives executives and non-executives a place to start from.

If you’re a board member in an NHS trust or elsewhere and have views on these, we’d love to hear from you.

The guide

Contents of the reference guide for boards:

  • As chair am I facilitating board discussions about potential new digital developments? Is there a culture of challenge on this topic? Does the board spend sufficient time on the relationship between digital transformation and the trust’s aims?
  • As chief executive can I confidently articulate what digital transformation means for my trust? Am I confident my senior leadership team has the capability and experience for this change, and sufficient curiosity to learn any new skills needed to drive it?
  • As company secretary am I confident that the format, and artefacts presented to board meetings allow members to properly scrutinise progress? Is the rhythm and frequency of governance conducive to successful agile delivery?
  • As finance director am I confident that the trust’s financial processes provide a proportionate attitude to risk and benefit? Am I clear on which benefits are cash-releasing and which are qualitative, and are there appropriate processes in place to track both? Has the trust considered the future revenue implications of capital investment?
  • As strategy director am I clear how our digital ambitions integrate with the organisation’s overall strategy? Are our digital ambitions appropriately aligned across our system with both NHS, social care and voluntary sector partners?
  • As transformation director do I think the organisation can clearly articulate how digital and change management intersect? Do I know what barriers exist to the organisation making a cultural shift to support the acceleration of digital transformation?
  • As medical or nursing director can I confidently and authentically articulate how digital transformation supports care quality and patient experience? Am I confident clinicians are engaged with and supportive of the organisation’s digital agenda?
  • As chief operating officer, do I know what the biggest pain points for new ways of working currently are? Am I confident that internal trust processes are not blocking agile, iterative delivery? Can I demonstrate the value of digital ways of working?
  • As chief information officer or chief clinical information officer, am I spending most of my time talking about IT infrastructure or service delivery and transformation? Is my role perceived as being one of vendor management or genuine leadership in digital transformation?
  • As human resources director am I confident the trust can attract, recruit and retain staff with digital skills, while developing the existing workforce to adapt to digital?
  • As a non-executive member am I convinced that the trust has a clear set of priorities within its digital agenda? Am I more experienced in digital than executives, and if so, how do I support them?

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