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NHS digital reorganisation: start by working in the open

The Department of Health and Social Care announced yesterday that NHS Digital and NHSX will be folded into NHS England. We have seen these kinds of reorganisations many times before, including in the NHS. All too often they are distracting, dispiriting and don’t deliver the intended benefits.

But that doesn’t have to be the case - providing you get off on the right foot. The reorganisation is not the story. What you do afterwards is.

We don't know all the internal mechanics of the NHS. But based on what we do know, here are our suggestions for using this transition to build trust and continue the momentum gained during the pandemic.

  1. Work in the open by default. Start by publishing the names of who’s in charge, and what they’re responsible for.

  2. Make an unambiguous, technically literate statement explaining what this means for patient data.

  3. Deploy expert multidisciplinary teams (design, technology, clinical, operations) at all levels of decision making and delivery. Make the most of NHS Digital’s specialist capability in design and technology.

  4. Explain which platforms are needed across the NHS, based on a thorough look at what exists now.

  5. Show how this organisation change is meaningful by delivering something quick, visible and helpful to the system as a truly joint team. Such as an MVP platform for ICS websites, or new clinical calculation APIs, by next April.

  6. Use the practice of working in the open to manage dependencies and duplication, instead of relying on spreadsheets held by Programme Management Offices. Get senior leaders to publish weeknotes.

  7. Fix corporate basics to reduce friction for staff: make the website clear, put everyone on the same email system and directory, modernise the most important internal tools.

  8. Do less so you can deliver more. Use the change to stop doing what is no longer needed or isn't delivering value.

Most important of all - don’t let this distract from the core mission of making the NHS better for everyone. We need it, especially this winter.

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