Our Inclusive Digital Transformation Discovery Journey (so far…)
Inclusive Digital Transformation Week is an initiative we are running from Monday 07 to Friday 11 March. The aim of the week is to facilitate the sharing of our assets, learning and stories to inspire change and help embed inclusive digital transformation.
The turning point
On 16 March 2020, the Prime Minister announced;
‘‘ ...now is the time for everyone to stop non-essential contact with others and to stop all unnecessary travel. We need people to start working from home where they possibly can.’’
I remember that day very clearly. Like everyone, our team was in shock. I had only just taken up the managing director role, there were others in the team who were also very new and despite being a digital team all our services were delivered offline.
We met online for the first time, mobilised our remote workspaces and agreed some new ways of working. We also took this opportunity to revisit our purpose and values, asking ourselves what we were best placed to contribute to health and care in this changing world. As a result, we pivoted our mission to focus on tackling inequalities through digital innovation and ensuring we (the system) do not compound pre-existing inequalities by the digital transformation of health and care.
The emphasis on tackling inequalities was driven by what was happening in the world around us and a commitment to the principles of the NHS enshrined in the NHS constitution; ‘a comprehensive services available to ALL’. As the pandemic took a hold and health and care services and wider society went ‘online’, the ‘digital divide’ became stark and it was clear that pre-existing health inequalities were being exacerbated by both COVID-19 and digital exclusion. Our concern was that the over 10 million people who are not able to easily use digital and who are likely to be in the groups (e.g. older, living with disabilities, living in poverty) that most need health and care services were being left out and left behind in many different aspects of life. We have tried to capture this social challenge in our digital health equity animation.
Digital Inequity in Health
Discovery
Recognising that digital exclusion is the result of a complex and ever changing set of factors, rather than focusing specifically on individuals we wanted to understand more about how to change the whole system to be more inclusive. This is articulated brilliantly by the quote from Alexander Den Heijer;
“When a flower doesn't bloom, you fix the environment in which it grows, not the flower”.
In the summer of 2020 we started inviting people to join us on a discovery journey to explore how to co-design inclusion into digital transformation. We began working with Paul Rice and the North East and Yorkshire NHS England region and Dawn Greaves and the three integrated care systems across Yorkshire and Humber. We explored inclusive and exclusive factors around specific remote monitoring tools, we co-designed a digital inclusion blueprint for integrated care systems, we developed a learning programme and we set up a repository on the FutureNHS workspace to share all the valuable resources, tools and insights we were gathering along the way.
We spent the next few months investigating different aspects of the Inclusive Digital Transformation jigsaw including mapping out the current picture at an Integrated Care System level on behalf of NHSX and working with Professor Trish Greenhalgh and her brilliant team on what inclusive remote video consultation looks like.
By the end of 2020/21 we were beginning to identify some key factors for inclusive digital transformation so we put together a prototype ‘canvas’ and headed into the next year aiming to test and develop a deeper picture with a small number of organisations and ICSs.
Deep Diving
In 2021/22 we have joined forces with Sarah Boyd and the Norfolk and Waveney Integrated Care System, Alexis Farrow at Connected Nottingham, Jenny Mason and Cheshire and Merseyside Integrated Care System and our own host Trust, Leeds and York Partnership NHS Foundation Trust. With these partners we have been deep diving into different aspects of Inclusive Digital Transformation, looking at strategy, cross sector partnership working, needs and asset mapping and working with more excluded groups, more disadvantaged areas and specific services.
We also worked with the NHS Confederation to develop a workforce digital skills guide, NHS England and Improvement’s digital mental health policy team to investigate inclusive digital transformation from a mental health perspective and NHS England nd Improvement’s health inequalities and transformation teams on the digital health inequality pioneers programme.
Synthesis
After much research and activity, although we recognise there is still much more to learn, we now have a more comprehensive understanding of what good inclusive digital transformation looks like. There are good practice case studies, top tips, and much more on our FutureNHS workspace. We will be releasing all our research and insight reports, tools, guides and more over the coming weeks and months with the aim of influencing and enabling Inclusive Digital Transformation of health and care services.
We have consolidated our learning into a simple canvas graphic showing the eleven factors of what good Inclusive Digital Transformation looks like:
Figure one: Inclusive Digital Transformation Canvas
Strategic Alignment: Inclusion is embedded into wider strategies.
Leadership: Senior leadership are championing inclusive digital transformation.
Sustainable Funding: Inclusion is properly resourced, moving away from short term project funding. (Some of our research has suggested a 10% top slice of all digital transformation funding.)
Digital Technology Infrastructure: Basic digital technology infrastructure is in place and working.
Population Health Needs: There is a granular understanding of digital exclusion in order to focus limited resources.
Strength Based Approach: There is recognition and mapping of the valuable assets and energy for change in people and communities.
Partnership: Digital exclusion is being addressed as a complex system issue in partnership with all the cross sector stakeholders pooling knowledge and resources.
Co-Design and Co-Production: There is authentic co-design and co-production with people who have living and learnt experience which will result in better solutions and engagement.
Local People and User Motivation, Capacity and Capability: There are digital inclusion activities to help build skills, confidence and motivation, which is one part of the picture.
Staff Motivation, Capacity and Capability and Ways of Working: Digital exclusion within organisations as well as the wider population is recognised and being addressed.
Use of Good Practice, Learning and Continuous Learning: Resources, experiences and ideas are being shared and there is an understanding that the context is rapidly changing and is different across the country and recognition that there is no quick fix means it is important to take a continuous improvement approach.
We have also been testing out a prototype self-assessment tool with the digital health inequality pioneers and have further developed our learning programme and our associate network of specialists Inclusive Digital Transformation coaches. Watch this space!
Launching Today
Inclusive Digital Transformation Tool: Today we are sharing our new visual canvas tool, which you can download, highlighting the eleven factors of what good inclusive digital transformation across health and care systems looks like.
Digital Health Equity: We are also glad to be sharing with you our brand new animation based on our research around digital health inequity explaining why it is an integral part of health inequity, the causes and factors of digital health inequity and why it is a complex and system design issue.
Fireside Chats
As part of Inclusive Digital Transformation Week we are hosting a series of fireside chats with our team.
Roz Davies Fireside Chat for Inclusive Digital Transformation Week.
Join nearly 300 people from a diverse range of backgrounds and places on our Inclusive Digital Transformation Challenge community on FutureNHS.
To find out more about our work email us on info@thrivebydesign.org and follow us on Twitter @TweetsByThrive.