£250m for NHS technology, but where are the staff to deliver it?

There is clearly an opportunity for technology to produce tangible productivity gains for the NHS, writes Romy Hughes, but reservations remain about the effectiveness of the plan

Towards the end of 2021 the government announced it would provide nearly £250 million to the NHS to modernise diagnostics technology. According to the official government press release, ‘the NHS will receive £248 million over the next year to invest in technology that will deliver more diagnostic tests, checks and scans to help provide faster diagnosis of a health condition, earlier treatment and reduce waiting lists’.

The announcement was framed in the broader context of the government’s plan to tackle waiting lists and speed up routine treatments as the NHS tackles the backlog of patients that have built up during the pandemic. Something that is clearly a priority for the country as a whole. What’s more, with one third of NHS trusts reportedly still being largely paper-based, according to evidence given to the House of Commons Health and Social Care Committee, the opportunity for technology to produce tangible productivity gains is certainly there. So, what’s not to like? There is one glaring issue with this announcement. Where are the people who can actually deliver this technology into NHS trusts? Technology alone doesn’t create innovation and efficiencies; you also need the people to deliver the technology, time to train the staff to use it, and most importantly of all – you need to ensure your staff want the new systems in the first place.

These challenges are compounded by the current supply and demand situation; every government department is investing in digital transformation and there aren’t enough people to deliver them all. This has resulted in bidding wars and shortages for skills at every level. It is a consultant’s market right now; they can pick and choose the assignments they want. Even the private sector, which is generally further along its digital transformation efforts already, is struggling to recruit the skills it needs.

It is not uncommon to see consultants increasing their prices by 10 per cent compared with last year. While some of this can be attributed to the recent IR35 changes, I suspect the surge in demand is the bigger factor at play here.

Bring me solutions, not problems
If the government is committed to delivering its transformation programmes then solutions need to be found. While there is little it can do to control the global surge in demand for digital expertise, there are things it can do to affect the supply available to it in the UK economy.

In the short term, it can relax the pressure by re-prioritising existing and pending projects, and potentially extending the timescales on projects that are already underway. The timescales of public sector IT projects have a chequered history of being overly ambitious to begin with, so these extensions might be necessary anyway – if anything to reduce the strain on those tasked with delivering them in today’s challenging market. This breathing space might afford the public sector some much-needed time to re-evaluate the realism of these projects, while helping staff to adjust and support the transition. These are not short-term projects either – they’re multi-decade transformations which require significant skills and expertise to deliver over a long period of time, so they need to be treated differently to more traditional projects.

We can expect this skills shortage to last for some time to come, so the sooner that expectations are brought into line the better to avoid disappointment and unnecessary strain on those delivering them. In addition to relaxing expectations, the government should consider policies to boost the supply of labour in the short and long term. In the short term this could be about relaxing immigration rules to bring in the skills we need. While the demand is global in nature, the UK remains an attractive place to work, so this would help to bridge the gap in the short-term. Longer-term there needs to be significant investment in digital skills, particularly in secondary and higher education. This is about more than teaching kids to code, but complementary skills like project management, collaboration, creativity etc.

The last ‘solution’, if you can call it that, is less policy and more an acceptance of reality, is to simply pay more for digital transformation. There is no getting around the fact that costs have gone up, so, if the UK is serious about maintaining its competitiveness on the world stage, budgets need to rise too.

No Silver Bullet
Ultimately the biggest question when it comes to digital transformation of the public sector can be summarised as ‘Where are all the people going to come from?’ Immigration really is the only short-term solution to the supply issue, but with digital transformation skills in demand all across the globe, even this isn’t a silver bullet. Longer term we need to develop more of our own skills, and we need to get started now. More realistic timescales would help to better manage expectations, budgets and help staff to adjust and support the transitions currently underway. The government also needs to recognise that these projects won’t be delivered quickly, no matter how many people it throws at them.

Romy Hughes is director of Brightman.

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