'Diversity of thought' missing from blueprint projects, says NHS leader

In a major move announced by HSJ today, NHSX plans to merge into a new transformation directorate to combine digital and operational improvement teams within NHS England and NHS Improvement. Although first proposed at a board meeting in January, NHS England is still waiting for full approval from the Treasury and the Department of Health and Social Care (DHSC) to begin the recruitment process. This follows UK health secretary, Matt Hancock launching a blueprint on 11 February which set out plans to reform the NHS and deliver a more joined up health and care system. 

Coinciding with this news, at the UK’s health tech and digital health HETT conference, in collaboration with HIMSS, experts discussed the importance of the NHS sharing mistakes, what components to consider when developing blueprints and why the exclusion of perspectives is a setback in the sector. 

Panellists shared case study examples of various challenges encountered in digital maturity journeys during the session: ‘Difficult Journeys to Digital Maturity Why Learning What Not to do with a Redprint Could be Your Best Route to Successful Transformation.’

The speakers were Toral Thomas, chief clinical officer at Norfolk and Suffolk NHS FT and Sarah Boyd, head of digital experience and transformation at Norfolk and Waveney Health and Care Partnership.


As a way of showcasing industry learnings, the NHS has curated The Global Digital Exemplar (GDE) Blueprinting workstream as part of the national Provider Digitisation Programme.

The blueprints are expected to help other NHS trusts deliver digital capabilities more rapidly and cost-effectively to improve services for patients and staff.

The aim of it is to underscore key components needed for sustainable digital transformation. Focal points include organisational leadership and culture, technical guidance, clinical and staff engagement as well as the people and processes required to deliver the benefits of technology. 


As well as discussing the significance of establishing an effective blueprint system, the panel highlighted the function of redprints within the NHS. Boyd touched on the importance of including feedback from patients and carers into the process: “Exclusion is a big thing. As a system, that’s something that we’re working towards. With the redprinting, what I would love to see is us being able to plan for the future from different lenses.”

However, Boyd admitted that a lot of the time it misses “diversity of thought” and that usually, it is the patient voice that is the missing diversity of thought not factored into projects.  

The panel also concluded that redprinting is a more organic process that is constantly growing. Thomas added: “(…) but that doesn’t mean that the next group of patients, carers aren’t going to have something new that they can add or something that they can share. With this redprint process, you can keep evolving, but it doesn’t have to stay static.”

Reinforcing the importance of sharing redprint learnings and experiences within the NHS, Thomas stated: “We are really passionate about sharing ideas with each other sharing information so that the NHS can stop wasting time, stop wasting money and get the best value and efficiency on large-scale digital products.”

However, Thomas also explained that the lack of transparency has previously been a barrier in learning: “I have started a couple of virtual meetings before, where people have been quite nervous, quite cagey about sharing some of the mistakes that they’ve made or some of the problems they’ve found in products that they’ve purchased.”

In 2019, Matt Hancock, UK health secretary, announced a new ‘digital aspirant’ programme to support NHS providers. Talking about the benefits of establishing and utilising redprints and blueprints in the programme, Boyd said: “In Norfolk and Waveney, we’re currently going through an EPR process. We’ve been looking at a lot of the GDE blueprint information to see what others have done in the past. Through our digital aspirant programme, we’ll be required to create a blueprint of what we’re creating.” In March 2020, the first twenty-three trusts were selected in the first wave of selections for the programme.


Recently, Norfolk and Suffolk NHS FT have implemented patient leaders, a key role that Boyd admitted they are looking to replicate within their sustainable and transformation partnerships: “Having some digital patient leaders so that we’ve always got that voice and that sanity check. And that ability to really have a clear dialogue around what the experience needs to be for future projects.”

Boyd also noted that the sector is very “risk-averse by background”, something which holds back the ability to learn. She also stressed the importance of sharing challenges and mistakes within the sector: “There are other people on their journey that may be on a really similar timeline as you and therefore they could be learning alongside you. They have to just wait for your blueprints to come out at the end, which might be months after you’ve completed.”

Thomas also expressed confidence in the potential of the NHS: “I personally feel more confident because I feel like this is an organisation that is transparent, that is focused on compassionate patient-centred care. I think it’s about time we started sharing our resources and being really open about what’s going well and what’s going badly. We can save time and money and be so much more efficient.”

Boyd added: “It’s just humaneness. If you can show a vulnerability as an organisation that allows such a good foundation for people to be able to trust you and then be able to do more for that organisation.

“Blueprints by nature give a kind of polished view, not a vulnerable view of actually how that the programme went. I think if redprints allowed organisations to show that vulnerability with no consequence, then you’re going to get far greater learning from that.”

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