Policy paper

DH digital strategy update: 2014 to 2015

Published 10 October 2014

This was published under the 2010 to 2015 Conservative and Liberal Democrat coalition government

© Crown copyright 2014

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Statement of intent

The Department of Health is a digital first organisation, leading a digital first health and care system. Over the last year, we have done much to turn this statement from an aspiration to a reality. But there is more to do.

The work that we described in the 2013 to 2014 digital strategy has helped to transform DH into a more digital department of state: from an organisation in which digital solutions were regarded as being of peripheral importance, to an organisation with a proven track record of using a digital approach to address some of its most pressing issues.

Our digital work is already helping us to innovate and think beyond our established ways of working, enabling us to find better, quicker, cheaper solutions to problems. But it is also giving us the confidence to look ahead and plan for a more connected, more digital future.

The use of new technologies, enabled by the internet, is growing in all areas of society. As the leaders of the nation’s health and care we need to harness these technologies to improve outcomes for patients, users of care services and the general public.

The exemplar projects we delivered as part of our 2013 to 2014 strategy have demonstrated how a more open, more nimble, more digital mindset can help the department save time and money, help staff work smarter, and ultimately help the department to develop and deliver more effective policy for the country’s health and care.

Our strategy for the next year is to build on what we have already achieved, moving from ‘proof of concept’ to ‘delivery at scale’.

By taking a digital first approach to our work we will strive to make time and cost savings across all of the department’s work, help our staff to work smarter routinely, and lead an increasingly digital health and care system with credibility and confidence.

In 2014 to 2015 we will concentrate on delivering work in the department and across the health and care system that addresses 5 big themes:

  1. openness
  2. simplicity
  3. evidence
  4. mainstream
  5. efficiency

1. Openness: conducting our work in the spirit of openness

A common culture of serving and protecting patients and of rooting out poor practice will not spread throughout the system without insisting on openness, transparency and candour everywhere in it.

Robert Francis, Mid Staffordshire NHS Foundation Trust Public Inquiry, 2013

1.1 Our strategy

Our strategy for the next year is to make digital both the channel for increasing departmental openness, and a guiding principle for the way we conduct our work.

1.2 Why this matters

The internet, and digital culture by its nature, enables greater transparency. It is now easier than ever to publish information, share data and work collaboratively and in the open.

There are huge potential benefits to working more openly. Our policy development work will often benefit from more, better informed, members of the public being involved in the process. We make better policy when more people contribute ideas and feedback, providing a constructive challenge to our work.

With greater access to data and information, people will be able to take a more informed view of the work of the department, and make better informed decisions about their own health and care.

1.3 What we will do

The department is committed to greater transparency in order to better protect patients and users of care services, and drive up standards.

We will use digital techniques to encourage people to get involved in our work. And we will make it easy for others to make use of our information and data.

We will conduct our work openly, unless there is a good reason not to, rather than the other way round. Working in the spirit of openness means doing more than meeting our transparency obligations. It means:

  • using our creativity to think beyond releasing data and publishing online consultations
  • putting the effort into meeting the needs of people who might benefit from greater access to our work
  • learning from the methods of those who motivate our audiences to voice their opinions en masse about health and care policy

1.4 Examples from last year include:

1.5 This also relates to:

2. Simplicity: making things easy

A complex system that works is invariably found to have evolved from a simple system that worked. The inverse proposition also appears to be true. A complex system designed from scratch never works and cannot be made to work. You have to start over beginning with a working simple system.

John Gall, Systemantics: How Systems Really Work and How They Fail, 1978

2.1 Our strategy

Our strategy for the next year is to use a more digital mindset, and digital tools and processes, to help make our processes and products as easy as possible to use for everyone who uses them.

2.2 Why this matters

The health and care system is complex. It can feel difficult to navigate and use with so many different people and organisations involved.

Rethinking and redesigning services to take advantage of the opportunities that the internet and digital culture provide can dramatically simplify processes for those involved.

Delivered well, digital services save people time, simplifying tasks and removing friction from the processes. The 25 exemplar services identified by the Government Digital Service are showing how complex, state-provided services can be radically simplified for the end user.

These services have tended to be fully redesigned for the benefit of those using them, rather than just be digitised versions of existing services.

In an increasingly networked world, successfully simplified services usually benefit from a “digital first” approach in their design, with provision included for those who do not have direct access to the internet.

2.3 What we will do

We will take a digital first, simplicity first, approach to services that the department is responsible for, whether high volume transactional services for patients, or internal services for small groups of staff.

We will demonstrate how digital first services can actually increase access to people previously excluded from access to government services. We will design services with a less digitally confident audience in mind, helping to reduce the digital literacy gap.

We will put the extra effort in to make sure everything we do makes things simpler for our end users. That includes applying this mindset to the ways we work within the department, the processes that we are responsible for, the products that we deliver, and the way we talk about them.

When organisations within the health and care system need to join up to provide a digital service, we see it as our responsibility to ensure the aims, the process and the outcome all serve their intended audience as effectively and simply as possible.

2.4 Examples from last year

2.5 This relates to:

3. Evidence: making consistently well-informed decisions

There is a magic in graphs. The profile of a curve reveals in a flash a whole situation - the life history of an epidemic, a panic, or an era of prosperity.

Henry D Hubbard, foreword to Graphic Presentation, 1939

3.1 Our strategy

Our strategy for the next year is to use digital evidence and insight systematically to help make better informed decisions across all of the department’s work.

3.2 Why this matters

Pervasive digital culture provides us with new sources of insight about how people behave that we can use to inform decision making, in ways that are usually faster and sometimes more sophisticated than other analytics or research techniques. A more digital mindset, with a focus on using data to continuously improve services and processes based on evidence, will enable the department to work more nimbly.

Working more nimbly, guided by evidence, will sometimes mean acknowledging when things haven’t worked as planned, changing course more often, working to different timescales and adapting our working practices and business processes accordingly in order to get the best result.

3.3 What we will do

We will provide staff in the department with greater access to sources of digital insight and evidence, supported by the skills and confidence to use them to help with their work.

We will provide products that enable officials to access and use the sources of data they need in order to make the best informed decisions about their work. And by providing them digitally, designed specifically to meet the needs of those using them, we will also ensure that they are pleasing and straightforward to use.

We will use digital insight to better target our work where it is likely to have greatest impact. We will discriminate more, relying more on hard evidence and less on intuition.

3.4 Examples from last year

3.5 This relates to:

  • Health and care citizen insight network [internal community]
  • DH communications strategy [internal document]
  • DH policy improvement plan [internal document]

4. Mainstream: having the confidence and experience to innovate again and again

Central Government wherever possible must become a digital organisation.

Francis Maude, forward to the Civil Service Reform Plan

4.1 Our strategy

Our strategy for the next year is to make digital innovation less extraordinary.

4.2 Why this matters

The internet is now so ubiquitous that in a modern workforce everyone needs digital skills and the confidence to use them, appropriate to their role.

And when digital, internet-enabled solutions have provided demonstrably better results, we see them becoming the default solutions, replacing less efficient, analogue methods.

4.3 What we will do

We need to enhance the specialist capability of those in technology roles in the department and across the health and care system.

But technology leaders should not have the monopoly on digital delivery. In the department, a small digital team will lead our exemplar digital strategy work, but all staff will be responsible for mainstreaming digital activity.

The department will scale up its digital capability programme, extending some of its current departmental digital champions work to our arm’s length bodies.

And we will lead work to normalise some of our more innovative digital solutions. That will mean providing some out-of-the box solutions that can be reused again and again, enabling innovation to be repeated and shared across the department, across the system, and across government.

The department and its digital team will lead exemplar projects, improve business processes, and catalyse change in the department and across the system. But ultimately digital solutions will become routine, and our staff will stop noticing they are doing digital work at all.

4.4 Examples from last year:

4.5 This relates to:

5. Efficiency: saving time and money

Thinking like a patient, acting like a taxpayer

Simon Stevens, CEO NHS England, speech to NHS Confederation, 2014

5.1 Our strategy

Our strategy for the next year is to use digital solutions to save people time, and save government money.

5.2 Why this matters

The department will be smaller this year than last, with tighter financial constraints. We need to think smarter about how we use our limited resources.

By investing in our capability and capacity to do digital work, we will save taxpayers’ money. On average, the exemplar projects from the 2013 to 2014 digital strategy saved 80% of their original projected budget. Some saved 99% of the cost of alternative solutions.

Internally, for every minute of time wasted by a member of staff due to an inefficient process, we lose the equivalent of 41p in lost productivity (based on average cost of employing civil servants in the Department of Health). By redesigning services and processes we can reclaim some of those lost minutes and pennies. And when we do this across the health and care system, we can drive up productivity at scale.

5.3 What we will do

We will scale-up our work within the department beyond a narrow set of exemplars, cumulatively saving the department significant sums of money.

We will also save staff time by redesigning services and simplifying processes. And we will provide faster, better services for patients and the other end-users of our digital solutions.

We will build reusable platforms and frameworks, and encourage greater joint working across the system, identifying opportunities to reuse internal expertise and already-built tools to save money and time. And by doing this, we will lead a system that can innovate more quickly and cheaply than has felt possible before.

And through the department’s role as the steward of the health and care system, including our role in financial controls, we will ensure that digital development work is delivered as efficiently as possible, making best use of resources, as well as always being for the benefit of the end user.

5.4 Examples from last year

5.5 This relates to:

6. A note on stewardship: applying these principles to the health and care system

DH is becoming a more balanced organisation that acts as a steward for the health and care system as a whole.

Una O’Brien, Permanent Secretary, Department of Health, interview with Civil Service World

The Department of Health is accountable for the health and care system. Responsibility for delivery in the system is devolved to others, but the department leads overall policy and strategy.

The department leads on the channel strategy for health and care, and the governance of digital work across the health and care system, working closely with NHS England, Public Health England and others.

Our channel strategy is simple:

  • the department sets standards, and is ultimately accountable for digital work in the health and care system, in line with the themes of this digital strategy
  • NHS Choices is currently the flagship citizen-facing digital channel for health and care, and the department is helping to shape its successor, working with NHS England, the Health and Care Information Centre and others
  • corporate digital channels for the department and our arm’s-length bodies should sit either on GOV.UK or nhs.uk by default
  • digital development work by the department and our arm’s length bodies is subject to the Digital by Default Service Standard and associated controls to ensure measurable benefits to end-users, consistency and value for money

6.1 This relates to:

7. How we do it

The Department of Health digital team are responsible for the successful delivery of the digital strategy, working with colleagues across the health and care system. The team will lead programmes of work that address the five themes of this strategy. The digital team operates in 3 ways:

  • advisory: helping colleagues make the best decisions about digital approaches, aligned to this strategy and best practice
  • building capability: helping to develop digital skills and confidence, in order to mainstream digital practice in the department and across the health and care system
  • strategic delivery: hands-on delivery of the projects that only the digital team can deliver

The digital team practice what they preach, applying the principles described in this strategy to their own working practices. For example by working openly, providing simplified services and processes, making decisions based on evidence, and designing for continuous improvement.

If this digital strategy is successful, there will be more demand for digital work than there is capacity in the departmental digital team to deliver it. The digital team will relentlessly and continuously prioritise their work following clear criteria, leading programmes of priority work, with open and regular reporting of progress.

7.1 This relates to

7.2 Examples from last year:

7.3 Vulnerable Older People’s Plan

We ran a digital engagement exercise to gather views on the Vulnerable older people’s plan. The work followed the principles of open policymaking. The work included providing a commentable platform for gathering feedback on the themes of the plan, digital outreach by DH policy officials to target audience groups, and a set-piece discussion with the #wenurses community.

More: Are twitter chats effective?

7.4 Dementia G8

We used digital techniques to run an open G8 summit on dementia. Activity included: an open consultation on the themes of the summit, data visualisation of dementia diagnosis rates, multimedia case studies, live coverage of the summit including video coverage of the whole day and social media commentary.

More: Evaluating our digital coverage

7.5 Adult Social Care Outcomes Framework

Working with the Health and Social Care Information Centre we published data from the Adult Social Care Outcomes Framework mapped by region and other filters, making existing data more convenient to use.

More: Adult Social Care Outcomes Framework

7.6 Connecting

We created a digital method for collecting, analysing and sharing staff experiences from our Connecting programme. The tools enabled staff to share feedback from their frontline experience quickly and easily.

More: Connecting programme

7.7 Simplifying controls

We simplified and documented the processes for navigating the digital spending controls so that staff in the department and our arm’s length bodies understood the process better, and could spend less time thinking about the paperwork, and more time thinking about how to deliver brilliant digital services.

More: Digital spending controls

7.8 Francis inquiry publication

We published the Government response to the Mid Staffordshire NHS Foundation Trust public inquiry as a digital publication. The site was designed to be easily navigable, enabling users to search, filter and sort a complex document by recommendation, policy, theme or audience group. It set a new standard for publishing departmental information in ways designed to meet the needs of our audience.

More: Mid Staffordshire NHS Foundation Trust public inquiry

7.9 Clear English

We established a programme of work to promote the use of clear English in the department. Clear English is embedded within our Policy Improvement Plan, and all DH officials are now encouraged to take a one day clear English course as part of our Policy Certificate, supported by online resources and a large-scale awareness and training programme for all staff.

More: Clear English at Work

7.10 Monitoring dashboards

We produced prototype dashboards for reporting on real time digital activity and social media conversations.The dashboards aggregated multiple sources of insight, presenting them together in a pleasing formats, and they were used by policy and communications teams working on dementia policy and winter planning to inform their work.

More: Performance reporting dashboards

7.11 Leadership coaching

We run executive digital coaching sessions for the DH leadership team. The programme involved initial workshops with privates offices to help plan sessions, followed by six half hour bespoke 1 on 1 coaching sessions over six months. The sessions covered for example: product development, social media, mass mobilisation, open policymaking, data, and online audience behaviour.

More: What makes a digital civil servant?

7.12 Communications capability

We ran a programme of activity to increase the digital capability of the DH communications division. The work included: running digital skills workshops with communications team, providing social media surgeries, piloting an ongoing in depth coaching approach with a cohort of 8 staff. The results included a 15% increase in digital confidence amongst DH press officers.

7.13 Digital champions

We created a network of 70 digital champions from teams around the department. The champions are all in non-digital roles, and are responsible for helping to mainstream digital skills in the department. We ran a summit for our champions, and are working with them to provide tools and resources to help scale-up digital capability in the department.

More: Digital champions - building capability across the department

7.14 ALB digital leaders network

We created a network for digital leaders in each of the arm’s length bodies of the department. The network meets bimonthly to share best practice and discuss system-wide issues affecting the digital agenda in the health and care system. Policy making toolkit

We developed a beta toolkit for policymakers, working with our Policy Improvement team. The toolkit provided guidance on digital techniques that might be used at each stage of the policymaking process. We launched the toolkit at Civil Service Live, and following evaluation, we are now integrating digital advice into a new tool for DH policymakers.

More: Presenting the PolicyKit

7.15 Cost savings on exemplar projects

We saved at least 80% of the projected budget, or 50% of the running costs, for each of the digital products we developed as exemplar projects for our digital strategy during the year.

7.16 Third party tools

We published policy on the used of third party digital tools, encouraging the appropriate use of web tools that aid productivity or provide useful functionality, often at no cost to the department.

More: Use of third party digital tools

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