The need to improve services while cutting costs is a major challenge for NHS organisations. In the commercial world, many firms have successfully used big data analytics to achieve the same goals through improved decision-making and tightly targeted investments. NHS organisation certainly have the necessary data, but they are typically constrained by the size, age and complexity of their data estates. This brief outlines the challenges and opportunities, and presents a potential solution.
Focusing on data
Data has long been seen as a key source of competitive advantage in the commercial world. The public sector is equally aware that data – when properly exploited – can transform operations and boost efficiency. However, public bodies typically face greater barriers in moving from awareness to action.
Clearly, public bodies possess huge volumes of valuable data on services, assets, citizens, finances and more besides. For NHS organisations, the data also extends to encompass a wealth of personal information about healthcare. If this data could be made accessible – with the appropriate level of security – to employees and other stakeholders, the benefits in terms of cost savings and service improvements would potentially be enormous. In an age of austerity, the promise of unlocking the value of data to improve efficiency and enable new capabilities is naturally very attractive.
As early as 2013, central government outlined its “Digital by Default” strategy in a Cabinet Office policy paper, calling on public service bodies to transition to a digital, data-driven approach for service delivery. Elsewhere, the House of Commons Science and Technology Committee has estimated that the NHS could achieve anything from £16 billion to £66 billion in cost savings through big data analytics. [House of Commons Science and Technology Committee – The big data dilemma – Fourth Report of Session 2015-16: www.publications.parliament.uk]
These central government policies are clearly reflected in the broader public sector: the techUK 2015 Civil Servants Survey found that senior leaders overwhelming see big data – and their ability to analyse it – as the single most important level for improving efficiency. Nevertheless, the same survey shows that, on average, only 12 percent of organisational data is actually being analysed. [Data drawn from techUK Civil Servants Survey conducted by Dods Research, May 2015 www.techuk.org]
Wealth of opportunities
There are significant benefits in giving decision-makers access to big data and the tools to analyse it. In financial management and reporting, big data analytics can make it much easier to demonstrate the all-important Value for Money, as well as simplifying financial transparency and compliance initiatives. The ability to base decisions about services and staffing on evidence rather than gut feel can significantly improve service quality and efficiency. And being able to understand what services citizens and patients want is invaluable in planning where and how to invest in future digital capabilities.
Obtaining these insights and behaviours depends on bringing together in an enterprise-wide view data that is currently split across multiple silos, and layering self-service business intelligence and analytics tools on top.
Barriers to change
For NHS organisations making the transition to a data-driven, “Digital First” approach, there are a number of potential obstacles to overcome before the expected cost savings and service improvements can be achieved. The most significant of these is likely to be the complexity of the existing data estate.
In many organisations – public and commercial alike – the data estate has grown over the years in a largely uncontrolled manner as new requirements and digital technologies have emerged. The lack of a coherent digital strategy over the years will have contributed to a sprawling mix of different systems, each in its own silo and potentially with its own unique technology stack. The software and hardware present in the data estate may be outdated, and potentially unknown dependencies between critical applications may contribute to the sense that the problem is too risky to fix. There may be a lack of clarity over software licensing, and the perceived effort and skills required to understand the costs and benefits of upgrading increase the temptation to keep things as they are.
For today’s digital operations, these challenges imply higher support and management costs, lower efficiency, potential compliance and data-security issues, and ongoing difficulty in delivering actionable insights to the business. They also imply that the data estate will not have the necessary migration, integration, performance, scalability and security to meet the needs of tomorrow’s data-driven organisation – particularly as the age of personalised medicine dawns.
Of course, recognising that the data estate is no longer fit for purpose is just the first step. Setting out to transform it highlights another potential barrier for public sector organisations: the skills gap. Data estate modernisation is far from simple – it demands careful assessment, planning, design, architecting, and execution. Internal NHS IT personnel may well have deep and well-developed skills in managing and maintaining the existing data estate, but this does not necessarily mean they have the skills to migrate to a new one.
Given budgetary limitations, NHS organisations are unlikely to have the luxury of a “big bang” digital transformation. Rather than being able to start from a blank sheet of paper and build a best-of-breed data estate, they will need to assess the resources they already have in place and determine how best to knit them into a fit-for-purpose solution for the future. In many cases, targeted upgrades of critical software can have an immediate transformative effect, particularly where the software in question is out-dated. For example, benchmarks show that Microsoft SQL Server 2014 is 13 times faster than its 2005 counterpart. A carefully planned upgrade programme could therefore enable significantly higher workload density on existing infrastructure, cutting licensing, management and maintenance costs. More important, it could provide the performance and availability boost required to deliver more effective decision-support tools to the business.
As previously noted, adapting the existing data estate and making the best possible use of past investments may require skills that are not readily available internally. Equally, engaging an external consultancy to perform a full digital transformation exercise is potentially risky and almost certainly unacceptable from a budgetary standpoint.
Bridging the skills gap in an economically viable way, the Northdoor SQL Server Advisory Service is designed to help public sector organisations understand the digital migration options and make the best decisions. Starting from a full review of the existing data estate, the Northdoor migration solution provides a comprehensive analysis of the gaps and what needs to be done to close them. Armed with clear recommendations, the internal team can then start the digital transition process in a controlled and efficient way.