[00:00:02:02 - 00:00:23:01]
Hi there, I'm Ben Pearce and welcome to the Tech World Human Skills Podcast. Every episode we talk through how to thrive in the tech world, not just survive. Now, if you want me to work with your team, just give me a shout. I love to help teams be more influential, memorable and successful with their stakeholders. Head over to www.techworldhumanskills.com to book a chat.
[00:00:23:01 - 00:01:20:03]
Human Skills Podcast. We have another fine episode for you today and thanks so much for listening. We're talking about a fascinating topic. We're talking about why digital projects fail. Some projects go brilliantly but a lot fail and we're going to dig into why that is and how we can make ours succeed. Now our guest today has a unique and compelling set of data to base his thoughts on. Loads of the NHS digital projects. He's the deputy director of the NHS digital academy and he's got a fantastic perspective to share with us. So please welcome to the show James Freed. James it is brilliant to have you with us. Thank you very much Ben. It is brilliant to be here.
[00:01:21:08 - 00:02:24:13]
(Laughter) Excellent. I'm really excited that you've agreed to come on the show because I saw you speaking at Tech Show London on this topic and really really loved your session and straight away I thought this would be brilliant to get on the podcast. So I was so pleased when you agreed to come on the show. Thank you for asking me. No, no, the pleasure is genuinely all mine. So thank you. Now for all our listeners that weren't at Tech Show London that perhaps don't know you, didn't see the show, could you tell us a bit about your background? Yeah, no worries. I started off as a scientist. I thought I was going to cure cancer. I didn't cure cancer. And it turns out, academic research, not quite for me. So I moved into the NHS. I started using my cancer skills, I suppose, and knowledge on change management. Started off in cancer services, moved into digital around the year 2000ish. I worked for a national organisation called the National Programme for IT, learnt quite a lot about why digital initiatives certainly at scale fail.
[00:02:26:12 - 00:03:10:16]
Did a little bit of time in public health before moving into health education. And so I was the chief digital information officer for an arms-like body called Health Education England for a decade and came to the conclusion that actually the biggest thing that we can do in trying to support digital enablement and digital success is people related, human related. So now I run the NHS Digital Academy. We've been running for about nine years now. And our job is to try and support the NHS workforce to develop the digital skills so that we have as much benefit and actually as little harm as possible from the digital transformations that are being undertaken in the NHS.
[00:03:12:01 - 00:03:17:12]
Brilliant. So years and years working in the NHS. Yeah, yeah, died in the wool.
[00:03:18:21 - 00:03:40:11]
Now I just wonder for our international listeners, could you kind of maybe just give a little bit of background on the scale of the NHS? So that's the UK National Health Service. Little bit on the scale of the NHS. Yeah, no worries. So the National Health Service, we employ about one in 20 of the workers in the UK. So about 5% of the UK workforce, 1.4 million people.
[00:03:42:01 - 00:04:07:17]
We provide everything from secondary care hospital services to specialist services around mental health or cancer to primary care services, you know, general practitioner and all sorts of supporting services, pharmacy, pathology, radiology, you know, all of that sort of stuff around helping people stay as healthy as they can be, but also when they do get poorly, have as good an outcome as they possibly can do.
[00:04:09:16 - 00:04:12:19]
So yeah, quite a lot of people doing quite a lot of things.
[00:04:14:02 - 00:04:51:13]
We've got more than 200 hospital trusts in this country, which I guess rather than a national health service, you might call us the biggest franchise, biggest franchise in the world. Yeah. And the NHS in the UK is the fifth largest organisation in the world based on headcount. Okay, the fifth largest organisation in the world. That is brilliant. And that's that you said what I haven't come across this one in 20 people works in the UK works for the NHS. Yeah, that is ridiculous. And about another one in 20 works in social care. Yeah, so one in 10 in health and care services.
[00:04:52:17 - 00:05:24:13]
Really? That's that's fascinating. So I guess the point is, what we're going to be talking about today is based on huge scale, one of the biggest employers in the world with a tremendous amount of projects going on. Yeah, yeah. But can I ask you this question? Because we hear a lot of bad stuff about the NHS. Yeah. In the press, we hear a lot of bad stuff. So why should our listeners be able to to learn anything from the NHS about digital projects?
[00:05:25:18 - 00:05:44:14]
Well, so fair question. And yeah, let's get this out of the way to start with, shall we? So firstly, the NHS is full of a lot of really talented and passionate people. You know, I used to run a software development team and I asked them why they came and worked for the NHS. It wasn't particularly for the salary.
[00:05:45:17 - 00:06:20:19]
It was because they'd had experience with people close to them using a publicly funded national health service and having a brilliant experience of that service. They felt as if they wanted to give something back. So we've got we've got this sort of this unique attraction to people who have talent and want to give something about there's a huge amount of talent in the NHS. It doesn't mean it's as funded as it needs to be. Right. So lack of funding means you do what you can, where you can. And sometimes it means that perfect digital implementations have their corners cut.
[00:06:22:11 - 00:06:50:01]
But so what I will say is I think there's a tremendous amount of good practice in the NHS that we can learn from. But the other thing I'd say, and actually, I'm going to quote my daughter when she was seven. OK. That's OK. She said, hey, Daddy, when I get things wrong, my brain grows. And I guess what what that meant was that and she was taught it. She didn't you know, she's not didn't come up with that wisdom. She's not confused. You haven't. I've not I've not bred.
[00:06:51:13 - 00:08:28:16]
Yeah, but the next computers, indeed. Yeah. But even were your listeners to think, what possibly can I learn from the NHS? They always fail. We actually learn more from failure than we do from success. And a lot of the data that I'll be talking through with you today will be from some of the failures and near misses that we've had that it's important to learn from and discuss. Yeah. Yeah, yeah, yeah. And and so it's fascinating. What you say there is you've got a lot of people that are tremendously motivated. And I saw on LinkedIn, it flashed up on my feed just the other the other day, actually, by industry, how how people are feel they've got a purpose in their job. And actually, that health and social care was right at the top, you know, where people feel they've got purpose, they make an impact in society, and they're proud of what they do. Actually, tech was a lot further down. And then it moved further down to marketing to sales, you know, to perhaps some of these really affluent and well paid roles. But actually, in terms of aligning to their purpose, it was a long way away from what they felt their purpose was. So you've got these bunch of smart, hyper motivated, purpose oriented people working for you. Yeah, I mean, we're there to save lives. I mean, how much more? Yeah. Purpose can you get? It's true. And it is such an area where people do want to give their role for that end. You know, they all they all believe it. And it is. It's an altruistic endeavor. And it's a vocation of people who can work for the NHS.
[00:08:29:18 - 00:08:47:18]
They do so primarily because they want to do good. And they have the opportunity to do so. Well, they do. So so these people that work in there, right, really motivated, really want to help people great purpose. What is their experience like using the digital services of NHS?
[00:08:48:19 - 00:09:33:16]
So like every industry, the experience of using digital technologies at work is not as good as the experience of using digital technologies at home. Invariably, companies don't have the hundred billion pounds, hundred billion dollar R&D budgets that the big tech companies have to develop really good consumer technologies. Also, you know, work based technology is much more complicated. So the experience of the NHS staff in using the technologies that they have on a day to day basis is about six out of ten. Right. It's not awful, but it is a net detractor score. People in the NHS will tend to talk more negatively about the digital technologies they use at work than positively.
[00:09:35:03 - 00:10:05:04]
OK, OK. So not the best, not the best, but not the worst either. So it's OK. But a net detractor score, that's the important thing. I guess you're bringing out there. So lots of improvement. And although I don't have comparative data with other industries, the anecdotal experience is very similar. So I wouldn't say that the NHS is a particular outlier in comparison to any other organization, really, whether it be big tech or retail or manufacturing or construction. You know, everyone has a worse experience at work using digital than they do at home.
[00:10:06:04 - 00:10:39:17]
OK, could you maybe bring that to life for us a little bit? You got any examples of the people using this tech at work? Yeah, so the role that I'm in, it gives me a tremendous privilege. I get to go out and talk to people and ask them what their experience was in order for me to understand how I can develop the services to help fix it. Right. And last year we undertook a large learning needs analysis of the NHS. We collected literally hundreds of quotes from hundreds of interviews up and down the country. And so the story I'd like to illustrate.
[00:10:40:23 - 00:11:20:13]
It's a bit of an amalgam of stories, but it is a real life experience. It's not everyone by any stretch of the imagination, but it is some people. It's a significant minority in the NHS. And it's going to be through the eyes of a cancer nurse who I've called Joy. OK. She works in a hospital. She works on a ward. And the story that I'm going to tell starts off. She's just had a consultation with a patient in a bed. She's she's got some information that she needs to record about this this patient. Recently, her hospital's rolled out an electronic patient record. She needs to put that data into a computer.
[00:11:22:01 - 00:11:28:00]
But there's only one on the ward. Right. This is fairly typical. We don't have a lot of money to spend on a lot of devices.
[00:11:29:07 - 00:11:37:08]
And so there's one computer on this ward. It's a big thing on a desk with wheels. It's called a computer on wheels or a cow, believe it or not. They're called cows.
[00:11:39:21 - 00:12:41:23]
And so she goes someone's using it. Right. So she wants to try and write the data down. She knows that if she keeps it in her head, she's going to forget it. If she forgets it, that might have a negative impact on this patient's care. Right. They might be harmed because of the the blood pressure data, whatever data it is that she's recorded, has not gone in the system. And the next care professional is unaware of it. So she needs to write down. Right. She doesn't have a pad. But like every like literally every nurse in the NHS, she's got stacks of pens. So she rips off a sheet of, you know, that blue absorbent tissue paper. Yes. And scrawls as many of the notes as she can remember very quickly on that bit of paper. So she's not forgotten some stuff. I mean, not exactly the most durable of materials, but that's what she does. And then she waits, she queues in line for the cow so she can write it in. When she gets to the front, she sits down, right? Logs on, which means a smart card puts in does she remember this time? She remembers her log on details. That's good. Takes a little while, maybe five minutes for the computer to boot up. It's a bit old.
[00:12:43:03 - 00:13:17:16]
She gets in, she starts typing the information not super quickly. Right. So she's not digitally literate by any stretch. You can do it online shopping at home, but we don't. She doesn't have to type a lot at home. She's never really learnt typing skills. She's got to keep she's using two fingers. She's look she's taking a bit of time. There are people building up behind her. She's starting to feel flustered and stressed. She gets to the bottom of filling in these patient records and there are two buttons. One of them says save, one of them says next, and the bottom falls out of her stomach. She feels physically sick. Now, the reason she feels physically sick is she's been here before.
[00:13:18:21 - 00:13:22:16]
She's clicked one of those buttons and it wiped everything.
[00:13:23:16 - 00:13:29:15]
And she can't remember which button it was. She knows at this stage if she clicks the wrong button.
[00:13:30:17 - 00:13:38:16]
Then she's just getting a jacket. You know, she wasn't given enough training on the system at the first place. It's cracky. They're stretched on their ward. They couldn't release her for the full amount of training.
[00:13:39:23 - 00:14:10:18]
It's it's a bit shonky in design, isn't it? I mean, cracky. Why would you have two buttons where one of them wipes all your all of your data? Maybe it's the reliability in the infrastructure. Who knows? She doesn't care. It's her experience and her experience is I feel as if I can't do my job anymore. If I can't use the tools on us to use and this thing's changed so much over the last couple of decades, if I press the wrong button, I'm out of here. And that's where I'm going to leave Joy's story. But it's true. So so bad experience,
[00:14:11:21 - 00:14:27:07]
including bad experience of using digital tools, is having an impact on staff well-being and things like burnout. And we are starting to see more people saying that they're going to leave the NHS because of their experience of digital technologies.
[00:14:29:02 - 00:15:04:13]
Yeah. And what a what a terrible place where the going back to the purpose, the purpose is to save lives, to help people. We've got experience of great tech in our real lives. And yet this workplace experience, whether they click save or next and get it right or wrong, is whether they're going to resign and leave their job and their mental well-being is, ah, you know, it is terrible. I think you've set the scene brilliantly there. And I think all our listeners listening to this are rooting for. Well, let's fix it.
[00:15:05:13 - 00:16:09:05]
So let's fix it. So maybe let's start to get into the sort of the title, because the title is around how projects fail, right? And why they fail. So I'm guessing you've got some projects where you've been able to to fix the cows. I've never come across that terminology before. I think that is brilliant that you've been able to fix the cows. Or not fix the cows. So I mean, what's the sort of percentage of your projects that succeed versus fail? Yeah, OK, so that's a really good question. In actual fact, we don't have data across the whole of the NHS for that. What we do have is really quite good quality data across all industries. So this will be for all of your listeners, regardless of nation, regardless of industry. There's a really great in fact, there have been there have been about four or five studies, but the one that I really like the most is one by the Boston Consulting Group. So they looked at 895 different digital transformation programs and they looked at the benefits that were expected and the benefits that were achieved.
[00:16:10:08 - 00:16:31:09]
And they identified that in 70 percent of cases, not all the benefits were achieved. The transformation in some way failed. The word failure may be strong. We know that digital transformations don't necessarily always achieve what you expect and sometimes achieve things that you don't expect. But nonetheless, 70 percent of those digital transformations did not do what they set out to do.
[00:16:32:18 - 00:16:48:12]
26 percent of them, you know, one in four of them failed to achieve even half of the benefits they set out to to achieve. And it's quite a long tail. You know, you had some some out there that achieve next to nothing. And this will be typically after a two or three year investment or build.
[00:16:50:07 - 00:17:04:13]
We're talking all digital transformation, so ones that are low complexity and high complexity and clearly the less complexity that you have in a digital transformation, the more likelihood there is of success and achieving the benefits. So it's looking at all of them.
[00:17:06:03 - 00:17:13:01]
So, yeah, 70 percent fail, 26 percent fail catastrophically across all industries, not just the NHS.
[00:17:14:07 - 00:17:22:16]
OK, which is a lot, isn't it? 70 percent of all investment isn't bringing the benefits that it said it would. That's pretty poor.
[00:17:23:16 - 00:17:31:11]
So. Yes. And the interesting thing is when you work in an organization, you kind of know it.
[00:17:33:00 - 00:17:50:13]
You know, you're that the reason why we go back to the NHS staff saying their experience of digital technology is six out of ten is because they know it. You know, that when someone says, oh, we've got a new digital project project, the majority of staff don't go. Yeah, they go. Oh, oh, another one.
[00:17:54:20 - 00:18:02:07]
Yeah, I mean, so that there is more and more change. Moore's law still applies. We're seeing a doubling of the opportunity from digital technologies every two years.
[00:18:03:13 - 00:19:17:13]
And that means bam, bam, bam, bam. You know, inside an organization, there's more scope for change and more people are undertaking it in 2020. Gartner released some data that indicated that more than half for the first time, more than half of a typical organization's workforce are what are known as business technologies. People are bringing technology into the workplace in order to make the services that they run better. Sometimes that's consumer technologies like WhatsApp, for instance, famously brought into the NHS in 2020 during Covid, because NHS teams, you know, doctors and nurses needed to communicate with one another and they couldn't get together in person as much. So suddenly they were using consumer technologies to sort of bridge the gap that wasn't there and that wasn't being filled by other platforms at the time. But it's true of all organizations. You know, there is more change happening delivered by more people with more chance of complexity and clash and failure than ever before. And it is resulting in this huge level of techno stress in our staff. And although I don't have data for that level of stress outside of the NHS, my hypothesis would be it's in any medium to large enterprise. Yeah. Yeah. Yeah. So so maybe we can start to dig into.
[00:19:19:16 - 00:19:26:05]
What why do these projects fail? Yeah. So so again, some data from Gartner.
[00:19:27:23 - 00:19:42:07]
I'm going to narrow it down to governmental projects, although actually there's no real reason why this data shouldn't apply elsewhere. Just happens to be what this data is. But they looked at I think they looked at about 200 chief executives and chief digital information officers and they asked.
[00:19:43:07 - 00:19:55:02]
OK, they've identified digital transformations that have failed and then they asked those senior leaders why what was the single biggest reason why your digital transformation failed and they collated all of those those stats together.
[00:19:56:13 - 00:23:15:21]
They identified about one in five of them failed for technology based reasons. About one in five of them failed for because of lack of resourcing, but fully three in five of them, if that's slightly higher, 63 percent failed either because of cultural reasons in the organization. You know, teams not getting on lack of leadership, that sort of stuff or lack of skills deficits. So whether that be skills deficits in the user base or skills based deficits in leadership or skills deficits in the digital and data professional staff, it was something around that that skill deficit. So most tech initiatives fail because of cultural skills deficit reasons. People reasons rather than technology resourcing reasons and things. The reason why I get so excited about this is that my job is a is a digital academy, right? I'm an education institution. So if there are things that people can do differently, behavior change that we can influence through education, that 60 percent failure rate or contribution to failure, 60 percent of digital failures that have failed because of cultural skills deficit reasons, we might be able to fix that. Yeah. And fixing 60 percent of all digital failures is I mean, that's quite a big deal. Yeah. Yeah. Big deal. And the other thing, you know, the flip side of what you're saying that that first one you said, so like 20 percent, I think said one in five, only one in five is due to product failure or the product not being able. And in the tech world, we obsess about that. Right. You know, yeah. OK, we've got to configure this right. We've got to do this right. What's the customer? What's the user interface like on? And we will over engineer and engineer and engineer. And actually, that is only one in five of whether it's a failure. It needs to be up to the job. Don't get me wrong. I'm not saying that's important. It's but 80 percent of whether it succeeds or not is not actually about the product. Correct. It's about all of the other things. Yeah. And there's one caveat and then one exploration of that. That's all right. So the caveat is this is data that comes from organizational digital transformation change. Right. So this is not a business to consumer tech where you've got very little impact on, you know, training up staff, how to use an Amazon shopping cart, for instance, that that sort of thing, I suspect, is much more heavily on the technology side. But when you're talking about technologies to support organizations to deliver better services, you know, things like the electronic patient record, absolutely. The technology itself is a is a minority contribution to its success rate. And we've got some really good data from within health care for that. So one of the reasons why this topic is so important to be discussed from a health care perspective is that the way health care is delivered by and large across the globe is kind of the same. And it's certainly recognizable from how it was conducted in the 1940s. You know, when the NHS was set up, the idea of doctors, nurses, clinics, operations, diagnostics is, you know, there have been advances, don't get me wrong, but it's it's wholly recognizable from the 1940s. And it's true across the globe.
[00:23:18:22 - 00:23:29:02]
So when we look at the digital technologies that underpin that, you can compare and contrast really easily. You know, you're developing technology that supports basic processes that are basically the same, no matter where you go in the world.
[00:23:30:08 - 00:24:04:23]
And the electronic patient record is a bit of a tenon. There's there's variation, different different people doing different ways. There are different suppliers. I wouldn't say it's necessarily a super healthy supply market, mind you. But it is there are a number of suppliers that do things differently. And there's a consultancy out of the NHS, sorry, out of the US called CLAS. They came up with an idea for something that they've called the arch collaborative. Any health care provider anywhere in the world can take a standardized set of questions, ask their users these questions around, largely around staff satisfaction and then get some answers about how organizations vary.
[00:24:06:19 - 00:24:11:20]
The first thing that comes out of that is that when you look at the variability of product.
[00:24:13:08 - 00:24:24:20]
That satisfaction is not strongly correlated. Right, so you can have the worst scoring organization and the fourth best scoring organization and they use exactly the same product.
[00:24:26:17 - 00:25:26:07]
OK. And when you crunch the numbers, no more than about 30 percent of staff satisfaction is anything to do with the product. And that's not even how it's configured. That's just anything to do with it. So you can take that same product and deploy it and it fails. That's a product deploy and it's successful. Correct. Yes. Tremendously failing and tremendously succeeding. And it is nothing to do with the product because the product is not the same. It's it's not nothing, but it's just it's just not the main thing. Yeah. Yeah, yeah, yeah. And and so it's those other things that we talked about, the skills, the people related things, the resources, those those are the things that are determining whether it succeeds or whether it fails. Yeah, yeah, yeah. So including things like core infrastructure as well. So in that joy story that when she's when she clicks on the wrong button and yeah, and it loses everything, which is a real example, we've had multiple people tell us what their experience of using their EPR.
[00:25:28:03 - 00:25:32:04]
It's not the product design, believe it or not. It's the underlying reliability.
[00:25:33:16 - 00:26:25:06]
So the system says it's going to try and save its data. It's really slow trying to write the database. It comes back and it times out and it loses its data. So, I mean, you could argue that there are system design things that could get around it. But fundamentally, the problem that has caused it is the reliability in that particular case. And when we've got a team in NHS England that's specifically looking at implementing electronic patient records up and down the country, and they've come up with four, four big highlights. So the first is recognize that staff satisfaction in and of itself, certainly within electronic patient records and health care is directly linked to. It correlates to things that really are really important. So things like patient safety and staff well-being and staff burnout. There's a there's a link between staff burnout and and staff choosing to leave the NHS and the satisfaction they have with their EPR.
[00:26:26:22 - 00:27:21:18]
And there are three things that they say are the things that organizations should concentrate on most, none of which is choose the right EPR, by the way. So the first is make sure you've got decent training in place. One hour's training a year makes a 17 point difference on staff satisfaction using electronic patient records. One hour a year. This is not expensive investments. You know, just supporting people to learn how to use a system, even if it's a rubbish system, is impactful. Yeah. Second thing is sort out your infrastructure. If you if you scrimp and save on your infrastructure, you end up with all sorts of catastrophic snowballing of issues. That leads to joy leaving and not coming back. You know, that might be 30, 40 years of experience as a cancer nurse out the window because you're unable to support her with the proper tools to do the job. And then the third one is make sure you and this is well understood.
[00:27:22:18 - 00:27:40:20]
And, you know, it's been the top of the top of, you know, Gartner's recommendations for a long time. When you're building and implementing digital products in your business, make sure that you've got multidisciplinary business and digital teams working together. And so that the three big things that the data indicates that organizations should focus on most.
[00:27:42:03 - 00:27:58:02]
OK, so let's let's just unpack that a little bit. So just thinking about then what can we do about it? So we're saying all these all these projects, all these projects are failing. Often it's the same product will wildly succeed or wildly fail.
[00:28:00:15 - 00:28:17:23]
And it's not the product. So the things that we can do about that. So the user experience, having a great a good user experience and a good experience is really important to people to the point where people are leaving or burning out because of that experience.
[00:28:20:12 - 00:29:24:16]
So then you're saying one hour of training, just making sure that people are trained on these and understand is going to have such an impactful place. Yeah, just a level of familiarity, actually. So one of the one of the quotes that we got was, I just want to know that it's not me, that it's not me making a mistake. If I just knew that it was the system being a bit chunky, I could kind of forgive it. But you know, that that feeling of sickness that Joy felt is a really visceral thing. I mean, I get that sometimes when I'm when I when I've got when I've got a technical issue that I don't feel I could solve. But it's like I don't even know how to start with this. I get that sick feeling. And so I understand, I mean, not to the same extent as Joy, almost certainly. But, you know, it is a very real thing if you feel as if I can't do my job anymore. I'm just not. I just don't have the skills to be able to do it. Yeah, which is untrue. But if you feel that way, it makes a big difference to your well-being, to your to your feeling of burnout, to your feeling of, you know, imposter syndrome at work. And it makes a big difference.
[00:29:25:20 - 00:30:33:10]
And and so how how do you do that training? So you guys come up with a good formula, a good way. What works? Is it in person? Is it we do video on demand? What's the best way to roll out this sort of simple training? Yeah, I mean, that's a really good question. And I don't think we've got the perfect answer yet. So looking at nursing staff in particular, we know that face to face training and online training, there's not a huge amount of difference in terms of uptake or or satisfaction from it. And because e-learning is so cheap, you know, you can deliver e-learning at 30 to 50 pence per person per session. So it's it's it's a cheap way of delivering education at scale. It's fine. The problem is e-learning is a bit of a chore face to face learning. Maybe not in the case of learning digital products, but in general can be quite a treat. Yeah. In the digital academy, we're starting to get involved a lot more in the the electronic patient record and digital product space. But we need to bear in mind that different products are implemented in different ways or even the same products implemented in different ways in different sites. We can't do all things for all people. What we think we probably can do is support the educators and the digital leaders within those organizations to make the right decisions.
[00:30:35:01 - 00:30:40:13]
For instance, one of the things that we found has been really impactful is the concept of digital champions.
[00:30:41:23 - 00:31:05:14]
One to one at the elbow learning when Joy is having difficulty, she can't remember which button to press. If she can go and talk to Janice, who does know which button to press and Janice happens to be right there, you've solved the issue right then. Yeah, Joy doesn't leave. Yeah, so those sorts of digital champions framework initiatives, when they're set up well, can be really, really impactful. Not super expensive either.
[00:31:07:06 - 00:32:00:17]
And we are finding that and I'm sure this is true for other industries, you know, and it's just stuff that say they don't have time to train. And it tends to be something that is less valued, both both by end users and by senior leaders before they've undertaken it. They don't they don't recognize the value of training. The stats do, but people don't. And so it's an easy thing to disinvest in. But but yeah, we're demonstrating it's tremendously value valuable. Like I said, one hour a year can make a huge difference. But you've got like 30 or 50 P per hour, did you say? That's that's how much it costs to do. The person. Yeah. Per person, possession. Yeah. So obviously it'll vary. But typically delivering because you because it's scalable, you know, you create a piece of learning and you can deliver it to lots of people. But yeah, for us, it's about 30 to 50 people a person.
[00:32:01:20 - 00:32:35:05]
Now, the other thing I've just left to maybe dig into a little bit is the connection between teams, having these multidisciplinary teams. Could you unpack that a little bit? Yeah, no worries. So historically, back when digital used to be called I.T., you'd have the I.T. guys who'd build a system and then they'd deploy it. And then if it wasn't used, it was your fault as a user. Now, it's just the user. They're not using it right. Then we started to understand things like user centered design and user research. You know, we started to recognize, oh, hang on a second.
[00:32:36:10 - 00:33:02:08]
There's an outcome here that's more important than an output. How do we help create a better outcome? And we started realizing that that understanding the problems that user had, that users had designing products with users in mind and importantly, co-designing with end users led to better outcomes measures. Now, I appreciate this is somewhat stepping on my point about about the system being less of an important thing than the than the
[00:33:04:04 - 00:34:00:17]
than other things. But if you look at the deployment of digital technologies in the business space, it's not really. In fact, it's less about the product and more about how organizational processes are redesigned. How existing processes are turned off. So in Joy's case, how do you stop her from writing her notes in a paper record, which no one else can see remotely, for instance? How do you stop her from doing that? Because it's taking up her valuable time and effort in order for her to be able to actually write in the electronic patient record and save it in a way that actually gets saved. You know, that that that is a that's a people and process issue. Stopping what she's done already or changing that whole workflow, perhaps so that instead of having to go somewhere and write it, which is what she used to do, and effectively, that's what she's doing now. She just restrained to a cow, right? If she had, I don't know, maybe some sort of
[00:34:02:05 - 00:34:24:14]
voice recording technology at the bedside, you know, people are starting to to employ these technologies more so that Joy can perhaps work in an entirely different way in order to get the same outcome, but in a way that works for her. So, yeah, I'll stand by. My no more than 30 percent of the end outcome is down to the product, certainly an electronic patient record space.
[00:34:26:17 - 00:34:41:21]
And typically, it's about that same figure for other industries and other other products. But from an education space, yeah, support people with basic training in the product, support people with basic digital and data literacy. Actually, if people don't have the foundations, it's really hard to build on them.
[00:34:43:03 - 00:35:36:02]
Different industries have different certainly in the UK have got different levels of digital literacy. In fact, believe it or not, the industry in which you work is more a predictor of your digital literacy than anything else. How much you earn your educational attainment and if anything else, you know, where you live in the country, how old you are, all of those things do correlate, but not as strongly as the industry in which you work. So if you work in construction, any any listeners who work in construction, I'm afraid you're working with the least digitally literate population. Health care is a little bit under average. If you work in the tech or advertising industries, bully for you. You know, chances are your workforce are a very, very high proportion of your workforce have got all the basic essential digital skills for work. And you can just deliver some sort of learning for your digital products. But yeah, everyone else think about digital literacy for a proportion of people. But one in 20 people working in the NHS do not have
[00:35:37:05 - 00:36:04:15]
even, well, any of the essential digital skills for work, you know, they may struggle turning a computer on. So we need to think about those people as well. And then finally, some of the education that we provide is for trying to address some of those wider implementation things. So education aimed at senior leaders, aimed at educators, aimed at digital practitioners to help them play their role well and put the focus where they need to put it, which is not just on the technology.
[00:36:07:16 - 00:36:21:17]
Well, on that bombshell, I think it's been brilliant for anybody walking their dog that zoned out, listening to the podcast. Yeah. Quick summary. What would be your key takeaways that you'd want people to take away from this session?
[00:36:23:13 - 00:36:56:21]
I think if you're not focus on the outcome, not the output, that's always been true. But when you focus on the output, you'll think about the tech. When you're focusing on the outcome, you will find out it's about training and infrastructure and leadership and implementation and customization much more than it is about the technology. Yeah, yeah. Fascinating. Thank you so much. I find it really interesting, this things that have struck out to me. I love the cow. I'm going to take that with me. I'm not sure that's our finest hour, I should say, as the NHS. But but but it is it is funny.
[00:36:57:22 - 00:38:13:11]
I love the cow. And also just what it was almost like a point you made in passing there, but it really stuck with me is when people are busy, people disinvest in training, adapting in building the skills that they need to get to get better. And then you said some it was something along the lines of people don't know this, but the data shows it that actually. If you take the time to do that thing, then you will get better at your job and it will be better. The data shows it, even if you're feeling I'm too busy to learn something new. And in this world where AIs come in and things the rate of change is so fast, just getting if you're in that mindset of training is a chore that I can't fit in versus training is something that's essential to make me relevant and and stop me from burning out and to help me with my well being and all of these sorts of that. That just sort of flared up with me. That was a really interesting point you made there. Thank you. And if I could also just add to so if organizations in the UK are interested in exploring that basic essential digital skills thing, there's a charity called Future.Now that I'm involved with. So a future. Future.Now. OK. All one word.
[00:38:15:05 - 00:38:33:01]
Which actually any organization can get involved with, you know, they've got a charter, they they support the Department of Skills, Innovation and Technology with the capability frameworks and the infrastructure to support organizations to build up essential digital skills in their own workforce.
[00:38:34:06 - 00:39:02:22]
And if you want to get involved, they are they snap your hand off at the wrist. So please, please do get involved if you'd like to. Brilliant. Well, what I'll do is I'll put that in the show notes. I'll get that link off of you and pop that in the show notes so that people can find that. And if people have loved hearing the sorts of things that you've been saying and want to connect with you, how's the best way for people to get in touch with you? Probably linked in actually. So if you just search for James Freed and look for an NHS one, I'm quite a rare person in terms of name. Right.
[00:39:04:06 - 00:39:41:02]
Just don't just don't pick the the US architect that would that's not going to help you get in contact with me. OK. And I'll pop that in the show notes as well. I'll get your LinkedIn profile. I'll pop that in the show notes so that people can look there. Thank you very much. So final thing for me to say is this has been really interesting. So thank you so much for coming on the show, taking the time out of your busy day to tell us about all of these challenges and really importantly, the insight of that. That you've shared with us really fascinating. So thank you so much for coming on the podcast. Well, thank you very much, Ben. It's been a tremendous pleasure. See you soon.
[00:39:43:02 - 00:40:03:05]
Don't go yet. Remember to subscribe to the podcast and rate the show. It really helps us grow and book new great guests. And remember, if the podcast isn't enough for you and you want weekly micro learning delivered straight to your inbox, sign up to the TechWorld Human Skills Weekly. Head over to www.techworldhumanskills.com to sign up.
