Sarah Wilkinson
Chief Executive of NHS Digital
Delivering digital and technology transformation in the public sector involves complex technical work, in a complex operating environment, within a complex governmental system. It’s a fantastic education for those who aspire to lead digital transformation in any sector.
Many of the individuals who work in public sector technology are motivated by a personal commitment. That may be a commitment to public service in general or to their specific area of work, be that the NHS, national security, the protection of our environment or some other domain.
Others see working in the public sector for part of their career as an opportunity for accelerated personal development by working in a system of – often extraordinarily high – complexity and criticality.
Delivering technology into the public sector is a complex task
Delivering new digital data and technology solutions in the public sector is a highly multidisciplinary challenge. Teams have to understand policy intent and be able to shape strategy in that context and they must be able to assess the wants and needs of a very broad set of stakeholders. They must be able to conduct detailed technical analysis of a target solution and an existing technical environment and then either design and build solutions, or shape the market and manage commercial engagement, or both.
They must manage finances under high levels of scrutiny, as is appropriate when public money is employed. These teams depend on strong people, programmes and operational management capabilities.
Cautious bureaucracy can slow technological advancement
Working in government has specific challenges. Ministers with whom you have developed an effective working relationship may suddenly be replaced by others who have no prior knowledge of the area or may have very different priorities.
The complexity of the system and the potentially disproportionate scale of impacts from relatively small changes leads to slow and cautious bureaucracy. It can be very hard to change decision-making procedures: old mental models and decision habits are often deeply ingrained, and risk-aversion is high.
To succeed, rapid adaption and system-level understanding is crucial
Success in this environment is determined by two key qualities: An ability to understand the overarching system within which you are operating from as broad a perspective as possible; technical, operational and political. And an ability to adapt rapidly and navigate that complexity. Developing these qualities will prepare you for even the most formidable career ventures.
Of course, the private sector can provide highly complex and challenging opportunities too, but the number and nature of environmental variables in the public sector is hard to equal.
New policies can create significant operational challenges
Recently, the Secretary of State announced an intent to make the systems used in GP surgeries more open, enabling much greater interoperability with hospital systems and much faster access to their data for medical research, driven by a more competitive market for the provision of these systems.
The team tasked with delivering this change must reshape the market and define new technical data and system standards. They must conduct an open procurement process in line with public procurement law. They must define the needs of GPs in a world in which the way GPs work is changing dramatically: the future of primary care includes much greater use of remote consultations, digital communications with patients and integration of patient-provided data streams – from wearable devices, among other things.
Public sector technologists must manage many stakeholders, high sensitivity in consumers of services and media scrutiny
The team must work with anxious, incumbent providers being forced into a new business model, and encourage incumbents making the hugely complex journey into the NHS system. They must navigate the hugely sensitive aspects of acquiring, storing and disseminating highly confidential clinical records to research communities.
They must assure the public on data handling and information security, and keep the media and social media audiences informed and educated and deal quickly with any anxieties or misrepresentations. And, of course, they must address technical challenges and ensure the systems delivered are reliable, resilient and performant. Working in public sector technology is an education in managing change in highly complex systems.
The challenges described above exist in one programme, within the agenda of one team, in one organisation, within a huge, pan-government digital transformation agenda.
It’s a rich learning-ground for future leaders of transformational digital change in complex systems
Good technologists don’t have to look far for work in 2019. But just understanding technology is an increasingly incomplete qualification for effecting technology-driven change within the complex systems in which we live and work. Give the public sector your skills and commitment for a time and in return it will equip you to work in the highly complex systems of the future.
