How and why NHS Trusts must take a longer-term view over software procurement

Getting software right is no easy task -- especially in healthcare. It must be applicable to a near-endless list of users, applications, and contexts -- and these are constantly evolving. These inevitabilities, paired with the inherent difficulties of managing such a huge organization, unfortunately means that software is often not as effective as it can be -- and costs the UK's National Health Service (NHS) far more than it needs to.

The reasons for this are, of course, many, but the fix is remarkably simple; NHS Trusts must stop looking at the micro and the short-term, and instead think about how to procure software that is both flexible and delivers long-term value. Easier said than done, I know, but it is not impossible. Here are a few things to keep in mind when choosing software.

Don’t get lost in the details

When you approach a software vendor with a big list of problems, there are several issues that can arise with any product created. Firstly, it hampers the creativity of solution providers. Procurement should be a problem and solution led process in which you explain your pain points to service providers and then assess the strength of their proposed solution; don’t be afraid to let experts come up with what they think is a suitable product – for individual problems, but also the wider context these problems sit within.

Secondly, because it focuses on solving a long list of issues specific to today, it can’t easily solve tomorrow’s problems; and you can be sure there will be several you couldn’t have predicted. This issue is compounded when you factor in the new rules, regulations, and technological innovations that the future will surely bring. Ultimately, the more precisely your software is suited to today’s exact problems, the less flexible it may be to solving tomorrow’s. In turn, this means that a Trust would have to buy a new, off-the-shelf software product to deal with any new issues or contexts -- costing good money which is being thrown after bad, and not fixing the inherent issue in the first place: inflexibility.

Top-down solutions never work

However, the other side of the coin is that you think too big, and too top-down. A software product that is built to be used in every Trust in the UK is simply unfeasible. Although on paper it is ideal, as it would avoid the problems that appear when each Trust has its own discreet software in place, it would be too costly and time-consuming to implement nation-wide. Furthermore, just as when focusing on the microscopic problems of a single Trust, software built for a long list of Trusts would be too inflexible -- lacking adaptability and the integration capabilities required for it to be adopted and used effectively at the local level.

It is worth remembering just how often the rules and regulations change. For example, the new National Standards of Healthcare Cleanliness have only been recently released, but these are meant to be reviewed and updated every 5 years. Furthermore, they were late being released. Therefore, your software must be prepared for unpredictable and regular change.

Choose a partner, not just a product

Turning a problem-solving exercise into a scoping one turns any potential partner into a yes-(wo)man. When selecting a software provider to work with, it is an important time to test their problem-solving capabilities, their creativity, and most importantly, how well you work together (rather than how well they solve your list of problems). When comparing several vendors, you get to compare them on the above factors -- leaving you with the best partner for your Trust, not just the best solution for your immediate problem.

Go configure

Often, Trusts are backed into a corner: they have to follow the approved process for procurement and they have little choice but to buy another discrete piece of software in order to solve the problem in front of them. This means a Trust can easily end up going out and buying a cleaning auditing piece of software, as well as security auditing software, time management software, a space utilization piece of software, and so on. They then end up with a whole tech stack that, by virtue, becomes so complicated that nobody understands it. Not to mention the cost and time implications involved in managing multiple different systems, and training the relevant people on them.

It's vital that you use software that is fully configurable and built to adapt -- not just to tomorrow’s world, but also to all the different teams and operations in your Trust. When you move beyond that 'fix problem X' mentality and engage with a platform that is configurable, you can gradually unify your tech stack without ripping out the floorboards. By doing this, each problem then becomes nothing more than another process within a single solution, rather than having a solution for each problem.

It’s about changing the mindset around what a piece of software is. Instead of thinking about a piece of software as a standalone fix, solving that one problem, Trusts need to think about software as a flexible tool that will help them solve multiple problems, known and unknown, both now and in the future.

Photo Credit: Marbury/Shutterstock

Dan Teare is Healthcare Sector Director, mpro5