Strategic commentary

Why integrated care systems require world class strategy execution technology


With growing demands on public services, how can integrated care services ensure they deliver on their strategies? Here’s why i-nexus’ Gillian Wilson is passionate about the need for a world-class strategy execution platform to safeguard the public sector’s strategic performances.

When looking at the NHS within the UK public sector we can easily understand the obvious focus on health and high-quality care for all. For many, it is something we have gratefully received over the years and its very existence certainly helps us sleep easier.

The complexity in delivering this service is also evident with an increasing and ageing population and the constant challenge of funding priorities in such a patient-centric, urgent and emergency led environment. Achieving the standards expected from the NHS requires a clear execution and on-going improvement of their strategic performance.

From cross-organisational co-operation to the ever-growing influence of digital technology, here are the reasons why integrated care systems, such as the NHS, require world-class strategy execution technology to succeed in 2019 and beyond.

The need to deliver on cooperative, integrated care

The NHS Five Year Forward View and the NHS Long Term plan along with initiatives such as the NHS Workforce Improvement plan all require health and care experts to work more closely together.

In pure numbers, however, that means 1.5 million NHS staff and 9 different organisations and services working together. That makes for a very real challenge of offering world-class integrated care across multiple regions, organisations and services.

When we take stock of the different stakeholders involved in delivering care, we begin to see the scale of integration needed. Those are:

  • Clinical Commissioning Groups
  • Sustainability and Transformation Partnerships
  • Acute Trusts
  • Mental Health Trusts
  • Teaching Hospitals
  • Emergency services (ambulance)
  • Primary Care
  • GPs
  • Borough / District or County Council

Given the length of this list and how each element of the NHS combines, we’re left with the challenge of ensuring that they’re all able to deliver on the NHS’ strategy.

Moreover, even with the alignment of the above, there is an evident need for a clear understanding of each stakeholder’s part of the plan, and an intuitive means to easily monitor progress to target in order to focus the strategic conversation on results.

This ever-growing issue of alignment and cooperation necessitates world-class strategy execution technology to support and safeguard the strategic imperative of integrated world-class care.

The NHS is an ever-transforming organisation

The very nature of the NHS means that it is constantly evolving. The NHS that arose in 1948 is now a completely different organisation. It has changed and will continue to change, but it must also continue to deliver world-class health care to the public. Quite the challenge.

Typically, organisations invest huge amounts of effort into the creation of a strategic plan, a core vision outlined for anything between one and ten years and then regularly fail to deliver, often realising the inevitable – it’s too late to correct course.

The NHS is a typical example who are in the process of reform whilst continuing to deliver business as usual and many separate organisations need to share strategy and transformation proposals to improve health and care.

Much like how clinical guidelines and treatment courses evolve, so too will the NHS’ strategy.

This approach will require digital technology to support the ambition.

No longer will disparate systems, spreadsheets and ad hoc reporting or presentations provide the focus or timeliness required to consistently deliver in this complex and pressured environment.

Organisations do not, of course, intend to fail.

Strategy is simply challenging when trying to balance the complexity facing enterprise-scale organisations and the ongoing performance management of the business whilst also managing change through the transformation, development and deployment of forward-looking strategic objectives.

Tougher economic times demand swift, guaranteed delivery of strategy execution through a higher volume of smaller scope deliverables explicitly aligned to each other and the greater goal. Simon Crowther, CEO, i-nexus

Simon Crowther’s words ring true for the public sector. After all, each improvement action contributes to the delivery of the overarching strategy, and ultimately high-quality care.

With a multitude of organisations involved, each with their own breakthrough and annual goals, there is the very real possibility that strategy execution, and in particular goal management, can be cumbersome without the proper strategy tools.

Digital-based Strategy Execution

To achieve the alignment and standard of delivery we’ve spoken of, the NHS, and the public sector, are looking toward digital transformation.

The positive news for the public sector is that there is growing support for digital technology, as reflected by surveys on that very topic among civil servants. In a Fujitsu study from 2018, 86% of civil servants agreed that technology was driving a positive change in the UK government. That’s a resounding signal, and one that integrated care services should use as a platform for a strategy that is supported by a digital platform.

So, now that we’ve established a need, there comes the inevitable what and how. When it comes to digitising its strategy, the NHS needs a digital tool that matches leaders’ and public expectations.

That requires world-class strategy execution technology to implement and manage at scale across multiple sites, board, management, division and departmental structures.

To achieve that, the strategy tool must address these core public sector challenges:

a) Strategy

  • Fragmentation between strategy, execution of project activity and ongoing operational management of KPIs/metrics and importantly how these are linked.
  • Converting the agreed strategy into an actionable plan, delegating those actions to a wide group of expert managers and critically seeing in real time the impact of those actions in one source of the truth.

b) Data

  • Too much data / data inconsistencies can cloud progress towards targets, resulting in a delayed ability to act early for those project or metrics that are off track.
  • Inefficiency and rework due to manual effort and multiple systems.
  • Lack of consistent view for management decision making.

c) Project

  • Lack of standardisation, methodology and version control within the project management process to support the PMO users.
  • A consistent set of tools and reports to provide one version of the truth.
  • Project prioritisation and visibility to stop those projects outside of the core strategy or replicate those with great benefit.

Results are what matter when it comes to strategies. For the NHS, and the public sector, it means highlighting the successes of each project within their strategy, and using data in a closed feedback loop that ensures operational improvement and the conquering of these challenges.

The conclusion?

So, those are the reasons that integrated care systems need a world-class strategy execution platform, but it’s only the beginning of the story. With organisations such as Birmingham and Solihull Mental Health Foundation Trust and University Hospital Coventry and Warwickshire leading the way with a digital-minded approach to their strategy, it’s hoped that this can show the way for the wider-public sector.

Interested in learning more about public sector strategy execution?

We have a wealth of resources freely available to leaders in the public sector, all designed to help you achieve your strategic goals. We’ve hand picked the below to set you on the right track:

About the author

Gillian has a rich background in strategy execution, supporting and advising public and private sector organisations across the globe to achieve their strategic goals.

If you’d like to talk more about your strategic challenges, reach out to her on or connect with Gillian on LinkedIn for the latest insights on public sector strategy.