diff --git a/app/case-studies/to-build-software-in-the-nhs-you-first-need-to-build-relationships.md b/app/case-studies/to-build-software-in-the-nhs-you-first-need-to-build-relationships.md new file mode 100644 index 0000000..1513271 --- /dev/null +++ b/app/case-studies/to-build-software-in-the-nhs-you-first-need-to-build-relationships.md @@ -0,0 +1,77 @@ +--- +layout: page +order: 1 +title: To build software in the NHS, you first need to build relationships +description: How the Rubie team found a partner who could champion the project and how ways of working are changing for the better +--- + +> [!NOTE] Impact + +> - Testing a new service in a real environment +> - How meeting regularly and having face-to-face time helps build strong relationships + +> “In the end, what we looked for in a private beta partner came down to one thing. We looked for a highly motivated person who would actively champion the project.” + +Ben Kirby is the lead product owner for Rubie, which will replace the 20+ year old technology that underpins the entire breast screening programme. He's part of a group tasked with modernising the breast screening technology that screens around 2 million people a year. + +## Finding the perfect partners + +Ben is talking through the considerations of testing in a live environment. + +> “We knew that we were going to have to actually go to a breast screening office and get them to use it for real, because there was no way we could replicate the technical setup of a hospital network with the mammogram machines and others that they use. But with the size of what we needed to build, and the complexities around it, whoever was going to help us from the breast screening office side needed to be fully bought into this long journey of testing features on Rubie.” + +## 'You are the people who are going to fix digital’ + +When Lesley Peacock, programme manager for the Humberside Breast Screening Service, heard about the Rubie project, she knew she wanted in. + +Having worked in breast screening for more than 25 years, Lesley knows the limits of what the current system can do, and sees how much is spent on workarounds and outsourced services, including printing and postage. + +She was impressed that the Rubie team travelled to meet her in person. She liked their explanation of the project, and their willingness to work collaboratively. + +> “After meeting them I said, I’m going to tell everyone that you are the people who are going to fix digital,” + +## How the teams are working together + +The Rubie team and the breast screening office meet via video call weekly and act as one (extended) team. At the start there were formalities to get through – standard operating procedure documents to write and go aheads to get from IT. These were done together, which helped build trust. + +Lesley describes the early days: + +> “We had a digital proposal form that you submit and I'm not the best writer in the world, but Ben was really good and went through it with me. He's got the words, I've got the enthusiasm. It was a good learning curve for me. I was saying, look I'm not technical, but this is what we want to do as a programme. We need the software to be developed for X, Y and Z reasons – we need to work with these people. And IT just bought in, so it was brilliant.” + +## ‘We’re changing their ways of working, and they’re changing ours’ + +Ben notes that breast screening offices and trust IT teams operate very differently. + +Trust approval and IT engagement are essential to make sure the live tests can run. They are working with limited resources and competing priorities, meaning that any ask for their involvement needs to be focused. + +Initially, Ben says, his team had approached IT teams with an offer to get as involved as they wanted, even helping solve some of the problems. This lack of fixed scope led to a lack of engagement, and Ben's team realised they needed to ask for something much more concrete. + +> "That became a completely different conversation. We said there may be other stuff that we come back to you with later on, but for now the ask is this - and the ask is tiny. + +> The other thing is you won't learn enough about all the people and their incentives until you just start going to have conversations. And I think you just have to, particularly if you're some sort of central team and you’re partnering with a distributed set of organisations or teams across the country: just go start talking to them." + +## Genuine collaboration + +What comes across is the power of a strong relationship, in particular how meeting regularly and having face-to-face time leads to genuine collaboration. + +Lesley describes the role of the breast screening office as helping the Rubie team navigate local systems and relationships, while the Rubie team provides expertise, guidance and support through unfamiliar processes. + +Ben talks about understanding what stakeholders need, and supporting local champions. In particular, regular communication helps cement relationships, even if some conversations do not lead to immediate success. + +Lesley says: + +> “We normally get told that a piece of software is being procured and then we get given it. In all my years of working in the NHS and with systems, this way of doing things has never happened before. You can't compare it – this is a really refreshing approach.” + +## Building technology for the NHS, by the NHS + +Sarah Fisher, Deputy Director of Digital Screening says: + +> “This way of doing things is new, and we’re finding that as well as building technology that’s fit for purpose, we’re also having to build the connecting infrastructure too. We’re building technology for the NHS, by the NHS. + +> It’s a learning curve for all of us and we’re finding that relationship building matters as much as, if not more than, anything else.” + +## Learn more + +- Read the breast screening team's [public notes](https://design-history.prevention-services.nhs.uk/breast-screening/) +- Read about the work of the [Digital Prevention Services team](https://www.digital-prevention-services.nhs.uk/) +- Contact us directly if you have questions or comments: [england.dpsp-front-door@nhs.net](mailto:england.dpsp-front-door@nhs.net)