How can the NHS adopt more Agile ways of working?

Agile project management is increasingly being used in many business environments and outside of traditional software implementation projects, because of the flexibility it allows and the faster realisation of benefits that are better aligned to users’ needs.

However, it seems to be under-utilised in the health sector – particularly within the NHS where Agile is commonly used for large IT transformation but less widespread in the business and organisational change arena.  This trend could and should be reversed, and we at Moorhouse have recently been using Agile methodologies in support of significant transformation in the NHS.

What we did

In January, pilots were mobilised across five Sustainable Transformation Partnership (STP) footprints which allowed patients to have more appropriate and faster care.

The tight timescales to mobilise these pilots dictated a move away from the more traditional Waterfall mobilisation approaches, with adoption of an Agile-based implementation to be able to mobilise at pace and prioritise scope.

Having utilised Agile principles in the mobilisation and successful implementation of these pilots, we have seen how the wider NHS could harness specific principles to use Agile more broadly to set up large transformation projects for success.

Agile steps to success 

We observed three major success factors to the implementation - all informed by Agile principles. These should and could easily be adopted more broadly within the NHS in any pilots or project implementation.

1    Feedback was important to ensure a direct, constant and consistent feedback loop, and this was facilitated by daily ‘stand ups’ between our implementation team and the commissioners. These meetings ran through the progress from the previous day, plans for the next day and it provided a forum for any issues to be escalated. This was great for communication, fast issue resolution and focused on end user needs, which is a key Agile principle.

2    Incremental development of the service provided flexibility, fast paced implementation and allowed for quick service improvements. The scope was prioritised on need, so we focused on setting up the service and the data recording within that. Later we were able to introduce enhancements. For example, we introduced a text feedback service so that healthcare professionals could text us directly about their experiences and we could then act as required. 

3    Clear Communication was crucial to success, using a short, sharp communications infographic that could be shared with all involved. This focused on the service users, to ensure clarity in how they could access the service. This was particularly important when working at pace.

Lessons learned

There are key lessons to learn in the NHS for those seeking to adopt an Agile approach to mobilising pilots or projects. We have identified our four top lessons to be applied:

1    Planners should always ensure their stakeholders are committed at the start to take part in evaluations, and this is particularly important when mobilising a pilot. Evaluation is crucial as it informs improvements, complements an end user focus and, if applicable, really helps with any business cases required to move the pilots to business as usual. Planners may also wish to look to approaching users of the service to promote the service. 

2    Those seeking to adopt an Agile approach should also keep in mind that although implementation may be at a fast pace, end users need to have absolute clarity on what they can expect from the service. This is crucial to effective stakeholder management, as it avoids any confusion for the end user and ensures that they will continue to use the service, and hopefully recommend it.

3    Clarity of communications is key – particularly with regards to the aims of the pilot or project. Frequent communication with stakeholders in important, even if it feels repetitive. The key message and  operational details must not be lost in implementation. Having stakeholders signed up and engaged in the overall approach assists in this.

4    And finally, holding daily ‘stand ups’ proved critical to success. This supports rapid issue resolution, and consistency and clarity of approach. 

Parting guidance

Moving to an Agile way of working can be challenging to implement, and requires a change in mindset – particularly for those accustomed to traditional ‘Waterfall’ approaches. The complex nature of the delivery and stakeholder landscape within healthcare can add to this challenge. However, our experience tells us that these challenges are absolutely surmountable; starting with small steps is a great way to introduce the Agile disciplines, for example, implementing daily ‘stand ups’ and then incrementally introducing other Agile principles over time… How Agile!

To find out more about how your NHS department can adopt a more Agile approach, please contact Lauren Grant.