Technology-Enabled Service Change

The Health Innovation Network (HIN) South London's Chief Executive, Rishi Das-Gupta; Digital and Transformation Executive, Amanda Begley; and Head of Digital Transformation and Technology, Ambra Caruso co-author the latest whitepaper on Technology-Enabled Service Change. The document sets out a practical blueprint for how health and care organisations can design, implement, and scale technology-enabled services in a way that is sustainable and beneficial across the system.


Technology-enabled service change is about using digital tools and new ways of working to create services that are more effective, efficient, and responsive to people’s needs. Its importance has grown as the 10-Year Health Plan for England calls for significant structural change, particularly in tackling the “transformation challenge.”


Summary


The transformation challenge


To begin unpacking the transformation challenge, it is useful to categorise innovations into different "types", each requiring its own approach. At the HIN, we categorise innovation into three core types:


  • Pharmaceuticals and medical products.

  • Digital health products.

  • New care models and pathway changes.

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By understanding the different needs of each type of innovation, it is possible to identify where innovations can be spread quickly and how any disruptions can be managed constructively.


Gaps to bridge during implementation


Various gaps in the implementation stage of an innovation become barriers that can slow down progress. These challenges include:


  • Cultural resistance.

  • Limited organisational capacity.

  • Lack of evidence.

  • Technical and interoperability issues.

  • Financial pressures.

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Making change that is lasting, rather than temporary, hinges on bridging these gaps. Approaches for closing these gaps are set out in this paper.

Making the leap easy


The document also outlines practical steps organisations can take to help implement technology-enabled service changes. To achieve this, it is imperative for organisations to:


  • Define a desired outcome.
  • Account for complexity.

  • Support the responsible use of digital and artificial intelligence (AI).

  • Run an effective pilot that lays the groundwork for scaling.


 Adopting appropriate processes at each step will generate insights that inform future actions for successful delivery.

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Achieving balance in implementation


Implementing technology-enabled services requires careful navigation of competing demands. Success depends on striking the right balance when managing key tensions that arise during implementation:


  • Too simple vs. too complex.

  • Too fast vs. too slow

  • Too rigid vs. too fluid.

  • Build vs. Buy.

  • Tailored vs. generalised.

  • Point solutions vs. seamless integration.

  • Rules vs. principles.

  • Short contracts vs. long contracts.

Frameworks informed by real-world experience are essential for making context-sensitive decisions.


Accelerating spread


To create the ideal conditions for accelerating the spread and adoption of an innovation, nuances of local contexts must be factored in. The following are imperative to achieving scale:


  • Deliberate planning.

  • Strong partnerships.

  • Clear understanding of the systems innovations are being introduced to.


Frameworks and shared learnings can provide practical guidance, helping organisations balance consistency with adaptability to support sustainable change.

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Working together


As pressures facing our system demand new ways of working, innovation in health and care is not a luxury, it is a necessity. Inventions alone are not enough, we must also commit to partnerships, implementation, evaluation, and spread. Together, we can move from isolated pilots to system-wide change.

The call to action is clear:


  • Innovators

    Design with users, plan for scale, and build in evaluation from the start.

  • Clinicians and staff

    Share your insights, challenge assumptions, and help shape the future of care.

  • Patients and communities

    Be active partners in co-design, feedback, and advocating which changes should be prioritised to happen early.

  • System leaders

    Create space for experimentation, invest in infrastructure, and support responsible adoption.

  • Research organisations

    Prioritise implementation research and allocate a greater proportion of resources to understanding what works in practice.

  • Employers and training organisations

    Ensure training in transformation, evaluation and digital fundamentals are built into training for new staff and support is available for existing staff to broaden their skills in these areas.


Let's build a health and care system that is more responsive, equitable, and sustainable, through shared effort, practical action, and continued learning.

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