Through years of conversations with NHS leaders, frontline managers, and operational teams, one message consistently emerges:
“We know we need to change, but we can’t afford to get it wrong.”
In today’s NHS, digital transformation isn’t optional, it’s essential. But for the teams expected to lead it, and believe in it each day, change often feels like a leap into the unknown.
Change in the NHS goes beyond new software; it’s about managing risk, protecting patient safety, and delivering results under pressure. It’s also about shifting culture and, now more than ever, navigating compliance every step of the way.
Whether it’s the pressure of patient care, under-resourced teams, or the legacy of previous rollouts, the barrier isn’t appetite, it’s a mix of capacity and confidence.
What NHS Leaders shared in a recent survey:
From years of experience in the ever-evolving sector, five recurring blockers stand out:
- Legacy systems and poor interoperability
- Change fatigue from repeat rollouts
- Compliance anxiety due to ever-evolving requirements
- Lack of internal champions to drive adoption
- Weak or inconsistent communication around change.
When asked what makes change difficult, NHS leaders provided clear and consistent responses. Key talking points focused on the shift from analogue to digital, and the growing pressure to meet compliance standards like MDOR:
- 100% of leaders highlighted reluctance to be early adopters, with their teams preferring proven solutions over taking a chance on something new
- Time and resource were recognised as the biggest barriers to change
- 1 in 2 highlighted procurement and governance processes as complicating implementation, with IT infrastructure and system compatibility issues also creating friction.
These aren’t isolated frustrations, these challenges reveal a fundamental truth: digital transformation can only improve patient care when the change behind it is sustainable and, critically, when it is backed by the teams involved.
What makes a great partner in change
Shifting from analogue to digital isn’t just a technical development, it’s a transformation that must balance innovation with patient care and regulatory responsibility.
MDOR compliance and governance are critical concerns, but they don’t need to be barriers. NHS teams are looking for partners who simplify the journey, making it easier to meet requirements confidently, while keeping momentum and safety front and centre.
When asked what they expect from a long-term digital partner, NHS teams were clear:
- 50% look for honest, responsive support beyond implementation
- All leaders highlighted the need for consistent, practical training for all users, with on-site support during go-live
When change works, it’s because the right support is in place. That includes:
- Peer support and local champions
- Hands-on onboarding
- Accessible digital resources
- Regular check-ins and post-implementation guidance.
These aren’t nice-to-haves, they’re essential for sustainable transformation.
Rethinking NHS change
Digital transformation requires a shift in how implementation is viewed: it is not just about the technical rollout, but about the teams who are adopting it, and the partner who is supporting them on their journey.
If change is to stick, which, while complex, is possible, it must be designed around the realities NHS teams face every day. That means listening more and being accessible from day one and thereafter.
The four steps to sustainable, smart change:
1. Budget: plan for change to stick
It is necessary to think beyond year one, that is when adoption begins, not ends. Use the year one budget to fund the work of embedding in year two; this means planning for ongoing support, refresher training, and continuous improvement, while also protecting resource time for staff engagement and feedback.
2. Change is a priority, not an add-on
Successful digital projects are 50% technology and 50% change management. Too often, change is left to the side. People adopt new systems because they see value, understand why, and, essentially, feel supported. That’s why change management needs to be defined from day one, with clear ownership, time, and visibility at senior level.
3. Start small and scale smart
An effective approach to NHS change is to start with a small, well-supported pilot that delivers visible benefits, then scale intentionally. Learn from ambassadors, build momentum through quick wins and stories of success, and follow a roadmap for expansion that leaves room to adapt and develop as you learn. Real, lasting momentum is a result of trust, not pressure.
4. The install is just the beginning
Partners shouldn’t disappear after go-live. Choose providers who understand NHS realities and who stay with you through adoption and beyond. Expect a partnership, not a transaction. Build long-term trust and shared accountability and ensure open channels for feedback and development. Successful implementation is critical, but it is just the start of transformation.
With realistic budgeting, strong ownership of change, a smart plan to scale, and a trusted long-term partner, you can make change stick, and do so confidently and sustainably.
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