Insight from an NHS Chief Digital Information Officer
Tech won’t solve systemic problems alone, start with a cultural shift
All too often flashy innovations mask deeper foundational issues.
It’s akin to having a Ferrari without a road to drive it on — an opinion shared with Neil Darvill, Joint Chief Digital Information Officer at North Bristol NHS Trust and University Hospitals Bristol and Weston NHS Foundation Trust.
Rather than pursue the “shiny new thing” in technology without a well-rounded strategy, Block, Neil and the Trust’s leadership team have taken a disciplined approach to digital investments. Each decision has been supported by a cultural shift that embraces accountability and sustainable impact.
It is by adopting a long-term, holistic, and outcome-focused strategy at the board level that organisations can ensure their underlying infrastructure is resilient and capable of maintaining future digital innovation.
Transforming Digital Infrastructure at North Bristol NHS Trust
In 2018, North Bristol NHS Trust embarked upon a radical programme of innovation. Despite having advanced systems, the underlying infrastructure was not always capable of supporting them.
North Bristol NHS Trust partnered with us at Block to simplify, standardise, and secure the entire network to improve connectivity. This meant the adoption of network-based security controls, protecting clinical end points and replacing all network equipment subject to end-of-life notifications.
Now, five years into the partnership with Block, the Trust’s digital strategy has delivered more than 30 initiatives, including telecoms procurement, new staff intranet, real-time reporting, and remote consultations.[1]
Together, we have completed a full network upgrade, greatly reduced digital interruption, and bolstered the Trust’s cyber security posture with a four-phase programme. Now, looking ahead, the focus is to craft a new data strategy, invest in the Cloud, and integrate with ICS-wide platforms.[2]
So: how was all this achieved? And what learnings are there for other healthcare providers looking to take similar strides?
For such change to happen, three elements needed to be in place to encourage the necessary cultural shift: steadfast leadership, accountability, and a focus on lasting benefits.
Challenging the status quo through leadership
Transformational change begins with leadership that prioritises courage, integrity, and vision over convention. It’s driven by prioritising patient care and staff well-being over short-term targets.
For CDIO Neil Darvill, “True leadership is about making choices that prioritise sustainability and long-term value, even when those decisions are difficult or unpopular.” At the heart of North Bristol NHS Trust’s transformation was a leadership team unafraid to make tough decisions and refusing to succumb to immediate pressures and a shortsighted view.
By standing firm on strategic goals, the team were able to secure buy-in with a “package of confidence”: a clear vision, well-informed recommendations, ongoing support, and the delivery of its promises.
Rejecting passive acceptance for cultural change
Before the transformation, a pervasive “culture of acceptance” characterised North Bristol NHS Trust. Digital disruptions were seen as inevitable, and workarounds became the norm. This mindset negatively affected patient care and staff morale.
“We needed every team member to see that inefficiency was not just frustrating—it was fixable,” says Neil. To that end, cultural inertia was tackled head-on. The leadership team worked to instil a new belief: digital disruptions are not normal, acceptable or unavoidable. Accountability became a core principle; with our ongoing support, we equipped teams to identify, address and resolve inefficiencies proactively rather than to tolerate them.
Neil describes the process as like “building a head of steam”—creating momentum through small wins and clear communication. The Trust gradually established a culture where improvements were celebrated, and complacency was actively challenged.
Building a foundation for long-term value
Robust systems form the backbone of a successful cultural and digital transformation. Yet, with only 2% of its budget allocated to digital initiatives, far less than the private sector average of 10%—the Trust had to invest wisely.
Block’s expertise in strategic planning ensured that limited budgets were used effectively. The Trust concentrated its efforts on fortifying the most essential systems. This focus ensured that every subsequent digital initiative would be built on a dependable, future-proof foundation.
By prioritising lasting outcomes over short-term savings, the Trust could avoid fragmented implementations and instead set itself up for sustainable growth.
Neil underscores the pitfalls of reactive, procurement-driven approaches often seen in public sector projects. “Digital transformation isn’t a one-year investment,” says Neil. “It’s a journey that takes consistent effort over five or more years.”
Considerations for healthcare providers
North Bristol NHS Trust’s transformation is testament that rejecting passive acceptance and embracing accountability can be just as impactful as technological advancements. With brave leadership, a commitment to cultural change, and a focus on building robust systems, the Trust has not only improved the staff and patient experience but also set a benchmark for sustainable digital transformation.
Those inspired by the ground covered by North Bristol NHS Trust should ask themselves the following:
- Do leaders feel safe or encouraged to challenge the norm within your organisational culture?
- What is the level of accountability in your teams and processes?
- Are your systems built for longevity?
A culture that empowers staff to challenge inefficiencies and embrace new ways of working is key to driving digital progress and improving patient care. Healthcare providers are only going to face more pressure to transform digitally. And as we’ve seen during Block’s work with these providers, preserving this culture of innovation is not just important—it’s essential for meaningful, lasting change.
