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Getting the culture right

Culture makes a bigger difference than technology

Successful innovation requires cultural and behavioural change. To make any transformation stick, staff need to feel empowered to adopt and champion new ways of working.

The cultural values that underpin the NHS and its workers must be understood, and technology must reflect these values and meet the needs of the NHS workforce.

Leadership at the board, organisational and Integrated Care System (ICS) level needs to feel empowered to embrace technology and lead on innovating change through tech-powered healthcare.

This essay explores the window of opportunity to achieve this cultural shift.

"Culture is instrumental to any kind of transformation in the NHS, but particularly one that includes the adoption of technology."

NHS clinical entrepreneur

54% of those surveyed felt culture was the biggest blocker to adopting technology in the NHS.

HIMSS survey for PwC



ICSs and other NHS bodies should be responsible for and incentivised to create a local culture that solves problems using technology.

ICSs should be encouraged to develop a ‘sandbox’ approach to operational inefficiencies, which should be funded by central money that ICSs can apply to having piloted ideas. This would support the scale-up and the cost of working with AHSNs to independently assess the impact of solutions.


Boards should recruit people with the skills that allow them to lead on technological solutions and implementation plans.

The NHS does not have the skills, at scale, to lead on technology. It needs to look outside for the right skills to bring in, requiring a cultural shift to recognise the importance of these skills alongside more conventional board roles.

User experience

User experience should be at the heart of developing solutions.

User experience of technology solutions is consistently cited as poor, leading to frustrations and delays at best, and patient safety issues at worst. To get the most from technological advances – particularly where there is an intention to drive efficiencies – communities and practitioners should be as involved as possible in the design process.


Innovation should be part of the day job. People must be paid to innovate and to spread ideas.

People do not convert overnight. The average amount of time taken to spread from conception to widespread usage is seven years; this is time we do not have. For innovations identified as a priority, clinical time should be protected for training and advocacy to promote spread, and programme management time should be dedicated to scaling.

Contact us

David Morris

David Morris

Health Services Sector Leader, PwC United Kingdom

Tel: +44 (0)7841 784180

Quentin  Cole

Quentin Cole

Head of Industries, PwC United Kingdom

Tel: +44 (0)7770 303846

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