NHS England - Transformation Directorate

Sustaining RPA

Automation sustaining pillars

Pillar 1. Benefits management

Benefits identification, quantification and ongoing management is imperative for RPA programmes to demonstrate value and create momentum within the organisation.

The primary aim of RPA is to release capacity for clinicians and other front, support and back-office staff so they can be more efficient in dispensing valuable, skilled activities.

To that effect, benefits management starts at the onset of delivery with the creation of an outline business case. In addition to process metrics, this should account for digital maturity – for example, legacy systems, levels of interoperability, system or application standardisation, and data source.

By building this initial, quantified view, the benefits can be validated and monitored throughout the delivery lifecycle to ensure that opportunities are progressed, paused or stopped altogether based on robust evidence.

Business case and return on investment (ROI) model

The intent of the outline business case is to help process owners understand the level of benefit they are likely to achieve through automation. This allows opportunities with the greatest return to be prioritised and implemented at pace.

Here we have used demand generation and triage processes to help the RPA teams to progress the right opportunities through cost/benefit analysis and establishing the right baseline to measure against.

These are the core components for developing the outline business case and ROI model. The business case and ROI will evolve as the solution is developed and delivered. It typically follows the steps as shown in the diagram below.

It should be used as a constant touch-point between the RPA teams, stakeholders and process owners to ensure that the solution delivered meets expectations and that the defined benefits will be realised. Throughout the programme, RPA teams should put in place the necessary touch points so that the benefits can be managed through the governance framework:

  • Validate the opportunity - validate target state and potential use cases to determine processes under preview can be automated
  • Analyse and develop automation options - develop options for automating processes using the available technology
  • Evaluate Options - perform cost to benefit analysis of developed options to determine return on investment
  • Implementation Strategy - define implementation strategy based on complexity of implementation
  • Recommendations - recommend processes to be automated


Join the NHS National Community of Practice for RPA to access our ROI and benefit case examples


Pillar 2. Automation target operating model (ATOM)

Defining and implementing an operating model that includes people, processes and technology infrastructure that supports RPA sustainability will help achieve and establish maximum value. These are some key factors:

Understand the impact & benefits
  • ATOM helps outline how the different functions (business, clinical, IT) must work collaboratively to deliver the RPA strategy.
  • Target operating model allows focus on the value being delivered, the use cases and those activities that will drive the realisation of intended benefits.
Collaborate and iterate through design
  • Collective design, governance and delivery processes ensures faster decision making.
  • Iterative design and embedded change management process enables delivery at greater speed.
Drive consensus and buy-in
  • Coordination and consensus across all impacted stakeholders is a key success factor.
  • Stakeholders conducting design decisions in coordination builds a cohesive environment with less chance of disruption or diversion.
  • This provides a sustainable setting to build on the momentum and support for the programme more widely in the organisation.
Enable value creation
  • RPA is still a relatively new technology.
  • The iterative design and implementation process enables the organisation to manage risk, test value propositions, and if successful, scale delivery quickly.
Embed continuous improvement thinking
  • ATOM design process does not end and should continue as part of the organisation’s continual ways of working as the scale and scope of the programme evolves.
  • This makes the organisation more prepared, malleable, and responsive to changing business requirements and new opportunities in the future.

RPA can play an important role in driving end-to-end operational outcomes, such as creating more capacity for staff to focus on providing the best care they can. As initial RPA deployments prove to be effective, teams should explore strategies for expanding across the organisation.

Multiple options are available to scale; here we consider one, the creation of a Central Competence Centre (CCC)* or RPA Hub. Establishing an RPA Central Competence Centre drives value, benefit and improved outcomes for RPA delivery.

CCCs bring together the management, best practices, research and training related to delivering and sustaining RPA across the organisation.

Note: * If you are starting your automation journey, then you don’t need to become a CCC or RPA Hub. To find out more about RPA Hub in your region reach out to us.

When identifying the appropriate ATOM, there are key factors to consider:

Scaling beyond proof of concepts (PoCs)

  • Automated solutions are generally used for a wide variety of processes across different parts of the organisation and often initially delivered at small scale through PoCs.
  • A key question, therefore, is how to scale and deliver enterprise-wide value, including combining with existing systems – for example, through using application programming interfaces (APIs) and in the future to incorporate new technologies, such as artificial intelligence (AI), whilst aligning with compliance and risk management requirements.
  • The setting up of a CCC is a good way of coordinating and monitoring these efforts.

Start with the simple questions

While a CCC can provide guidance on building, sustaining, scaling and embedding automation across the organisation, there are “simple” questions that often create roadblocks and need to be addressed upfront:

  • Where and with whom does ownership of RPA sit within the organisation?
  • What is involved?
  • How many people are needed, and what expertise is required?
  • How long will this take?
  • What is an estimated budget?
  • Is there an option to leverage or integrate partially with an existing competence centre in the wider NHS to benefit from their experience and de-risk initial setup and delivery while reducing delivery turnaround times?

But don’t underestimate the detail

  • It is crucial to address these questions; creating a charter is one tool for providing the framework for evaluating proposed processes, and fostering the skills, methods, tools, and technologies to most effectively implement the automation.
  • Clear roles and responsibilities must be addressed up front, and clearly defined across all key stakeholders within the organisation. For example, different groups within IT may need to be involved, as they are responsible for different applications and provision of the platform itself; as CCC stakeholders, they will offer remarkably different insights from within and across IT functions.

There are 3 key options that form the basis of designing and standing up any Central Competence centre (CCC) or hub.

Centralised

One central CCC with multiple business units linked to it.

One CCC serving all business units (BU).

Pros

  • One platform to provide centralised support for all lines of business
  • Easier to disseminate skills, methodologies, lessons learned and best practices
  • Standardised RPA design, development and support process

Cons

  • Automation prioritisation challenge: some lines of business might struggle to meet central ‘one size fits all criteria’ to make the cut
  • Slower RPA deployments

Hub and spoke/federated

Hub & Spoke Federated

One central CCC, linked to federated CCC dedicated to business units (BU).

Pros

  • The Central CCC handles most complex projects while federated CCC cover the rest
  • Reduction in prioritisation challenge, with federated CCC dedicated to lines of business and functions
  • Higher functional process knowledge can be built within federated CCC, given their proximity to businesses

Cons

  • Lack of collaboration can lead to discrepancy in expertise, governance and methodologies between Central & Federated CCC

Decentralised

Decentralised

Independent CCC for each business unit (BU).

Pros

  • Each business unit drives their individual automation programmes and their prioritisation
  • All RPA CCCs are close to individual business units

Cons

  • Regular exchange of best practices across separate CCC must be enforced
  • High risk of incoherence in standards, governance, methodologies & support levels
  • Certain CCC roles will be duplicated


Pillar 3. Govern

Organisations will require a holistic framework for managing and scaling the ATOM and RPA programme capabilities in an effective manner by embedding appropriate governance and enablement policies.

The Govern Pillar has two sections – 3a. Governance and 3b. Business Change.

Pillar 3a. Governance

An effective governance framework will help outline design principles and decisions across people, process and technology design elements.

RPA projects require multi-functional coordination across several teams. Therefore, the framework provides leadership, coordination, and best practices for the most efficient delivery of the project.

This is even more critical in the context of delivery of health services, as any new digital pathways should account for impact on patient care and safety. As part of overall governance for RPA programmes, they should build in a detailed risk management plan and ongoing engagement with clinical safety officers and clinical governance committee and leads to ensure clinical risk is minimised.

The framework allows for combining multiple technology, process and data solutions to empower and assist staff.

The framework enables benefits realisation and ensures ROI.

  • People and skills

    • Roles and responsibilities
    • Training and upskilling; team mix – internal vs external vs hybrid
    • Providing assurance to staff on value added
    • Mitigating risks for neurodiverse and disabled staff
  • Governance and standards

    • Assessment and prioritisation standards
    • Development governance
    • Operations governance
    • Regulations, requirements and compliance
  • Process and delivery

    • Enforce secure coding
    • Scoring and ROI
    • Reusability of assets
    • Establish development best practices to avoid waste
  • Technology

    • Track tool usefulness
    • Security standards
    • Manage scalability
    • Bot infrastructure and licenses
    • Platform and bot management and maintenance

Pillar 3b. Business change

Change management and the focus on embedding new ways of working as part of culture needs to be part of delivery to influence a mindset shift.

To define and deliver the interventions required to make the organisational shift that is required to embed automation solutions within the NHS, we recommend using a change framework consisting of the following points to consider:

  • Case for change
  • Future state
  • Readiness for change
  • Change leadership
  • Stakeholder resistance management
  • Communications
  • Training and people development
  • Organisational alignment
  • Culture

Ideally, these activities should be included as part of the delivery roadmap across every phase of the programme. This will ensure impacted NHS and its staff are ready, willing, able to deploy and sustain automation solutions. It will also support key activities to build the foundations for change, deliver change throughout, and make it stick through inflight and early life support actions.

The change framework should provide a robust approach to support the communication strategy and other change management interventions to ensure that stakeholder management is embedded in all phases.

Strategic change planning
  • Developing the ‘Case for change’ – understanding the “Why” using a data driven approach
  • Creating and agreeing a future state for the CCC and automation in the line of business, function or organisation, enabling leaders to tell a compelling narrative and story that rallies all staff and business areas showing improvement to patient care and pathways
  • Understanding the line of business, function or organisation’s readiness for, and past experiences of, change and assessing the impact of the RPA automations and CCC
  • Answering questions on redeployment and reskilling needs
Mobilising and engaging
  • NHS stakeholder engagement strategies and plans
  • Senior sponsor mapping and resistance management across functions and business units
  • Communications strategies and plans aligned to programme phases
  • Establishing automation change leadership network of sponsors and change champions
Delivering change
  • Developing change agents – giving them the skills to act as facilitators of change
  • Embedding ways of working and organisational changes to support the programme
  • Giving staff the knowledge & skills, they need for working alongside automation – understanding “How” 
  • Hypercare and early life support teams ensuring change is adopted, embedded and sustained
  • Identifying and applying lessons learned from the projects and programme



Pillar 4. Enable

This pillar has three sections – 4a. Training and upskilling, 4b. Accelerators and assets, 4c. Innovation and continuous improvement.

Pillar 4a. Training and upskilling

Organisations will need to invest in upskilling staff and teams in key skills and tools to support the delivery and adoption of automation.

The RPA CCC team should provide knowledge and capability building for Automation in wider organisation across lines of business. This capability can be curated, built and developed within the CCC and leveraged across the business. This capability should:

  • Create and deploy a role-based NHS Automation Capability Framework
  • Provide Automation Capability Maturity Assessment tools and services to determine training needs
  • Curate, develop and deploy a range of learning resources
  • Taking steps to engage and consult with neurodiverse and disabled staff
  • Provide ongoing coaching and capability development

The initial focus should be on CCC staff, however as the programme matures, the learning resources should be made available to all staff to support adoption across the business, with a specific focus on a group of key team leaders who will be coached in operational excellence.

The learning approach, formed by insights from other automation programmes, should leverage a multi pronged strategy:

Be ready now

The CCC should be a high performing multi-disciplinary team. All CCC staff should be trained and coached to have the skills, capacity and motivation to thrive in this demanding environment.  

Help teams adopt

Automation projects rarely fail due to technical capability. They struggle because the organisation is not ready or capable to drive and adopt the benefits of automation. Hence, the teams should work with your key business team leaders to provide them with operational leadership coaching and equipped team leaders to be inclusive to freeing up capacity and improve the value of automation.

Prepare to own

NHS needs to be certain that their own staff have the skills and capacity to be self-sufficient for the transfer of all or most CCC roles “in-house”.  While the programmes might start with the support of external advisors, there should be plans in place to develop this capability and transition internally.



Plan for design, delivery and continual management of training and skill requirements from initial RPA programme set-up through to business as usual.

The ongoing process for managing training needs starts with confirming the CCC Roles RACI (responsible, accountable, consulted and informed) and using this to create the CCC capability maturity framework.  This will describe the automation capabilities required across a range of maturities (developing, performing and excelling) and will be used to complete individual and team assessments, and personalised Training Needs Assessment (TNA). Along with the CCC Role RACI, this can also be used to guide and inform recruitment into the CCC as part of your transition state approach and to create role-based learning paths.

Ongoing management of training

  • Confirm CCC roles - the activity/role RACI matrix informs CCC capability needs
  • Create capability maturity framework - adapt capability framework for all CCC roles. Use to help development and recruitment.
  • CCC team assessments and TNA - individual assessments and training needs analysis will create learning need.
  • Facilitate and deliver CCC upskilling - deliver learning interventions according to agreed need.
  • Ongoing coaching and mentoring - on the job individual and team coaching of CCC team.
  • Regular CCC capability reviews - re-assess individuals as their experience and skills grow.
  • Create CCC learning pathways - create pathways for each CCC role and capability level.
  • Create CCC learning portals and materials - creating and curating automation content.

Pillar 4b. Accelerators and assets

Using standardised templates and tools can help significantly increase the pace of delivery and hence shorten the timelines to benefits realisation.

Tried and tested techniques, templates and tools can significantly accelerate the pace of RPA delivery programmes. They can be utilised from the outset and incorporated quickly into the RPA delivery capability teams and avoid the need to establish them from the ground up.

The teams should also encourage development of reusable assets at every stage of delivery to continue to add to the set of accelerators that other teams can draw upon as they set up their programmes. Innovation exchanges or automation marketplaces can be effective ways of collating, managing and sharing this collateral across programmes.

Recommended list of templates or frameworks for RPA delivery programmes:

Designing
  • Intelligent automation playbook – Central to the operation of an automation capability, containing the operating procedures, governance, templates and processes to run the programme effectively
  • Capability maturity framework and roles RACI – Can be used as a framework to create learning pathways for specific technical roles
  • Use case characteristics checklist – A simple checklist to allow business users to identify use cases fit for RPA
  • High level prioritisation matrix – A 2x2 or 3x3 matrix based on strategic, operational and business imperatives to prioritise the use cases generated by the business
  • Benefits case design – Framework to develop the business case for RPA, either quantitative or qualitative, based on the operational effectiveness criteria business wants to meet
  • Detailed use case assessment framework (for example, ABC framework) – Framework to assess business and capability requirements, select the right technology for the job and right use case for the technology selected; for example, ABC framework outlined under the Demand Triage section
Enabling
  • Operations support plan and SLAs – People, process and technology plan to run and maintain automations solutions; typically outline L1-4 support options and service SLAs
  • Training and skills development framework – Framework providing capability build for automation in the wider organisation. This competency can be built, developed and delivered centrally via the CoE
  • Continuous improvement approach – Multi-pronged approach to build upon automation solutions to keep up to date with industry and technology trends, as well as broaden the remit to continually drive business process improvement 
Delivering
  • Delivery methodology and associated gated approach – Typically agile based delivery approach incorporating a toll gate methodology to control and manage the delivery quality
  • Process design document – Detailed design document outlining RPA design at the click level; validated by process or use case owner prior to development
  • Release management approach, including solution design document – Release management approach checklist and framework to go live with RPA solutions in line with IT change management approach
  • Change management framework – Approach defining and delivering the interventions required to make the organisational shift required to embed Automation
Other
  • Benefits management framework – Benefits management framework to enable rapid identification, tracking and realisation of benefits throughout the automation lifecycle


Pillar 4c. Innovation and continuous improvement

To drive continued growth, improvement and value from RPA programmes, it is important to consider approaches to embedding Innovation and a continuous improvement (CI) culture.

Innovation and CI is an essential mechanism to keep the NHS’s automation and business process improvement services as valuable as possible.

These programmes can make an important pillar of cross organisation partnership to solve existing and emerging business and operational challenges and opportunities.

An innovation and CI approach can be built into the automation delivery roadmap from three perspectives:

  1. Leverage existing capabilities (reviewed on every process design)
  2. Bring in new capabilities (strategy, typically reviewed once a quarter)
  3. Explore disruptive concepts (on demand, internally or in partnership)