Executive Overview
Smaller surgeries can embrace new digital tools without overstretching people or putting patients at risk. The key is to run innovation through a lightweight but disciplined process: choose the right ideas, pace the rollout, reuse clinical safety routines such as DCB0160, and keep everyone informed. This guide shows how to build that model with limited time and budget.
Understand the Common Pinch Points
- Limited time: Partners and managers juggle operational pressures, leaving little room for large change programmes.
- Single points of failure: Knowledge about systems often sits with one person; absence can stall projects.
- Supplier dependence: Smaller contracts can slip down vendor priority lists unless expectations are clear.
- Regulatory expectations: Commissioners, PCNs, and the CQC still expect visible governance, even in small teams.
Knowing these risks helps you design proportionate controls from the outset.
Build a Simple Decision Framework
- Create a scoring matrix covering patient benefit, practice efficiency, safety complexity, cost, and staff readiness. Weight patient safety highest.
- Log all ideas in one place, including vendor approaches, PCN initiatives, and in-house requests.
- Review monthly with at least one partner, the practice manager, and the Clinical Safety Officer (CSO). Select no more than two active projects at a time.
- Align with PCN and ICB priorities so you can tap into shared funding, training, or expertise.
Set Up Light but Reliable Governance
- Name the core roles: CSO (clinical sign-off), practice manager (project coordination), digital champion (operational lead), patient or PPG representative (user perspective).
- Hold a 30-minute “digital and safety” huddle every fortnight during active work, moving to monthly when stable.
- Use a single change calendar showing testing windows, go-live dates, and blackout periods so rotas and clinics stay protected.
- Document decisions briefly in your safety file to satisfy DCB0160, DTAC, and DSPT evidence needs.
Deliver Innovation in Three Manageable Phases
| Phase | Focus | Exit Criteria |
|---|---|---|
| Discovery (2-4 weeks) | Confirm problem, review supplier assurances, sketch patient pathway, identify hazards | Business owner agreed, CSO satisfied risks are understood |
| Pilot (4-8 weeks) | Run with a small cohort, gather incident data, check training works, confirm supplier responsiveness | Incidents understood, staff confident, metrics within agreed tolerances |
| Scale (ongoing) | Extend to full caseload, embed monitoring, schedule post-release reviews, refresh documentation | Safety case updated, change calendar reflects steady-state checks |
Only move forward when the exit criteria are met; if not, pause and review.
Keep Safety Front and Centre
- Re-use DCB0160 controls: hazard log, safety case, change records, and supplier assurances for every project.
- Plan training: draft quick-reference guides, record short screen captures, and brief locums before they go live.
- Prepare contingency plans: identify manual backup processes, key messages for staff, and patient communication templates.
- Share feedback loops: maintain a digital inbox or form for staff and patients to flag concerns quickly.
Get the Best From Suppliers
- Agree escalation routes and support hours in writing.
- Request pre-release notes at least five working days before deployment.
- Ask for confirmation that their DCB0129 documentation is current and how you will receive updates.
- Schedule quarterly reviews to discuss metrics, upcoming features, and shared actions.
Monitor Progress Without Heavy Reporting
Track a short dashboard during each phase:
- Project status (discovery, pilot, scale, on hold).
- Incident count and severity linked to the innovation.
- Staff effort (hours spent weekly) vs plan.
- Patient feedback themes from PPG sessions or surveys.
- Supplier response times on support tickets. Review the dashboard in the safety huddle and store it in the safety file.
Scenario: Willowbrook Surgery
Willowbrook Surgery wanted to launch three improvements: online triage, automated prescription authorisation, and secure messaging. They:
- Applied a scoring matrix and selected triage first because of high patient impact.
- Ran a four-week pilot with one duty doctor and limited appointment slots.
- Logged every supplier change in the safety file and held a fortnightly CSO-led review.
- Paused before the next rollout until the triage metrics stayed green for two months. The approach kept workload manageable and meant commissioners saw a clear audit trail when signing off future funding.
Pitfalls to Avoid
- Too many live projects: limit active workstreams so staff are not overwhelmed.
- Ignoring small incidents: minor issues often signal larger problems; record and address them early.
- Skipping patient communication: tell patients what is changing and how to get help if something fails.
- Losing sight of legacy systems: retire old tools formally to avoid backdoor usage and unsupported workflows.
Action Checklist
- Build a shared ideas log and prioritisation matrix.
- Confirm core roles and schedule the first digital and safety huddle.
- Map current and planned projects on a change calendar.
- Prepare reusable pilot templates: risk log, training checklist, patient comms.
- Set up a simple dashboard and storage location in the safety file.
Resources to Bookmark
- NHS England – Digital Primary Care Good Practice Guidelines
- NHS England – Clinical Safety Standards (DCB0160 and DCB0129)
- RCGP – General Practice Technology Guides
- NHS Digital – Data Security and Protection Toolkit
Key Takeaways
Innovation in small surgeries works best when it is paced, transparent, and tied to everyday safety routines. A clear pipeline, empowered CSO, supportive supplier relationships, and concise monitoring help teams deliver new digital services without sacrificing patient care or staff wellbeing.