We had a 2‑day Personalised Prevention Services leadership meeting this week. Some of it was about reflecting on the past year, but most of it was about looking forward and reorganising our work. Our leader is moving to lead cross‑portfolio coordination in a new team. Working on how screening, vaccination, behaviour change and home testing work together with a focus on creating a coordinated experience in the NHS app.
Making things happen
The vision for Personalised Prevention Services – help people understand risks and connect them to the right support – has been accepted across Digital Prevention Services (the portfolio our team sits within).
When we first wrote it, we thought being agnostic about use‑cases was a strength. Build components for assessing risk and connecting to services, then apply them everywhere. For example, a ‘check your blood pressure’ component could be used in heart disease screening, diabetes prevention, and stroke risk assessments. Infrastructure that could support multiple use‑cases and conditions.
But it’s accepted wisdom in digital that you shouldn’t build platforms too early. You’re building complexity before you’ve proven it’s necessary. So we switched. Teams would own end‑to‑end journeys for single use cases instead.
This has been moderately successful. One team has integrated with existing NHS services and moved as fast as anything does here. But this has been harder than we anticipated, primarily due to high technical and clinical governance overhead. As a result, we haven’t been able to test our assumptions as much as we’d hoped.
Now there’s a new coordination team and we’re reorganising again. Reorganising so we can work with the NHS app as it focuses on better coordinated journeys is sensible. But we’re in a phase of uncertainty. The exact scope of the new team and how it impacts Personalised Prevention Services is unclear.
The unit of delivery is the team
There’s gap between strategic good and what it means for people doing the work.
Strategic reorganisation makes sense – reducing duplication and coordinating better. But for teams doing the work, it means relationships they’ve built might be disrupted, understanding they’ve developed might not transfer, and work they’ve started might need to change direction.
I sit between those two perspectives. I helped create the strategy. I support the delivery teams. Both views feel true and they don’t quite fit together.
If I’ve learnt anything this year, it’s that changes work better when you make them with people. But that takes time and creates uncertainty while you work things through. Sometimes speed matters more than involvement. Both have costs. I’m not close enough to that decision to know how it was made.
The next few months will help us figure out how teams support each other and work closely.
Irina wrote about the competing needs we’ve struggled with on Personalised prevention