Change and Transformation in the Public Sector
PwC and its partners helped NHS England deliver the national Frontline Digitisation programme by creating a new ‘first of type’ delivery model – built on trust, regional Learning Labs, large‑scale engagement and AI‑enabled support – that rapidly built readiness and capability across the NHS, avoided costs, and set a new paradigm for humane, high‑quality digital transformation.
The Frontline Digitisation programme addressed one of the NHS’s most urgent transformation priorities: improving patient safety, staff productivity and operational resilience amid rising demand and workforce pressure. Backed by around £2 billion of national investment, it aimed to accelerate adoption of Electronic Patient Records (EPRs) across the NHS, replacing fragmented paper-based processes with integrated digital records supporting safer care, faster decision-making and more efficient services. Programme evidence suggested EPR implementation could reduce average inpatient length of stay by 4.5%, releasing thousands of bed days annually while improving patient and staff experience. Yet this was not simply an IT rollout. It was a large-scale organisational transformation affecting clinicians, operational teams and digital leaders. Delivering it across more than 190 organisations, each with different maturity, capability and culture, required a new national change approach. The programme addressed the lack of experienced expertise in the system and the need to deliver in small funding windows.
Working with NHS England, PwC and its consortium partners designed and delivered a first-of-type Frontline Digitisation Support Offer that reshaped how complex change could be enabled in a federated public sector system. The challenge was as much cultural and organisational as technical: aligning around 17 national NHS England teams with more than 190 provider organisations, overcoming scepticism created by previous national IT programmes, and building confidence among local leaders who wanted support rather than prescription. In response, the team focused on trust, creating an “emotional contract” with stakeholders and a one-to-many model combining shared support for common challenges with targeted specialist intervention where needed. This approach made better use of scarce expertise, reduced duplication and increased reach. PwC and consortium professionals worked alongside 30–50 NHS England colleagues. Capability building was strengthened through 120+ in-person Learning Labs involving over c900 clinical, operational and digital staff, plus more than 150 national events on change, cutover and data migration. A multi-channel engagement strategy extended the programme’s reach, generating over 160,000 views of online resources, engaging more than 3,500 bulletin recipients, connecting with a community of practice of over 500+ members, and responding to more than 200 requests for specialist support.
The programme delivered measurable impact, built lasting capability and set a new benchmark for national change delivery. More than 80% of participants reported improved delivery readiness, and over 80% of Trusts said they were more confident in leading their EPR programmes. Trusts also strongly endorsed the value of the support model: only 24% believed comparable support could have been sourced locally within the NHS, while around half said they would otherwise have needed to procure similar help externally, increasing cost and risk. Economic analysis estimated savings of £35.5 million to £122 million through reduced duplication, lower procurement costs and decreased implementation risk. Beyond these figures, the programme improved the relationship between national and local delivery, created practical mechanisms for peer learning at scale, and showed how data, agile methods and human-centred engagement can make transformation more effective and sustainable. For the NHS, it established a repeatable model for future digital change: a bold response to a systemic challenge, innovative delivery in complex conditions, benefits realisation, optimisation, and a legacy beyond it.
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