Reliance to resilience: Building technical in-house capability for the NHS

Apr 25, 2023
  • 4 min read

Which challenges do large public sector organisations have in common? Immovable deadlines to meet policy change, maintaining national critical infrastructure, and designing for complex user needs spring to mind.

We know this first-hand, having helped central government departments including HMRC, DWP, DfE, and DESNZ tackle these very challenges. Crucially, we’ve also helped them build up and take ownership of the skills and capability they need to maintain their digital solutions without dependence on external suppliers.

NHS Trusts share a lot of the same challenges. What would happen if they too moved towards full independence from suppliers? In this article, we explore how making this shift could be the stepping stone it needs to find a sustainable solution for saving taxpayers’ money and freeing time for its frontline staff to focus on their critical work.

Supplier dependency: NHS Trusts’ hidden challenge?

What are the NHS’s biggest challenges? As the sixth largest employer in the world, the list is understandably long. But two of the biggest are releasing time to care for frontline staff and building digital services that are tailored and easy for staff to use.

There’s no simple answer to why these challenges aren’t always being met. One common thread, however, is that enlisting consultancies to build and implement solutions can become very expensive long-term.

The cost of the initial work will be relatively predictable. The true issue is that this model can create heavy dependency on the suppliers who build the solutions, as the skills and IP that underpin them is fully owned by the consultants. This makes the solution financially unviable over time, and more importantly, it keeps Trusts and teams in the dark about the IP that underpins the technology that’s driving their change.

The only way out of this would be to adopt a completely fresh take. If NHS Trusts prioritised building up their in-house technical capability, they could lose their reliance on external suppliers and serve their frontline staff and patients both better and more sustainably.

Lessons from central government: HMRC’s path to self-reliance

Tecknuovo’s mission is to help the publicly funded organisations deliver for citizens. We do that through our Zero Dependency Framework, which helps organisations de-couple from reliance on consultancies and contractors by creating their own capability in-house.

What does this look like in practice? Our customer HMRC is a great example. We’ve helped its Borders and Trade teams build in-house capability, meet immovable deadlines, and provide national critical infrastructure for the UK — for example through the Goods Vehicle Movement System. We’ve also built HMRC a microservices centre of excellence, centred around a container platform that lets teams deploy applications 77% faster by using reusable patterns and tools.

The best part is the end goal: for HMRC to eventually run these services fully independently of any supplier’s support, saving precious taxpayers’ money and providing better services for citizens all in one go.

Drawing the parallels: NHS and central government challenges

We want to help NHS Trusts support frontline staff and patients in the same way. The parallels between Trusts’ and central government organisations’ challenges are striking: immovable deadlines, policy that can change fast, and delivering services that the country and its citizens simply cannot be without.

NHS Trusts are already making strides to enact digital transformations that streamline operations and improve care for patients. What if, as part of that, they honed in specifically on becoming fully technically self-sufficient by building up their in-house capability?

It could be transformative for Trusts’ service delivery, people and skills, and cost efficiency.

With organisations across the private and public sectors already adopting this approach, what could it mean for the NHS’s frontline staff and patients?

A future of supplier independence for the NHS?

By prioritising in-house technical capabilities, NHS Trusts can transform service delivery, build up its in-house technical skills, and make best use of taxpayer’ money, there are no bounds to the change this could bring for frontline staff and patients alike.
If you’re curious about what this approach could mean for your organisation, we would love to talk to you. Please get in touch with one of our team at

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