Falling into the Evolution of Digital Healthcare…….

I am now four months into what has felt like a roller-coaster of an adventure, coming out of the NHS so I thought it was a good time to ramble on a bit about my adventure that was my fall into the world of Digital Healthcare in the NHS.

Falling is something that we don’t have control over. Falls happen all the time, everywhere, all over the world, but not all falls are the same, our personalities fall as much as our bodies. Whether it is falling about laughing, falling in love, or falling into a job. As the American singer-songwriter, Hayley Williams said

“Sometimes it takes a good fall to really know where you stand”

…and for me, this was so true.

When I am asked about how I got into Digital Health I always describe it as a dramatic fall that I enjoyed all the way down.

After been in the NHS since the age of 18 and leaving 19 years later (with a small fall out in the early noughties) it remains my best-unplanned adventure ever.

I joined the NHS as a temp in finance after returning from traveling the world for 2 years and was introduced to the wonderful world of this thing called the “National Programme for Information Technology” or NPfIT for short I went there for 2 weeks and “did” 10 years, it sometimes felt like a “prison sentence” and one you always threatened to escape from but never really wanted to. I have a lot to be thankful for to NPfIT and the (mostly) amazing managers and colleagues I had during my time I started as an admin assistant and learnt on the job how to be a planner then on to be a project manager and eventually the nuts and bolts of procuring National Contracts, delivering complex results to complex situations.

Onwards and Upwards

With all this new knowledge and experience I was offered the opportunity to step into the real world NHS, to go and work in Informatics in one of the biggest Teaching Hospitals (Leeds Teaching Hospitals Trust) in the UK it was daunting but an opportunity I could not pass up.

Just to pause for a moment; when I say real-world NHS there are colleagues of old who will agree and some who will not but when working for a National body (in the ivory tower of the centre) whether that be the NHS, DWP or Central Government if you do not interact with the customers of that service the only thing an amazing colleague and inspiration to me Andy Kinnear would say is, ‘all you have in common is a logo and in my case the blue and white badge’, this is something I learnt fast!

My first 12 months at LTHT were a whirlwind one thing that did not differ from NPFIT was staff turnover, but it seems to be at an all-time high in my first 12 months. I saw a change of guard from the top down and I went through 4 line managers and the membership of 5 teams which at times made me nervous, had I done the right thing, but again, I look on this time now fondly it gave me a new set of skills, managing your manager, team integration and a perspective of how to work with people that I call out as invaluable to this day.

Twelve months in I started to find a home and a purpose; the amazing crazy world of building your own Electronic Healthcare Record (EHR) done by only a few Trusts across the UK, something I didn’t know was even a reality 12 months before but something that I realised and was caught up in very quickly the love and passion the team has for it saw no bounds!

The next two years saw me go through many checkpoints on this adventure from a secondee to permanent from Project Manager to Programme Manager and I loved every minute, I started to discover for the first time something I was good at and that this that had started out as adventure actually was maybe turning more into a journey that I was ready to take hold of and curate. An adventure that turns into the journey to a new reality still rings out as a lucky moment for me, not everyone gets to be able to find themselves and then become the best ‘me I can be.’ As Sophie Neary, the digital leader for retail at Boots said earlier this week on Social Media said, “We learn the way on the way”, that is how I got here, I learnt from everyone and everything that happened on the way to ‘here’!

Finding me

Apparently, as it turned out I was a bit of an IT geek at heart (Yes I am from the IT Crowd now, just not sure which character) and when I found myself two years in sat in a meeting waxing lyrical about Integration engines and messaging and it being key to the survival of the NHS, I even sounded like it made sense I took myself by surprise. I had always been a person who never really knew what I wanted to do. Music was a passion for many years but once I knew it could not be a career I knew I needed to look around I was always described as someone who caught on quickly, a fast learner when starting a new positions it wasn’t until this moment that I found something I really wanted to learn about, enjoy and ultimately fall in love with.

This was fascinating for me because when I was growing up, I would have said I wanted to be a Teacher, Musician, or Nurse. No seven-year-old dreams of being a Digital Health Enthusiast. I can’t think of anything else I would rather do – maybe the Musician, but when I look at the Digital wonder that I get to play a part in – yes, it is exactly where I want to be. Half the beauty of this, is that it never even crossed my mind that is where I would find my happy place.

My last two years at Leeds moved me from the detail of digital the building of an EHR and the firefighting that is keeping a live service running for a multi-site Trust to how do we take this thing called Digital to the next level and actually use it to actually Transform how Healthcare is delivered.

New Horizons

We had a new CDIO start with the Trust in November 2018 and it felt like we were starting a new journey, one which the LTHT informatics team needed. As a team, we had become siloed we all had a purpose whether that be the EHR, Live Service or keeping the kit churning all needed and valid parts in the machine in their own right, but no appreciation that they all needed to work together to ensure the success of each part and for the machine to run smooth.

We spent the next 12 months coming up with and cementing a vision into the whole team a north star that we could use every time we questioned what we were doing. There were many challenges on this journey and some that were sadly never won but with adaptation a compromise was found so we could forge forward.

Personally, I sparked a newfound passion, that of teams, people, transformation, and how do we make it all work? People first, opinions second, technology, and the way forward only falling into place when the ingredients started to mix right!

I’ve always loved been a people manager and prided myself on not “managing” anyone but being the enabler to help people grow, make the wrong and right decisions and provide a healthy challenge to help them on the journey they choose, recognising that everyone is different and for some it will be climbing that ladder and some not. I want to be, I strive to be a manager than has no bias at the start of the conversation and wants to see the diversity of life in everything we do.

Along with this I went on a journey which to me was harder, how to work with passionate peers one much less straight forward but one that was so rewarding when as a senior team we affected a successful change. I learnt to listen to the end, to show respect and understanding at all times even when you inevitably disagree, and you soon realise the thing about passionate peers is that we all want the same outcome and when you inevitably find a way of working and a level of appreciation that everyone has good, bad and hard days you will have success after success and those successes will become easier.

Finally, we come to transformation, it means so many different things to everyone but to those delivering Digital Healthcare to the frontline it means streamlining, simplification, advanced accuracy, safeguarding of staff and patients, and ultimately acceptance of users. I feel I should add in true NHS style whilst delivering value for money for the taxpayer. Transformation is picking the right run on the SAMR ladder as the answer to every problem, are we here to substitute, augment, modify or bring full transformation and redefine the problem that came to us in the first place. That is the key skill I want to take to every role from now on, to ask what, and then help redefine how.

NHS Transformation journey

But we have gone on a journey of transformation in Healthcare we started out thinking at the incarnation of NPfIT that putting paper behind glass was the key, and the collation of every figure and scrap of data was needed not sure why but it felt right. We have now thankfully been on a relatively short journey, just 10 years, well it took 10 years for Take That to reform and we all know what a success that was, to realise yes, we should reduce and where possible eradicate paper, but we need to question why do we have that piece of paper what does it deliver to the clinician and/or the patient? How many other variations of this piece of paper are they and this questioning will continue to ensure you realise the right digital transformation. I feel the data journey is still lagging we now have all this data; some good some bad but because we didn’t take a logical approach to how and why we collected it in the first place we now have people battling with the best way to use it whether that is to change the way we treat Oncology patients, move patients around hospitals or even better to not bring them into the hospital at all. My hope here is that with the power of Data Lakes and AI and some amazing brains we are lucky to have in the UK to call out Rebecca Pope, Geoff Hall and Monica Jones to name but a few will mean this journey will be massively accelerated.

Professor Geoff Hall in particular for me crystallised this ask for me, at the outset of Building the Leeds Way, the amazing programme created to rebuild so much of the LTHT estate he asked why, he paused everybody and asked that we truly considered should we be building for more beds in the next decade or should we be more disruptive and consider what a patient journey looks like when the patient need not come into the ‘moths lightbulb’ and can, in fact, stay at home and receive care. He didn’t win that debate (one of the few I have seen him not win!) but he didn’t lose either, it is still a topic to be considered.

In my last year at LTHT I was successful in being appointed as Associate Director of Digital, a position I was as equally humbled and privileged to gain. The next 12 months saw a lot of changes a change of guard as our CDIO moved on to pastures new and time of interim which again taught me lots more skills for my kit bag when using that word “transformation” that sometimes just keeping the ship afloat is ok and that small pieces of transformation will come naturally when you have made them part of the norm, and I feel this what I successfully did for those 12 months.

Where I am today

During this time of Social Isolation, and the children showing an interest in something other than their phones, I was asked did you always want to be a Digital Health enthusiast (or in the words of my 8-year-old, do computers for the NHS) which made me sit back and reflect on this adventure that has got me where I am today and hasn’t ended yet…..

Next though is to facilitate more and more people to start the adventure and take the journey, that has to be my reason to get up every day now I am very proud of the journey I have been on to find my way into Digital Health joining a profession by exploring my strengths and talents and I will continue to encourage and help anyone on theirs so we continue to encourage diverse talent not to be part of the tribe so we can truly continue to make a difference…

In my next blog, I will be talking about how I’ve taken the step from the NHS into the Private Sector as a supplier to the NHS at DXC

Take care everybody, stay safe.