Meeting the NHS Leaders Driving Rapid Digital Change - Part 2
Meeting The NHS Leaders Driving Rapid Digitalisation - Part 2
Every Thursday, thousands of Brits up and down the country stand on their doorsteps to applaud the work of NHS staff.
Since the campaign first started on Thursday, March 26, Major landmarks across the UK, including the London Eye, have been lit up in blue in support of the campaign.
The Clap for our Carers website states: “Healthcare workers, emergency services, armed services, delivery drivers, shop workers, teachers, waste collectors, manufacturers, postal workers, cleaners, vets, engineers and all those who are out there making an unbelievable difference to our lives in these challenging times… bravo, you are amazing!”
And for many of our own consultants, who have helped talented engineering, infrastructure and development talent secure jobs in the NHS, their tributes on those Thursday nights are often held with particular individuals in mind.
We reached out to those individuals to spare a few minutes of their busy schedule to share their insights on how they’re driving massive digitalisation while supporting the front-lines who continue to fight the COVID-19 crisis.
This is the second part of a series looking at the tech leaders in the NHS who are driving change. If you missed part one, you can view it here.
Ian Townend, Lead Architect at NHSX
Ian Townend is the Lead Architect at NHSX, a team with a range of skills and expertise, including clinicians, technologists, policy experts, developers, data scientists and project managers, all working towards the digitalisation of the NHS.
In his role here, Ian leads across the architecture, standards and interoperability areas. This covers a range of programmes including LHCR, Integrated Care and the CCIO7 priorities as well as a number of policy areas.
Like most working in the NHS, Ian has been overwhelmed with the support offered to the NHS. From free delivery, to reduced rate, all the way to technology solutions - the support has been, at times, boundless. But when it comes to technology support, Ian has to proceed with caution.
“For a number of companies, it’s been a case of them coming in, asking what we need help with and them getting on with it. That’s been great. In some cases we’ve had, for example, an e-consultation platform offered to us. But there 40 different offers and little time for us to assess them to make sure they are a right fit.”
Consultancies, telecom companies and hardware providers have all pledged support in varying degrees. These have all played their part in the on-going fight against COVID. One of the most startling example being NPEX’s provision of systems and tools to help speed up the reporting of test results.
“Managing all these offers, responding to them and making sure they’re right is a task in and of itself. Now we have a team entirely dedicated to it.”
For Ian, there are two elements when it comes to decision making around solutions offered to the NHS. Firstly, is it safe? Is it the right solution? Secondly, it’s about the solution itself. Do they roll one solution out nationally? Do they lay the framework down?
“When we decide we do want to do something and go out for review, which can be a case of ‘here’s a pack of 10 solutions you need to read them tonight so we can make a decision in the morning’. We need to put solutions in so quickly, but it’s because of this we’re seeing success.”
As an example, Ian is quick to reference consultations. Before the COVID-19 outbreak, 90% of consultations were done face-to-face. Now the scale is balancing out with more access to e-consultation services, something Ian and his team at NHSX have worked tirelessly on despite very challenging working conditions.
“I’ve got a mixed team across the country. Some of them are single, some have families. Everyone has pulled together in sharing the workload. We’ve found that for some members of the team coming in to work is a big social element and losing that may have had a bigger impact on them then first thought. Many of the team are working on new areas in different parts of the organisation and making sure we maintain our sense of team has been important”
To address this, Ian and his team introduced twice weekly team calls with no real agenda, followed up with an update call for people to provide feedback on work, past and in the future.
Perhaps unsurprisingly, staff and managers are paying closer attention to how other members of the team are responding to the situation.
“I’ve had situations where someone has called me to tell me that someone may be feeling a bit down - I can jump on a call with them and address that whether it’s just a chat or if they need some additional support to manage their workload.”
Nigel Batey, Head of Business Intelligence at Yorkshire Ambulance Service NHS Trust
Nigel Batey is the Head of Business Intelligence at Yorkshire Ambulance Service NHS Trust, His responsibilities include providing intelligent information to the senior management teams within the Trust in order to improve service performance across the various service lines and support development of key strategic initiatives.
Given the nature of Nigel’s position, planning was happening long before isolation was introduced.
“We would have meetings with partners in the service so we could understand what would happen if portions of staff were lost. We also used this time to ascertain which were our key services and which services could be brought in to support them.”
A portion of this planning was devoted to the redistribution of staff to other areas. Business Intelligence for example, trained to be in the scheduling team, other support teams trained to support the call centre. This was done while working very closely with capacity to understand what the NHS’s demand might be and what impact that might have on performance if certain things happened.
“Everyone was really keen to help out, going the extra mile to work weekends to get the reports delivered. These national reports go out everyday without fail, even bank holidays so my team, even though they’re not contracted to work those extra hours are working them.”
The issue for the Ambulance Service as a whole was that call volume was likely to continue to increase once lockdown was rolled out.
“At the time no one was 100% certain what would happen - of course we were anticipating a lot more calls. We had to understand how many calls were coming in, what was the worst case scenario and what might happen to staff.”
Nigel’s team was already set up to share information across web based platforms (such as Power BI and Qlikview ) and making use of the latest technology by piloting the office 365 platform. When the news came that everyone had to work in isolation that plan had to scale up dramatically. This led to the introduction of a few more things including the use of Microsoft forms for people to create a weekly overview of challenges to be presented back in power BI reports.
“We also worked hard on setting up power BI dashboards for key COVID stakeholders, this would go out to partners as well as internally. This showed stats like performance, sickness and effectiveness. This was combined with the national data sets that were being released at 9am every day. We had to put steps in place to make sure we could inform the national team of certain KPIs they needed to know about.”
Amid the enablement of key staff and the delivery of key dashboard, Nigel and his team have had plans to move to a team work space. This was forecasted to take between 6 months and a year. But if there has been one key takeaway from isolation it’s been that we can move mountains if we need to.
“We had a plan to move to team spaced working as a trust which was forecasted to take between 6 months and a year. This would include infrastructure changes and a lot of training. But just now, overnight, over 2 million licenses for Teams were released overnight for the NHS to access. Everyone suddenly had access to teams and was able to video call, share screens quite quickly.”
The future, for Nigel, is one that has very much been enabled by this rapid change of working methodology. Everything about the way we work will be different.
“The strategy as well, we’ve already moved towards electronic patient records with 90% of patients already onboarded. There is plenty more coming as well.”
Rony Arafin, Assistant Director of Informatics of Devon Partnership NHS Trust and Director of Engagement for Apha – The Association of Healthcare Analysts.
Rony and his team of 49 BI Analysts and Software Developers support over 3000 staff providing Mental Healthcare and Learning Disability services across the Devon region supporting Metal services in hospitals and the communities.
Experienced in successfully implementing Agile and Lean based framework and Digital Transformation, Rony
Some of the key issues that Rony faced included enabling 65% of the workforce to work from home, to support clinical pathways and continuation of key services. This was done while the Operating model changed to maintain the incident, with a massive impact on services. There was an estimated 45% drop in service, Rony and his team now focus on bring these back over the next 3 months.
“Most of the workforce equipped with laptops so it was around creating capacity to deal with large influx of remote workers, on our platforms, applications such as Carenotes and bespoke metal health applications that support the work flow”
One of the biggest challenges Rony faced was equipping and implementing MS Teams in short space of time to all 3000 staff. This was done with a reduced workforce as many of his team were redeploying from Analyst roles to support the service desk and users.
Looking forward, Rony expects to see services return to full capacity over the next 3 months and the usage of data and analytics to become more widespread.
“I see a lot more use of Data Science, Analytics and AI to manage capacity, shape services and bring further benefits to the clinical and support services we run, as such we have invest heavily in developing clinical application and solutions to manage the trust."