Meeting The NHS Leaders Driving Rapid Digitalisation
Meeting The NHS Leaders Driving Rapid Digitalisation
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-line key-workers who fight the COVID-19 crisis.
Leroy Adamson Parks, IT Director at Croydon Health Service NHS Foundation Trust
Leroy Adamson Parks is the IT Director at Croydon Health Service and takes strategic roles within the NHS, driving change and planning for the future. Having been with the NHS for 15 years, Leroy is the first to admit that his entry into the NHS has been less than typical.
“I’m not your typical IT director. Never programmed. Never been a desktop engineer.”
Sitting at a Director level, Leroy Adamson-Parks has been a driving force for many of the changes brought in to enable the level of care needed to push back against COVID-19. The Trust that Leroy operates from, Croydon, is an acute and community trust, which means it is responsible for providing health and care both in the communities as well as at its main hospital.
“We’re in the position where we were lucky to have the capacity and capability within the IT programme team when the pandemic hit, so this opportunity, although a shame, is an opportunity for us to scale quickly.”
But when no two hospitals are the same, the challenges are many. Leroy is working collaboratively with other CIOs in South West London, to share best practice and identify where common ways of working can be delivered at scale and at pace.
But, like with most companies and institutions, it’s mindsets that are the biggest roadblocks to progress.
“We need to continue to change the perception of IT. We’re a critical enabler for all staff of NHS, and are there to use our knowledge and expertise to assess the systems and solutions in the market to identify how they can be deployed to meet the needs of everyone who uses the NHS not just for right now, but also in the future.”
Forming the COVID IT Team and Supporting the Front Lines
To support the Trust in this time of need, Leroy rapidly identified expertise from the various teams within the IT department to form a COVID IT Response Team. Currently, they’re busy working on rolling out new hardware, new systems and new workflows to improve the care given to patients. This situation is making everybody think “digital first”, and are finding new ways of working and technologies are becoming ingrained in what is likely to become the new normal, such as where patients are provided with the same level of medical care, but without the risks associated with travelling into the hospital.
“I’ve got a Covid IT Team headed by an expert program manager who is coordinating the options, the bids, the proposals in a central store that anyone of us can access. There is a real blend of leadership skills needed in the NHS to provide excellent IT and digital services. That being said, working during this period has not only been physically demanding, mentally and emotionally it’s been incredibly draining.”
To achieve these goals, collaboration is key.
Be it Sales/Marketing or Front-line NHS workers and Operations, whenever two teams pool their knowledge great things are achieved. Outside of the IT Team, Leroy is working closely with front-line NHS staff to ensure that IT solutions are grounded in the reality of the front-lines.
“I work closely with the Chief Clinical Information Officer. She’s making rapid decisions based on a number of options, as well as providing clinical care to geriatric patients. She has the perfect blend of what the tech is capable of and how the patients would benefit and was a major driving force in our decision around the video conferencing software we’re using to contact patients.”
One of these solutions that have truly benefited from the combination of knowledge from the front lines and the operations is the ‘Attend Anywhere’ service. Attend Anywhere is a digital platform for running outpatient services that would historically have been done in person. Instead of coming into a busy hospital and potentially coming into contact with infections, patients can use a virtual waiting room before being seen using the solution.
Not only has this addressed the immediate concern of keeping potential infections down, it has also provided greater access for residents in the Borough.
“We have a diverse population in Croydon. The solutions we have introduced allows us to provide the same care remotely, and can even bring in other third parties into outpatient meetings, such as other family members, carers or interpreters. This is such incredible value for our patients and our staff.”
Digitalisation was, in recent years, at risk of becoming a bit of a buzzword. Something a lot of people talk about but maybe don’t fully understand, or know what it really means. The move to being digital first is a fundamental shift in the way our staff and our patients work, and use our systems.
The NHS was no different and as set out in national plans, such as the Long Term Plan,digitalisation was needed, with Leroy playing a big part in that in his local trust area.
“The organisation is giving me more resources to bring in key skills to make this happen. I was lucky we were in the right practical mindset. I was also lucky that many of the projects that we needed to deliver at the end of March weren’t finished. This meant we could easily do an audit on these projects and realign some of these resources to focus, with immediate effect on COVID.”
Leroy’s restructure brings into play a clear distinction between day-to-day IT operations as well as a new digital transformation programme team. The latter being completely focused on doing things in a more efficient way, supporting the Trust to identify new ways of working that best meet the current needs of staff, carers and patients.
“It’s not about having significant amounts of legacy equipment that we manage each day, and check the lights are flashing. That’s old-school.”
Instead, the focus for Leroy’s Digital Transformation team is on bringing in a new set of skills, such as developing improved business relationships and helping write compelling business cases. This new approach to finding talent has led to breakthroughs that have helped revolutionise outpatient services. These services, that were initially conceptualised and executed in response to COVID, are sending digitalisation ripples throughout the entirety of the NHS.
The ‘New Normal’
As social distancing measures continue to be enforced, companies will naturally be assessing the old ways of working.
Many people have been questioning if things will ever be the same again. For the working landscape, many of those who have been working from home for months will be questioning why they get on the train every day.
One of the areas in question will be commercial real-estate - something Leroy is already witnessing massive changes in.
“The Estate is probably one of the most expensive pieces of the puzzle. We are moving to a different way of working. Multi-organisational and multi-purpose buildings are becoming the new norm.
Acute hospitals are seen by some as old-fashioned. I read a comment on social media recently where someone asked the question “Why do 3,000 people drive to work because that’s what they have always done? Most back-office teams don’t need to be physically on-site and can provide as good if not a better service remotely. If we take this leap, we can reduce costs and improve the life balance for staff.”
Getting this right could well be a revolution for the fabled life/work balance. With less time devoted to things like travelling, new working routines can be set up.
“Both my wife and I work in the NHS. we both come home after 12 hour shifts and it takes a lot of time to decompress and be ready to do it again the next day.”
But, with all this extra time, it’s up to leaders like Leroy to ensure that balance is achieved for what promises to be a very long and difficult period for everyone.
“This is going to be a scenario that will last a while. We need to work on managing people, their health and wellbeing, through the marathon in front of us.”
Michael Knight, Associate Director of Technology Management And Architecture at NHS South, Central and West
Michael Knight, Associate Director of Technology Management and Architecture at NHS South, Central and West takes up a strategic function across service desks, resourcing and field engineer management in response to COVID. It’s up to Michael and his team to enable all members of the NHS to do their job effectively from remote locations.
Michael and his team first heard about a practice closing because of COVID in one of his areas on the 13th of February.
“At that stage, our major incident team was starting to get together. We started to find our stride quite early on in having that quite solid way of working, which we scaled up as the situation changed.”
As that grew, Michael put together a dedicated IT incident response team who met once a day. This team of 15 is supported by over 300 staff who are working with primary care to support new ways of working. A team of that size is able to meet the demands of all the sites they serve, but size also comes with its challenges. For Michael, the biggest was logistical.
“Looking at how our service desk is doing, what the resourcing is like. What’s happening in the field? So our desktop engineers have built huge numbers of laptops to get our teams working from home. Some from NHS England, some CCGs bought themselves via us. This is quite the logistical challenge because we have to get them all tagged and checked before the kit is sent out. This is sometimes well over 100 a day in each of our 3 hubs.”
Looking to increase effectiveness across all of his teams, Michael began work digitalisation and standardisation many months prior to COVID. This stood his teams in good stead when COVID started to isolate teams.
“We used to be three separate organisations so we had lots of different techs which we’ve since rationalised down. Now when we react to something we know exactly what we’re using.”
“You’re NHS and that means something.”
Despite the improvements to processes and infrastructures, Michael and his team are still working around the clock to make sure everyone in the NHS can continue to provide care to those who need it. This single-minded focus on support is something that Michael believes is very much part of the NHS ethos.
“Everyone who works here is a health and care person through and through. Whether you’re IT or BI, you’re still NHS and that means something. Be it working extra hours, be it working a completely different role. Everyone here has worked above and beyond.”
Despite front-line workers often taking the headlines for their continued bravery in the face of COVID-19, we often forget about those working behind the scenes to enable them and support them.
“We offered support to the Bristol Nightingale project. I sent out a request for volunteers from across the team in the morning and by lunchtime I had 50 volunteers.”
Naturally, the increased demand put on all members of the NHS has led to leadership challenges. This is especially the case with Michael and his team who find it difficult to work from home safely while others are putting their lives on the line daily.
“We need to focus on people’s well-being. I’ve been at home in Yorkshire for about a month. I’ve found it really difficult not being there on the ground. I feel like because I am at home, i’m not making the biggest contribution. Having to accept that the best and most effective contribution I can make is to enable and support the people who can go out and do the work has been difficult for me.”
Peering Behind the Red Tape
In a matter of weeks Covid-19 has shown us that change is possible. Traditional GP appointments have been supplanted with rapid adoption of video and telephone consultations, enabling vulnerable patients to safely speak to their doctor. Online prescriptions via the NHS app increased by 97%, including a huge surge in use by over 65-year-olds. Used intelligently, technology can increase the number of people using the NHS and their level of satisfaction with it, as well as improve care.
“People are mobilised. Everything is possible. But also, the balance to that is risk. They don’t want the compliance to be lifted too much because it’s there for a reason.”
Panicking and overspending now would only lead to question marks over spend, something Michael and his team are constantly measured against. Instead, a balance has been struck ensuring that everyone gets what they need through the procurement team Michael works closely with.
The other area that Michael has seen a significant organisational change in is operational. Recently, his team has just finished an interim role for a community provider. The project involved real business change ideas and Michael was tasked with supporting their digital transformation plans.
“We planned to do these changes in a really controlled way, so we pencilled it in for 6 months time. Well, we’ve done that in just 2 weeks.”
Confident that the spirit of change will remain, Michael and his team still expect to see governance come back. The middle ground is the best option for both parties but the seismic shift in the culture of the NHS is being witnessed by all.
“During Wannacry I worked at a trust that was particularly impacted. There was a good cultural benefit that came out of the crisis. We had a band 6, Junior Project Manager working overnight on a project. The next morning, the exec director of strategy took over the same work.”
For the time being, Michael and his team are all working remotely in very difficult times. Amidst increased demand and changing expectations, Michael is adjusting to remote working and homeschooling duties.
“He’s 2 in august. I had terrible planning. I accepted this role on the friday and by Monday I found out I was going to be a Dad.”
This ‘new normal’, where a work/life balance is almost entirely obliterated in favour of a simpler outlook on life in general, many people are finding their feet in what could be several months of remote working.
“Luckily for me, that’s not going to change. When we get out of the back end of this, i’ll be spending a lot more time with him.”
Mike Cox Head of Clinical Engineering at South Tyneside NHS Foundation Trust
Mike Cox is the Head of Clinical Engineering at South Tyneside NHS Foundation Trust. Tasked with reducing risk to patients and staff by ensuring medical technology is working to capacity as well as operating on-call systems for all front-line staff to use.
“I’m head of service, my department has been down in numbers for quite a few weeks. We’ve put on hold our normal maintenance schedule and have refocused on maintenance of crucial Covid-19 equipment.”
As this article is written (06/05/20) there are 195,000 confirmed COVID-19 cases in the UK. Initial response from the NHS was centered around the provision of care to critical patients and access to ventilators. This directive, filtered down to individuals like Mike, has led to some very fast-thinking.
“We’ve had to move our ICU to a different ward to cope with the influx of ventilated patients. We had to move all that tech, network it all and basically create a new ICU from scratch. That’s what we’ve been focusing on. We’ve even turned our anesthetic machines into ventilators.”
Mike’s function, at the heart of ‘front-line care enablement’ gives him particular insight into just how much change is happening at the NHS. Change that is happening rapidly and at scale.
This change has been felt by Mike who has been able to send many of his already highly qualified engineers on training to enable them to react quickly to any given situation.
“Our engineers are top grade engineers. We’ve been able to do that for the last 20 years. Funding has been available for technical training courses so we can take things off contract and have them internally maintained. This allows my department to react quickly to any given situation within the Trust. This may be an infusion pump one minute and the next a ventilator or other life support device the next. We could be called to move an entire department together with all the medical technology associated with the care of our patients. The training courses I send my staff on gives them a wide range of skills to manage around 13,000 medical devices across both acute and community sites. The COVID-19 pandemic affects our work in the community as well as hospitals. The community service which is just as vital as the acute hospital based service is often overlooked as the media focuses on the situation in Hospitals.“