Putting digital on the agenda in the NHS
Author: Sarah Finch
- Service Digital experience
- Sector Health
- Date 28 June 2021
Andy Callow, CDIO of Kettering General and Northampton General NHS Trusts, on using digital as a tool to improve patient and staff experience.
As digital technologies become more widely seen as crucial to modern business, organisations face an issue of talent. Not only in recruiting for experienced technical roles – where the talent gap has been widely reported — but also in finding the right people for senior leadership positions. In this series, we speak to digital and technology leaders from a range of organisations, to find out how they're meeting their biggest challenges.
What would your teenage self think about the work you're doing now?
It's an interesting question, and perhaps one we can use to hold ourselves to account.
This is the view of Andy Callow, Group CDIO of Kettering General and Northampton General NHS Foundation Trusts, who discovered electronics at the age of 14 — and immediately understood it as a way of improving people's lives.
From developing software in the private sector to local government, NHS Digital, and his current role as CDIO of two NHS Trusts, Andy has always seen digital and technology as a tool to make a difference. And where better than patient outcomes in the NHS?
TPXimpact caught up with him to find out how organisations can go about creating a digital culture, the demise of old school attitudes towards IT, and the place of technology at board level.
Putting the funds behind digital
Like other C suite digital roles, the Chief Digital and Information Officer is typically tasked with creating an organisation's digital strategy, which for Kettering and Northampton Trusts sets its sights on becoming the most digital hospital Group in England by 2023.
As Andy states, this will involve improving systems and processes for both patients and staff, such as joining up care records, making systems simple to access and use, and investing in technology to allow patients to be cared for at home.
“There's lots to do, but it's a really exciting time,” he says. “What's clear is that as a Group we're really putting our money behind digital as an enabler to delivering great clinical services. My Group CEO describes it as our superpower, that's going to help us go from being where we are now to the excellent services we want to make sure we're providing.”
Let's go fully electronic
One of the first items being worked on as part of the digital strategy is an electronic patient record programme, which is being delivered at Northampton and Kettering Hospitals as two separate programmes but will eventually become Group-wide. Not only will this provide greater clarity to patients, but it will also reduce the burden of systems and paper-based processes which have been changed, partly digitised, and added to over time.
“There are over 220 different clinical systems across both hospitals,” Andy says. “Every single one of them has got an overhead in terms of training, in terms of upgrades, and the contract management and account side of things... So part of our strategy is to look at those clinical systems and firstly seek to integrate them together across the hospitals, plus also reduce the number that clinicians have to deal with.”
This will be music to the ears of both hospital clinicians and digital teams, whose time is eaten away by the burden of multiple systems, logins, and administration. (In fact, Andy cites one clinician who had 42 separate logins for systems around the hospital...) It's all part of improving the user experience of all interactions with the hospital Group, for both patients and staff.
“Moving to the electronic patient record and a single sign on for clinicians is really important because it's going to enable clinicians to give back time to care, by having that single record across both hospitals,” he says.
“We want to make sure the patient experience is improved. At the moment there are not many opportunities for patients to interact digitally with the hospital. So, we're getting to a position where all their appointments across Northamptonshire – not just in the acute sector - are in one place, and they can view them, reschedule or cancel.”
“We also want to do some work around pre and post events, so if you are coming for a procedure, you have information that's going to help you orientate yourself in the hospital, understand your procedure, and then afterwards make sure you have the right information specific to your rehabilitation. None of this is rocket science, and in many cases, it already exists. But making sure it is part of a really good experience is key.”
A voice and a seat at the table
One theme we have already come across in this interview series is the place of digital and technology roles at board level.
It's not just symbolic: having a Chief digital, technology or information officer on the board changes the kinds of conversations senior leadership are able to have, and therefore the decisions they make.
“Both Kettering and Northampton hospitals had different arrangements regarding technology leadership,” Andy says. “At Kettering this was created as a board level role in 2019, but at Northampton the CIO had historically reported into operations and then finance. When I joined as Group CDIO in 2020 I could see the difference, just from the organisational perspective, about how important digital was to the success of the hospital. I'm not trying to disparage my finance colleagues who are brilliant, but if you put technology underneath finance it will always be treated as a cost overhead rather than an enabler to your future success.”
According to Andy's research, only 22% of NHS Trusts have a CIO or CDIO on their board. Over time, this will surely become a differentiating factor for those Trusts who are making real progress in patient and staff experience.
“Being on the board is a double-edged sword — you are responsible for the delivery of your strategy and you are quite rightly held accountable for that in a complex environment. But it means your priorities and agenda are right up there with everything else,” he says.
“When we talk about particular problems at board level we can see that technology will help us get to better outcomes. Without that digital and technology voice on the board – you have those conversations in a different realm, or they become a bit more abstract. So having a seat at the table is really important.”
There is a further consideration for NHS Trusts to take into account when considering the place of technology roles at board level. It comes down to attracting and retaining top talent.
“There are some colleagues within my network who are planning to leave the NHS because there is no prospect of their role moving to a board position and they feel like they are quite hampered by that,” Andy notes.
What is digital?
When it comes to putting a digital strategy into practice, it is the skills and dedication of employees that make it happen. For Andy, this requires a shift away from “old school” IT directors in the NHS, who typically focused on keeping systems running, rather than excellence in patient care.
“This is the difference between a technology and a digital approach,” Andy says. “So when we have a problem, let's not just throw a piece of tech at it as some may be tempted to. Instead, let's approach it in a digital way, understanding user journeys and redesigning services based on user experience, even if those services aren't digital themselves.”
In order to recruit the talent needed to work in this way, an organisation must send signals that it is embracing these new philosophies.
“I started putting Tom Loosemore's definition of digital in our job descriptions,” says Andy, “to send a message that this is an organisation that gets it, or at least is trying to move in the right direction.”
This kind of attitude is a huge draw for those looking to work in more digitally mature organisations. And there are other benefits too.
“We are implementing automation, which has really captured people's imaginations,” Andy says. "Staff can easily see that computers can take care of certain tasks, for example, HR has been talking about how they could improve the onboarding process through RPA. This would be a real selling point to potential candidates - with the onboarding process being so much quicker than the other people they could go and work for.”
From small beginnings...
The complexities and specificities of our public sector institutions, particularly in the NHS, make digital transformation no easy task. However, with the right attitude, talent, and strategy, forward-thinking NHS Trusts can really make a difference for their patients and staff.
For Andy, the benefits of this approach are already beginning to show.
“Technology delivery was considered by our staff as something that they were told was going on – and it just happened (or in some cases, it didn't...),” he says. “Now we've managed to build a reputation where if we say something is going to happen it does, and it works well for people.”
“Of course, there are things that we want to improve but we've gone from a position where there were very low expectations to a realisation about the journey we're on and a sense of excitement and possibility.”
This sense of possibility is crucial for a digital vision that sees not only traditional hardware come under its remit but cultivates a collective responsibility for everything from the hospital car park to the cleanliness of the corridors.
As for the thoughts of a 14 year old Andy? He'd probably say that's pretty good going.