We spoke to Andy Callow Group Chief Digital Information Officer at Kettering General Hospital NHS Foundation Trust and Northampton General Hospital NHS Trust
about his recent research into CIO representation in the NHS at board level, digital acceleration and the responsibility of innovation.
When Andy Callow, Group Chief Digital Information Officer at Kettering General Hospital NHS Foundation Trust and Northampton General Hospital NHS Trust, heard about some exciting developments happening at a neighbouring Trust he was keen to reach out and collaborate.
Following his initiative and passion for transforming processes for the improvement of patient care, Andy was disappointed to find roadblocks.
Despite his best efforts, he couldn’t locate a CIO to start a conversation with and there was no information available to help point him in the right direction.
From that initial disappointment, a large research project was started. After reaching out to others across the NHS who had had similar experiences, Andy decided to focus his research on CIO representation on NHS Trust Boards.
“I was motivated by conversations with some other folk in the NHS and contrasting the experience I have as a Board member compared to theirs, where it seemed much harder to bang the drum about ways of working and approaches necessary in the internet era.”
The findings details that 22% of the 226 English NHS Trusts who were researched in the study have CIO representation at Board level.
Andy’s research drew links between the low representation of Trust CIOs in social media to their representation on Trust Boards. His hypothesis was that if CIOs are not publicly visible, how visible these CIOs are in the organisation.
An initial alarming discovery was the fact that, of the 226 Trusts, Andy was only able to find the names of 169 senior tech people. For the purpose of the research, Andy grouped many senior tech roles into the CIO job title but admits that, in reality, there are many differences between roles.
“People who are operating like Directors of IT from 10 years ago do not have the skills and approaches needed for the coming years. So if you’ve got an old-fashioned Director of IT, reporting to the Board via the Director of Finance, then I’d suggest that the Board are going to simply view technology as an overhead to be managed down, not a crucial transformational tool to change the whole way our organisations work.”
This could go some way towards explaining why CIO’s continue to remain underrepresented at the board level.
“So if the most senior technology lead in the Trust is not agitating for this approach and not setting out a compelling case for the future, then I can see why Boards are content not to have CIOs around the table.”
Change, it would seem, is something many of us are getting used to. From our daily routines to the way we communicate with our team – everything is different and nothing is the same. While we adjust to the new set of quickly established standards, other, more monolithic organisations are carefully gripping the opportunity for change.
For the NHS, one the world’s biggest employers, funded by the public themselves, change isn’t as simple as flicking a switch. Between fighting the pandemic, mobilising full-scale homeworking and keeping the country running, digital transformation has gathered momentum within the NHS. With the wind very much in their sails, it’s now up to the NHS to keep up with the pace of change.
For Andy, the key for keeping up with the rate of change lies in an openness both personally and professionally.
“I think we continually need to be open to learning both personally but also by creating that environment in our teams where continual learning and horizon scanning is the norm. I find social media; Twitter in particular a rich source of learning about what is happening and the deeper conversations that spring from a generous exchange of comments. We need to expect to change and therefore take decisions that don’t lock us into long contracts, or services that become irrelevant.”
The death of agility, in the case of the NHS, is tied closely to the fact that it is a public sector institution. Implementation challenges, local hosting and supporting uptake in addition to procurement overhead of changing systems in the Public Sector can all contribute to an aversion to change and risk.
This is something Andy is keen to address so that significant progress can be made in the digital space.
“All these costs can incentivise an attitude to award longer contracts, which impacts our ability to change. I’m hopeful that as we move to more and more cloud-based subscription services, that offers increased flexibility.”
Over the past few years, we have seen a growing number of Innovation roles develop. A welcome change, a step in the right direction and an important role at the senior level – but, somewhat beside the point.
“I think it is an important function and some Trusts are more ready for it than others. I think it is more about an attitude that spreads across the organisation than assigning it to a single portfolio. So being prepared to take some risks is a key factor. That’s where the agile methodology can help, by seeking to test assumptions early, do the smallest thing possible, to experiment, to be prepared to fail. I like the Dan Ward FIST approach – Fast, Inexpensive, Simple, Tiny.”
My series, Female Leaders in NHS Tech, although not a formal study has certainly shined a light on the lack of female representation at the highest level of the NHS. Andy’s research adds to that concerning picture.
“My research found that of the 22% of CIOs on Boards, only a quarter of those are women and there appears to be only 2 BAME Board CIOs (based on very basic research involving viewing LinkedIn profiles), so there’s a lot to do in terms of diversity in the CIO community.”
Research on the psychological contract shows that people want to work for employers with good employment practices. They also want to feel valued at work.
To be competitive, organisations need everyone who works for them to make their best contribution. Increasingly, employers recognise the importance of diversity and inclusion in recruiting and retaining the skills and talent they need.
A diverse workforce can help to inform the development of new or enhanced products or services, open new market opportunities, improve market share and broaden an organisation’s customer base. However, people need to feel they have a voice in the organisation to allow their different perspectives to be heard.
Andy, who only made his move into the public sector because of the environment of excellence created by a former boss and colleague Carol Brown, is a massive believer in cognitive diversity and it’s effects on improved decision making of organisations.
“I’ve been fortunate to have worked for some excellent women in my career. I was a bit wary making my first move into the public sector and it was down to the environment of striving for excellence created by Carol Brown at Derbyshire County Council that led me to take a plunge I’ve never looked back from and for Wendy Clark at NHS Digital, who was inspirational, and able to bring a more rounded human approach to an organisation that can be quite mechanical. I’ve got some brilliant women working in my teams currently who have the potential to be CIO material if they choose to do so. I was very impacted by reading Rebel Ideas by Matthew Syed in 2020 and the importance of cognitive diversity to improve the decision making of organisations.”
Having recently recruited for his senior leadership team in Kettering and offering roles to applicants from a diverse range of background, Andy is keen to carry that momentum into 2021.
“I’ll be doing more recruitment in Northampton and Kettering in 2021 and I’m going to be more deliberate in seeking applicants from unrepresented groups, for example by seeking help from the Shuri network. I’ll also be drawing on the help from the BAME networks at Kettering and Northampton to be part of the selection process for those posts. You can’t be passive about the disparity we see across the industry, it requires deliberate effort.
