For centuries, technology has both inspired and frightened human beings. Today’s technology is no different in it’s dualistic nature.
Popular opinion of technology is rather nuanced, with the general populace understanding it’s value but nonetheless expressing worries around safety, job security and more.
Intrinsically, technology is neither good nor bad—it is the use to which it is put that makes the difference. For digital and technology leaders operating in the NHS, one of the world’s biggest employers, technological applications are made for one thing and one thing only: the well-being of the 16 million patients it treats every year.
We spoke to a few technical leaders from across the NHS to discuss the applications of technology they’re seeing and how they’re driving value for both the patient and the caregivers.
Saeed Umar is the Head of Technical Services at Lancashire Teaching Hospitals NHS Foundation Trust, a major trauma centre.
With a career spanning 20 years and focused entirely on tech, Saeed has worked as a technician and various other roles on that career ladder throughout the NHS before securing Head of Technical Services in 2016 – a role that encompasses cybersecurity, networking, telecommunications, switchboard and help desk.
For Saeed, who has enjoyed a long career in the NHS, the biggest change that has happened over the COVID period has been around the investment technical projects in the NHS receive.
“There was a very stop-start nature to investment. That has changed over the last couple of years. And we’re kind of moving in the right direction with a lot more rigour from NHS digital.”
For Saeed, it wasn’t a specific technology or new project that has made the biggest impact on end-patient care, but rather the way that infrastructure has been allowed to kick up a gear.
“We were able to crank up the dials on all our infrastructure, without the need to go out and buy anything, just upgrade, enhance or increase the capacity with our fantastic vendors. People had Teams instantly, people had the ability to work from home, thousands of users were able to go home within a matter of weeks. Without any change in the way they had to really use technology.”
Enabling thousands of NHS staff to operate uninterrupted from a place of safety has allowed the NHS to keep up with the pace of change and match the crisis every step of the way.
This increased emphasis on infrastructure has also had a very deliberate positive impact on the end user who has benefitted from new, digital solutions for visitations, out-patient care and video translation for non-english speaking patients.
“Historically, we’ve struggled to build public consumer software that can integrate into a hospital. Now, we’ve quickly managed to turn it around and quickly roll out patient-facing devices that can use Zoom and Facetime that use low touch functionality. By the beginning of November, we will have these in every ward.”
Significantly reducing patient anxiety and keeping hospital attendance low, this solution is just one example of many advancements made possible by reduced friction in NHS infrastructure.
These tech solutions, that bring families together and drive real impact for the end-user, are revolutionary. The example above manages to keep healthy people out of hotspots for infection while allowing them to maintain contact with those infected.
For those who use technology in their everyday life, and have access to the infrastructure to enable that technology, it’s a welcomed, yet expected change.
But for the 1.9 million households with no access to the internet and tens of millions more reliant on pay-as-you-go services to make phone calls or access healthcare, education and benefits online, it’s a reminder of the growing ‘digital divide’ that Saeed and his team are working hard to address.
“We have to think innovatively about how we make our solutions accessible to people who don’t have the technology, including children and schools.”
Saeed, who heads up Inspiration Sessions across Lancashire, works with schools to provide workshops and educational sessions around digital as part of the Gatsby Benchmark.
One part tutorial and one part career inspiration, these sessions give children access to digital solutions and technology while demonstrating the vast array of career opportunities within the NHS.
“We realised very quickly that from schools all the way up to universities, they’re just a big gap in preparing children and students in what we expect as employers. So about three years ago, we started a partnership with Inspira. And last year, we worked with three and a half thousand children in high schools, doing Dragon’s Den and mock interviews.”
Taking members from his team, Saeed brings activities into schools and begins the process of inspiring and embedding digital opportunities in the curriculum.
“We’re trying to show them that technology isn’t just about fixing things. So we take Digital Nurses, Digital Project Managers, Infrastructure and inspire kids to look at the full spectrum of careers in the NHS.”
So far, this initiative has won partnerships with two schools from less-affluent areas and focuses on showing those from BAME backgrounds the full range of careers in the NHS.
Continuing the good work at an educational level, Saeed is also working in partnership with two of the leading colleges in Lancashire, Irwin, Shaw and Newman. Here, the NHS is providing placements in digital positions to help shape their impression of career options.
“Inspiring the next generation to get into digital. That is tech for good.”
Investments are being made at every level of the NHS, investments being pumped into the delivery of digital solutions that provide value to those who work in the NHS and those who benefit from it’s services.
But as Trusts begin to develop their own solutions, the data collaboration and rationalisation between trusts has to keep up to ensure the NHS, as a whole, moves forward.
For Saeed and his team, the rationalisation of these developments and the sharing of data presents the next big challenge.
“Tech rationalisation and collaboration will feed into the access to data and predictive analysis. What that really means is if we don’t share our data with our partners and create a massive data lake, I think you’ll never really get into that next generation of predictive analysis.”
Matt Oakes is the Business Intelligence Manager at Northern Care Alliance NHS Group, which is made up of Salford and Pennine Trusts.
Predominantly looking after the data warehouse team and data engineering side of things, Matt and his team focus on the processing of clinical data and creation of dashboards.
Starting his career as an internal auditor, o, Matt moved into a role in the NHS as an analyst and worked his way up, eventually taking the opportunity to lead the data engineering team at the Northern Care Alliance NHS Group. Although Matt does not have a data engineering background, Matt leads his team with a strategic vision.
“Not having that background certainly makes my job more interesting. Most of my role consists of organising the work of the team, removing blockers and setting the vision for the future.”
Echoing Saeed, Matt is seeing the perceptions around communication and collaboration shifting in the NHS. With the swift transition to working from home, everyone is now seeing the benefit of more collaborative technology options.
More specific to his role, Matt has seen the culture around data start to shift.
“Data used to be a ‘nice thing to have’ but now it’s absolutely at the forefront of everything we do as an organisation. It should underpin all key decision makers and I’m fortunate enough to work in a Trust that champions this approach. For instance, our trust has a Director of Analytics and Business Intelligence, so there’s a recognition that data and analytics should play a part in strategic decision making.”
With board-level representation, Matt and his team are able to drive data decision making and rationalisation for their Alliance. Driving the use of Microsoft Azure, Power BI and other data tools to improve the care of the patient and the patient’s experience.
“It’s about creating a platform to underpin decision making for the benefit of patients and the wider population. This is one way we can technology for good, and I think it’s one positive thing to come out of this pandemic.”
With an increased desire for world-class data and more access to data than ever before, Matt and his team are working hard on creating a platform that can drive decision making.
With priority now for more robust data mechanisms, Matt and his team are working on designing, developing and implementing a new data platform from scratch with Azure as a basis.
“We’re using a lot of learning from the past and trying to make sure that it’s a data platform that is going to be really stable, robust, and intuitive so it can be the ideal foundation for decision making – for the benefit of patients.”
Tori Hutchinson is the Lead Digital Delivery Manager at NHS Business Services Authority (NHSBSA), an Arm’s Length Body of the Department of Health and Social Care. In this position, Tori leads a number of digital delivery teams towards the delivery of new national services for the NHS and improvement of existing national services.
Tori worked in the private sector before joining the NHSBSA 3 and a half years ago. Making a conscious move into the NHS, Tori enjoys seeing her projects and work delivering tangible results that benefit patients and staff of the NHS.
Tori told us about one of the recent projects delivered within the digital team at the NHSBSA – implementing text messaging services to support Covid-19 initiatives, for example notifying ‘at-risk’ patients that they need to shield and sending test results.
“We started that service really early in the pandemic and it’s kind of ramped up iteratively throughout and spawned a few different needs for messaging. In a four week period alone, there were about 17 million text messages sent which was huge.”
The NHSBSA, whose digital team has grown massively over the last couple of years, has been working closely with Government Digital Services to design and build user-centred and accessible services.. As a result, technology is being deployed with a unified effort and having a real impact on the end-user of the service.
“We’ve digitised many previously paper-based services now. In some cases, this has reduced patient and user journeys from eight weeks to a matter of minutes.”
This combined approach isn’t just providing a better service to the end-user, but it’s also changing the culture around collaboration.
“The COVID-19 response from all of the NHS organisations and all of our delivery partners has shown the power of multiple organisations being focused on one thing.”
Relatively new to the NHS, Jav Yaqub joined the NHS a year ago after a period of 5 years contracting across the public sector. With work predominantly focusing on migrations, infrastructure and implementation.
Currently working as the Interim Head of Infrastructure at Pennine Acute, Jav is responsible for all of the Pennine’s IT infrastructure and is currently focusing on a platform refresh for the Trust.
“There’s quite a lot of legacy infrastructure, which urgently needs replacing and a lot of systems running on unsupported software which, for various reasons have not been upgraded over the years. This coupled with poor technical design decisions made in the past has resulted in an underperforming environment that is unreliable, unsupported and consumes excess resources to support and manage. Over here, it had certainly reached the critical stage and was adversely affecting clinical services. So when I came in, that was my remit to get the platform refreshed, performant, secure and reliable which we’ve done.”
Implementing a new storage and backup system, alongside a new Dell VXRail platform and Microsoft 365 platform, Jav is driving infrastructure change that will improve patient care across the Trust.
Not limited to the designated list of suppliers due to the extraordinary impacts brought about by Covid, Jav and those in similar positions, are free to explore the wealth of products on the market and even acquire them through the supply chain and frameworks such as G-Cloud 12 and more.
“You’ve got lots of startups that have got very good products, who have previously struggled to get to market historically. Now all of a sudden we are offered new and innovative systems that give us new capabilities overnight such as the hi-def examination ward bots that allow our Doctors to carry out medical examinations of Covid patients, in minute detail, from the safety of their office or indeed anywhere in the world.” We were able to roll some of these fantastically useful solutions out in a matter of weeks compared to the traditional project led delivery approach which can take months, even years.”
While new technology becomes easier to acquire, the culture around what IT, Infrastructure and Digital mean for the NHS is also changing. For Jav, the shifting attitudes and perceptions around IT in the NHS have been driven by the flexibility and autonomy provided to IT as a department.
“Things used to be quite rigid. It resulted in IT seeming like a blocker at times and we would usually only get involved when things reached the complaint stage. Now, because of the investment being made in digital and the direction we’re going in, as an organisation, we’re involved from the beginning. We’re definitely being seen as enablers.”
Janet Young is driving digital transformation as the Head of Digital Programme Delivery at Lancashire Teaching Hospitals. With her previous role as General Manager in Outpatient Services, Janet has been serving the NHS for just over 20 years in various roles from Change Facilitator to Business Analyst.
“I’ve grown up with the NHS and moved around in different roles but I’ve come back to IT. I did that because I wanted to make a change. I wanted to see things using technology and make the most of our EPR.”
Right now, Janet is leading a portfolio of projects which aim to meet the technological needs of healthcare. Most recently, that has come in the form of a massive roll-out of devices and infrastructure to those working from home.
A lot has been said about the massive deployment of working from home infrastructure. From laptops to headsets, to office chairs. Each bit of kit has been meticulously set up, checked and distributed to ensure the uninterrupted flow of crucial, life-saving work.
For Janet, who has been working hard on ensuring continuity and interoperability remains while NHS staff work from home, this infrastructure roll out has been a major positive change for the better.
“We’ve had consultants who’ve been shielding, and consultants who have been isolated who are still able to do a follow-up appointment with a patient. Technology has enabled that.”
This infrastructure roll-out, while providing consistency in care, has also contributed to the shifting of perceptions around infrastructure and IT.
“Many people now understand why we need powerful broadband, and why the network needs to be strong. There’s a real appreciation for the applications we have and the interoperability between them.”
It has grown people’s understanding of why the network needs to be strong and why we need to, but that funding into, that the heads of IT budget so they can actually bring the infrastructure to where it needs to be for a sustainable future.
Operationally, the MS Teams roll-out coupled with connected home-working, technology has been used to enable collaboration. On the patient side, technology is being used in a similar way.
“We’ve piloted iPads in critical care units in the past to bring in virtual visitors but we couldn’t rely on one application. Now, we’ve got four iPads set up and the feedback from patients has been amazing.”
The initiative was so successful that Janet was actually contacted by a patient’s relative. After benefitting from virtual visitor technology during critical care, the patient was moved to another ward that lacked the same support. The patient’s relative reached out to Janet herself.
“She asked me if we could expand the virtual visitors to different wards and that’s exactly what we did. Collaborating with that ward’s IT team we started to mobilise the technology and think critically about where we want to take the platform in the future.”
