How to recruit your NHS Trust Board CIO

TL;DR: Throw away your Director of IT Job Description. Be open to experience outside of the NHS. Create a fabulous candidate pack.

Introducing Part Two

This is part two of a two-part set.

If you’ve become convinced in Part 1 that you do indeed need a CIO on your Trust Board, then the next step will be to put together a job description and advertise the post.

I’ve seen a couple of adverts this year that should have been cause for celebration but were so poor I a) feared for the calibre of candidates that would apply and b) worried about the kind of environment the poor successful candidate would arrive into.

In Part 1 I argue that recruiting talent from outside of the NHS will be important. The challenge for Trusts is that when there are plenty of places in other areas of the public sector that already “get digital” for great people to go to, then a lot more effort needs to be put into attract talent into Board-level CIO roles.

What follows are my thoughts on how to make NHS Board-Level CIO roles attractive.

Firstly, don’t even think of digging out that old Director of IT job description and thinking you’ll just add a few things to it. Digital is not just IT rebranded. If you don’t know the difference, then you’re not ready to advertise — perhaps reading Part 1 of this series will help.

What should be in the job description/person specification?

A whole load of stuff linking the strategic importance of digital to the success of the organisation, something like this would hit the spot:

The key responsibility of the CDIO role is to ensure that the Trust has a cohesive, engaging and deliverable digital strategy that reflects the values
of both Trusts and the needs of patients. The CDIO will lead our digital and information technology transformation to create a strong, values-based culture which is vital to the success of our organisation.

Please also consider some key things you will need to include that you won’t find in that dusty IT Director job description:

  • A reference to the approach to meeting User needs. If you don’t know and expect the incoming CIO to work this out, that’s fine, but a mention of user needs as being really important is a good signal.
  • A recognition and appreciation of Agile methods. Mentioning PRINCE2 will be a red flag to the type of people you are trying to attract.
  • A track record of public presence, blogging, conferences, social media. Working in the open is a key capability for digital transformation. You should expect the leaders to exemplify this. You may also use this moment to take a look round the existing board table and ask the question if existing leaders have a public personal presence aligned with your organisational ambition? If not, why not?
  • Don’t you dare mention that Informatics word. This is a personal bug bear, but what the heck does this word mean? This seems to be a predominately NHS word. Using words that are known in all industries will do better at atttacting candidates from the widest pool.
  • Makes sure previous NHS experience is only marked as desirable. Don’t get sucked into thinking the NHS is unique in terms of complexity. In many cases, previous NHS experience means you’ll get more of the same, not the new skills and experience the NHS badly needs.

Also, make it clear if this person is part of the Director on Call/Gold On Call (or equivalent) rota. That is a big deal for some folks.

So now you have a job description/person specification that has all the right stuff, but now onto the rest of the candidate pack.

Candidate Pack

The opening paragraphs should come from the Chief Executive or Chair and talk specifically about the Digital ambition. The two I’ve seen recently fail to sufficiently capture this. It is not good enough to just talk about the Trust’s strategy or progress or overall ambition, the blurb needs to signal that the Board has identified the potential of Digital transformation and what it hopes to achieve through betting big on that as a future strategy and signal that the organisation may need to change to accomodate this.

You also should consider including some more detailed content, specific and pertinent to the role:

  • Some idea of the areas of responsibility. Don’t assume everyone knows. Some CIOs have responsibility for Information/Reporting, Clinical Coding etc and others don’t. Make that really clear.
  • Some indication of the tech landscape — is an EPR in place? Are all services still on-premise? Is a Cloud-First policy agreed?
  • What insourcing/outsourcing is in place?
  • Is there an understanding of user research and service design?
  • Is there a digital strategy in place?
  • What’s are the ICS arrangements for digital — any cross organisation working in place so far? What’s the roadmap agreed?
  • What’s the link to transformation? If separate, how do they work together
  • Being clear on the delivery capability. If your organsiation has outsourced technology to one of those VAT-dodging vehicles, then most CIOs worth their salt will run a mile – to be agile enough to do this stuff we need to be able to reshape and configure teams, rather than having to commission stuff through a dusty contract not designed for the internet era.
  • Being clear if a Digtial Strategy that the board are happy with is already in place or if this will be one of the first jobs the candidate will need to do. You’ll also need to consider what to do if your new CIO politely points out that your Digital Strategy is just a rebadged IT Strategy and needs a re-write.


If this is a board position, even if you’re using a recruitment agency, make sure the candidates are given access to the CEO to chat through the role ahead of the interview. Whether access to the CEO is in place is a strong signal to the importance the Board is attaching to this role. Be open to an interview process that uses a combination of virtual and face to face; this is about signalling a willingness to think differently.

Consider who is helping with shortlisting and interviews. It will be worth asking one of the existing NHS Board-Level CIOs to get involved, or seek help from some of the excellent Digital Services in the public sector outside of the NHS.

What Should You Expect

Having a CIO on the Board does not absolve the Board from becoming more tech savvy. The CIO should be learning about the needs of the other Board members, their teams and patients, and then helping educate them of the possibilities of technology.

You’ll start to hear terms like user needs and service design, and there will be a greater push to develop more services in-house or with an agency rather than always buy off the shelf. You’ll have to get used to open sourcing software and sharing things freely, rather than seeking to generate IPR and sell back to the NHS something it has already paid for once. You should also see more people working in the open¹, sharing their learning through blogs and social media.

The other area of friction will be for Boards to start getting their head around Cloud as the method of delivery for the internet era and should be prepared to do battle on Capital (old NHS/Gov) and Revenue (future Cloud services). It’s likely that your Trust is part of the majority that have failed to publish their stance on Cloud-First to the rest of the world. This will be a position that will become untenable very soon.

Finally, don’t have a heart attack if you see someone wearing jeans. Last time I checked, what I wore had no bearing on how good I am at my job. Wearing jeans has become a bit of a totem in the digital world; saying we are here to do a little bit of gentle disruption, to change the way things are done and we’re signalling this by escewing suits and ties. It’s worth noting that a no-jeans policy is a warning signal to some Digital folk — if the organisation can’t cope with a few pairs of jeans, how will it cope with wholescale service transformation?


¹ “Make Things Open, It Makes Things Better” is principle #9 in the NHS Digital Service Manual.

Husband. Dad to 3 smashing lads. Cub Leader. MAMIL. Group CDIO for Northampton and Kettering Hospitals. Ex NHS Digital. Views own. Always learning.