Reflections: 6 months into Group CDIO role

I’ve been doing this every 6 month reflective exercise for a while now¹. I’ve decided to shift my timescales a bit to align with the end of my first 6 months as Group Chief Information Officer at the University Hospitals of Northamptonshire (Northampton and Kettering Hospital Group). As a result, there’s not complete continuity from my KGH 18 month reflections.

I use my weeknotes as a regular reflective discipline. However, this is an opportunity to take a longer look back.

L-R, T-B: Cover of Humble Leader — one of the books we’ve read as part of the NGH-KGH Leadership bookclub. A load of chocolate sent to me from Debbie, KGH CEO when I broke my collar bone. Me at Kettering train station in my new mega winter coat. Trying to make pizza a tradition on Board days. Making my committment on International Womens Day. Kettering Hospital in the Snow. A thank you flapjack at NGH. My home Kanban board.

What has gone well?

1. Group Digital Strategy Agreed. During January to March, there was an extensive consultation exercise, resulting in agreement of the Group Digital Strategy in March. I think it was the first of our new batch of strategies to be published in an accessible format. It has raised some eyebrows with the level of ambition, but I’m really proud of it as a readable document that sets us in the right direction for the next three years. As I said to the Boards at the time; if I’ve done what I intend to do in the next few years, this will be the last time we need to create a digital strategy separate from the overall Group strategy as it will be just the way we do things.
2. Appointing Key Roles. With the Hospital CEOs, we appointed Digital Directors for Both Trusts; Dan Howard and Ian Roddis. I also recruited two CCIOs and a CNIO at NGH. My experience is that these clinical roles are crucial for ensuring digital transformation is successful. We now have a super team at both Trusts and we’ve started to work across the group more regularly.
3. Developing the REACH networks. The REACH group at each Trust stands for the Race, Ethnicity and Cultural Heritage Network. The group advocates for the inclusion, equality and empowerment of our staff and beyond. I’m honoured and priviledged to be the Exec sponsor for both Trust networks. I’ve continued to try to educate myself further; through reverse mentoring. sessions and also meeting with members of the network 1–2–1. I was honoured to be asked to join a recording of the NHS Providers Podcast where I talked about my view that those in leadership positions should display cultural competency, including being able to have uncomfortable conversations around race, in the same way they would be expected to display technical ability. I fully intend to seek to continue to improve my competency in this area.
4. Role in the ICS. I’ve taken on the role of Executive Digital Lead in the Northamptonshire Integrated Care System. It is only in my new Group role, and the appointment of some brilliant Digital Directors at each Trust that I feel I’m able to devote more time looking outwards. But as the ICS develops, it is critical that Digital has the appropriate input into the conversations.
5. Midlands Digital Health Skills Development Network. I’ve enjoyed working with Mike Emery and many others to try and get the Midlands Digital Health Skills Development Network off the ground. This is building on some excellent work from other regions. Other regions use the term Informatics Skills Development Network, which I’ve got a massive allergic reaction to. Thankfully others in our steering group are prepared to humour Mike and I and work with a more appropriate title. We’re really keen that the network takes the essence of the Topol review and equips our teams for the future rather than simply the now.
6. Sitting CHIME Exam. Obtaining Certified Healthcare CIO certification was one of my personal goals for 2021, so I’m pleased I managed to work through the material and sit the exam. I could be putting this wrongly in the “What Went Well” segment as I’ve not got the exam result yet.
7. Building the KGH and NGH Group reputation. In the last 6 months, NGH were awarded Robotic Process Automation Centre of Excellence status, KGH recieved some cloud funding from NHSX, on the back of publishing the cloud-first policy. Dione, one of the CNIOs at KGH won the Chief Nursing Officer for England’s Silver Award for her outstanding contribution to digital nursing. I got to speak at Rewired (a keynote on cloud adoption and a panel on professionalism). I was ranked #28 in UK CIO 100, which was a surprise and honour.

Top Left: Covering page for Group Digital Strategy. Top Right: Being included in the UK CIO 100. Bottom Left: Press article about Dione winning Chief Nursing Officer Silver Award. Bottom Right: Meme saying ‘“informatics”, kill it with fire’

What have I struggled with?

1. Working out my new place in the various teams. I’ve always found that moving roles within an organisation is never as inevitabily clean as when you move to a new one. The great thing about staying within the University Hospitals of Northamptonshire group is that I have all my existing contacts and have some of the knowledge of how things are done in at least one of the Trusts that is missing when you join a new organisation that I reflected on when I first joined KGH. However, the transition is more tricky. It has taken me some time to work out how I work and operate differently in the Group role compared to being focused on a single Trust. There are some things that I realised I didn’t give up as quickly, and some other things I handed over too quickly, and I’ve certainly stepped on the toes of the Ian and Phil as the Digital Directors at each Trust during this time. There’s been a period of adjustment for my colleagues too; what things do they ask Ian and Phil about and what things do they ask me? Given my tendency to say yes, rather than “not me guv”, has probably meant the shake out on roles and responsibility has taken a while to settle down.
2. Reaching capacity. Potentially linked to the saying yes element above, I had a moment where I recognised that I had reached capacity. This manifested itself in me losing the ability to prioritse and think clearly. I certainly went into a brain fog. Recognising the situation was the key to solving it and once I admitted to myself that I couldn’t do it all, the clouds cleared a bit and I could start to get some clarity. What I’ve talked to my coach about is how I get better at spotting this situation emerging and being able to deal with it earlier.

What have I discovered about myself?

1. Impact of not doing solo exercise. My weekly target is to cycle 100 miles. Typically when I cycle, I do it solo, to work around family and work, but this year as restrictions relaxed, I’ve started cycling regularly at the weekend with an ex-colleague. Whilst that has been fantasic in terms of pushing my fitness on (he’s stronger than me), what I didn’t realise is that the time I spent on my own was a great time to process my thoughts, think about work, solve problems, think about approaches to stuff. I’m convinced that the feeling of being overwhelmed I have mentioned was linked to not having any time to give my mind this kind of space. As I write, I’m recovering from breaking my collar bone, so there is no cycling on the cards just now, but when I’m back on two wheels I’m going to have to be less sociable to give me that essential space.
2. Putting some effort into presentation skills is hard but pays off. At the end of 2020 I was fortunate to have some “personal impact” sessions with acting coach Ken Rea (you can read more about it in my weeknotes at the time). Since I did those sessions I’ve tried to be more concious about the way I present — thinking about the energy in my delivery. This isn’t my comfort zone, so it still feels unnatural to put more “underarm energy” into presentations, but I observed how well my presentations to the Board landed when I presented the Group Digital Strategy using my newly acquired skills. I recognise that this is something I’ll need to keep working on; part of this is to volunteer to speak at events, which forces me to push myself into that zone again. So if you see me standing up when presenting, even on a video call, you’ll know I’m taking it seriously.

Tweet from Andy Kinnear about my Rewired 2021 Keynote on Cloud Adoption in the NHS. Source: https://twitter.com/Andy_Kinnear/status/1372115007408836608

What are thing things I have appreciated?

1. More working in the open. Early off when I started at Kettering, and after I’d removed all the shelving and bookcases from my office to free up wallspace for a whiteboard, I put the NHS Design Principles on the wall and have attempted to ensure they’re how we work across the Group. I passionately believe in #9 “Make things open. It makes things better”. I’ve been delighted this year to see people starting to blog and share what they’re working on. I published some research on visibility of CIOs in January and the lack of blogging was stark. I’m hoping that this percolates across more teams (and in the wider NHS) as the year progresses. Read more from: Mary, Jas, Ian, Emily.
2. Learning from Podcasts. When I took on the Group role I was a bit aprehensive about driving to Northampton. I’d got into quite a nice rhythm working on the train on the way to Kettering, so was concerned about the impact driving would have on my productivity. I’m pleasantly surprised that the 90 minutes goes by really quickly with the help of some podcasts. I’ve found that whilst I can’t do any work on the way to work — not many people have taken up my offer of doing calls at 6am, I can at least arrive feeling I’ve used the time productively. Much to the hilarity of my family when they join me in the car, I listen to them at about 1.6x speed, which means I can get through 3 or 4 on my my typical journey length.

Screenshot of my podcast subscriptions

Update on some things I committed to do in my last reflection:

• Contributing to the Group Digital Strategy. Got this approved by the Board and in action.
• More Statements of Intent. Although Ian and I have talked about this a few times, we’ve not published anything further. One to carry forward.
• Work out how we take things to the next level. This was about developing service design and user research — two roles that we’d struggle to fund as an indivual Trust, but ones that should be possible at a Group or even ICS level. We did commission some journey mapping work on discharge pathways during this year, but we need to make this more commonplace.

What will I work on over the next 6 months?

1. Getting out into the hospitals more. Due to the covid restrictions, I’ve not been out and about on the wards as much as I’d like, and that’s certainly the case at Northampton, so I’m intending to do more shadowing, following Ian’s excellent example.
2. Leveraging the Group. I set out at the start of the year, talking about the principle of “Once For Both”, and we’ve seen good example of that during this first 6 months, but I want to accelerate this and make the most of common ways of working, single contracts, shared learning and cross-fertilisation.
3. Make sure the new stuff all works together. One thing that is emerging is that there’s danger that we’re adding more things to our EPR suite, but not necessarily going back and checking that it all still works together coherently. The user experience needs to incrementally improve in line with the reduction of paper. This will be increasingly important as we expect clinical systems to work coherently across the two Trusts.

¹ Reflections: First 6 months at KGH, One Year In at KGH, 18 Months in at KGH