The ex-CEO of UK ISP TalkTalk, Baroness Dido Harding, has been recommended for appointment as chair of NHS Improvement, following a grilling from MPs last week on her suitability for the position.
NHS Improvement is responsible for overseeing NHS foundation trusts, NHS trusts and independent providers, with the aim of helping them give patients consistently safe, high quality, compassionate care within local health systems that are financially sustainable.
The Chair will be overseeing a health system that is under significant pressure, within the context of falling funding, an ageing population, a lack of skills and significant technological change. The opportunities to rethink the system within the context of new digital technologies has been discussed extensively, and investments are being made, but the NHS has a poor track record in successful implementation.
It’s interesting that the Health Minister and the House of Commons Health Committee have endorsed the appointment of a leader that comes from a technology background, however.
That being said, MPs also warned that Baroness Harding has a lack of professional experience in health and social care, and recommended that she “gain the widest possible experience of listening to both staff and service users at all levels and in a wide variety of settings on the front line of NHS service provision”.
Harding said during her Q&A session with the House of Commons Health Committee that despite this lack of experience in health and social care, she has “considerable experience of leading large and complex organisations through major change.”
Harding stepped down from her role as CEO of TalkTalk in February this year, following a major security breach of the business in 2015, which affected 157,000 users and cost the business more than £42 million.
Upon her departure, Harding said that she wanted to “focus more on my activities in public service”. The Baroness lead the creation of Internet Matters, a cross industry not-for-profit supporting parents with child internet safety.
Speaking to MPs, Harding said that her ambition for the role is to improve the lives of citizens. She said:
I have spent the last twenty years working in and running large consumer businesses. The individuals and families who use the NHS are the same people who shop in Tesco, book their holidays with Thomas Cook and buy their broadband from TalkTalk or one of their competitors.
My involvement over the last few years in child internet safety issues, the UK Holocaust Memorial Foundation and the Bank of England has taught me that I am more interested in serving those households by improving the public services they depend on than I am in running the consumer businesses they buy things from.
In her pitch to MPs, Harding said that she has considerable experience in leading large and complex organisations through major change. On her time at TalkTalk, Harding said:
I have led the business through demerger from Carphone Warehouse, post-merger integration of Tiscali and AOL, and successfully navigated an extremely challenging and high profile cyber-attack. TalkTalk has in that time changed from a collection of entrepreneurial businesses put together through a series of acquisitions, with competing systems, processes and cultures, to one integrated team with a change accepting, fast moving culture that genuinely tries to put customers first.”
I am accustomed to operating in highly complex and fast-moving environments.
It’s no doubt that similar comparisons could be made to the NHS, which is made up of a complex and disparate structure, where implementations of national technology plans have failed because of unique requirements at a local level. Finding common challenges and implementing solutions at scale has never been easy within the healthcare system.
The most notable failure being the National Programme for IT (NPfIT). NPfIT was a disaster. It cost the taxpayer over £13 billion and there has been very little to show for it.
The programme was pitched as a blanket upgrade to the NHS’ IT systems and as a chance for all organisations in the health service to standardise on a new platform. However, as time went on, it soon became clear that local inertia meant that many organisations resisted the standardisation.
Any chair of NHS Improvement will need to figure out a way to better the NHS through the use of technology and new systems, but do so whilst managing all the different stakeholder relationships. Harding hinted at her ability to take this challenge on. She said:
Seven years ago I moved sectors to telecoms, a heavily regulated and highly technical sector, where that technology is rapidly evolving. This means I am used to working in a complex environment where I am not a technical expert but have needed to earn the respect of the technical experts in my organisation and externally so that they have been willing to follow me.
Whilst hardware and software engineering are very different disciplines to healthcare, I believe that the skills I have honed in building the respect and confidence of a highly educated and specialised workforce will stand me in good stead in building strong relationships with other NHS leaders and the clinical professions.
On the challenges facing the NHS, Harding said:
Many of the key risks and challenges that NHS Improvement faces are ones that are common to the sector as a whole. An aging population that is not just creating growing demand but also driving healthcare professionals worldwide to review past siloed models of care in favour of more integrated models. T
The sheer speed of technological change and the opportunities and challenges that brings, coupled with the significant financial challenges that the NHS and our country as a whole face to balance the books, all make for an extremely challenging backdrop against which NHS Improvement must deliver on its objectives.
During the session, Harding identified three areas of improvement upon which she should be judged, with regards to the NHS Improvement’s specific contribution to system performance:
- NHS Improvement’s ability to drive improved performance in the sector through having performance management processes that are transparent and seen as adult and fair
- NHS Improvement’s ability to identify, codify, share and support scaling of best practice
- NHS Improvement’s contribution to developing the culture of leadership excellence and collaboration across the NHS.
On the one hand I think it’s good that the NHS is looking to leaders that have an experience in driving complex organisational change, particularly with a background in technology. On the other hand, Harding has a bit of a chequered reputation following the TalkTalk breach. If she can drive some significant and measurable performance improvements across the NHS - a huge challenge - that might go some way to repairing that.