In 2012 the CIO of University College London Hospital (UCLH) stood out in a power list of the UK’s leading CIOs for bringing customer journey thinking to the management and deployment of technology into a major healthcare provider. In the following years NHS CIOs have substantially increased the dosage of patient centric technology in healthcare. The success of patient driven health technology is dependent on more than the CIO though, the entire leadership team of the NHS trust has to be aware and committed to injecting health technology into their organisation. Mandy Griffin, MD of the Health Informatics Service at Calderdale and Huddersfield NHS Foundation Trust in Yorkshire is one of those health technology leaders whose Trust is passionate about the power of technology in healthcare.
The Yorkshire NHS trust employs 6000 staff in two major hospitals in Calderdale and Huddersfield and provides the full range of healthcare services, including emergency, maternity, gynaecology, critical care and children’s medicine. Between 2018 and 2019 the trust provided clinical care to 119,000 people, 440,000 were outpatients, 150,000 were accident and emergency admittance and 5000 babies were delivered. As a result the trust is under huge demand and this government’s austerity measures add to those demands.
Austerity does have an impact on the ability to deliver better patient care. We have been in deficit since I have been with the trust, but we have always found ways to deliver the care.
Austerity, put in place a decade ago by the current Conservative government has had a widely reported impact on all parts of the NHS. With less money, digital methods enable trusts to innovate and reduce costs, but digitising healthcare is costly in itself.
We are one of the most digitally enabled trusts.
Griffin and Calderdale have continued to inject digital methods into the trust despite the government’s austerity agenda. A digitally focused leadership of the trust has been instrumental.
The chief executive is so wedded to digital that it is a pain - a good pain, because I get the support I need.
As a result Calderdale and Huddersfield NHS Foundation Trust is now moving to the next stages of its digital transformation, while there are trusts across the country that are still moving from paper to digital methods. Calderdale and Huddersfield NHS Foundation Trust has a leadership team that includes a Chief Clinical Information Officer (CCIO) and a Clinical Nursing Information Officer (CNIO), which Griffin meets with every week to discuss developments. Throughout the NHS as well as in Ireland, the partnership of CCIOs and technology leaders has enabled new health technology and digital working practices to land successfully and modernise care.
Griffin and Calderdale and Huddersfield NHS Foundation Trust has embedded technology into the patient journey through their hospitals. A simple, but effective, strategy to ensure technology is adopted was to implement a digital vital signs system, the first port of call for every health care assistant, nurse and doctor when dealing with a patient. Calderdale and Huddersfield NHS Foundation Trust has also digitised all patient records, which Griffin said had deployment challenges but has been successful.
On the May bank holiday of 2017 Calderdale and Huddersfield NHS Foundation Trust cut over from a self developed patient admin system (PAS) to the Cerner electronic patient record (EPR) platform.
The EPR was a massive challenge because it was about the people, process and engagement,. We took the decision early to adopt a big bang approach for going live, that I would definitely advocate for any big change programme.
It has become almost unfashionable for CIOs to advocate a big bang approach to change in today’s Agile culture, but Griffin says the approach was effective for Calderdale and Huddersfield NHS Foundation Trust. She reveals that in doing so the trust adoption accelerated and whilst some functionality was lost, the whole experience gave insight into guiding the future technology developments.
The old PAS had to be replaced, it was 20 years old and she says held together with sticking plasters. Calderdale and Huddersfield NHS Foundation Trust also worked in collaboration with its neighbours Bradford Teaching Hospitals NHS Trust to deploy the single instance across both trusts working alongside their CIO Cindy Fedell.
Calderdale and Huddersfield NHS Foundation Trust carried out the major upgrade to its technology infrastructure without being a member of the Digital Exemplar programme, a funding round from NHS England to promote digital adoption.
Interoperability between health technology systems is high on the agenda of the health technology community at present, particularly with the funding and initiatives coming from the newly formed NHSX. Griffin and her team are already planning on allowing adult social care services access to patient records in the Cerner EPR, providing integrated care in and outside of the hospitals in the region. To support greater interoperability the trust is about to make significant investments in upgrading the technology infrastructure.
RPA can take away admin tasks and we shouldn’t lose the opportunity to look at all parts of the trust, like admin and finance.
Griffin is passionate about clinical care, but her retail career reminds her that the clinical demands must not dominate the technology modernisation debate, and that major health improvements can come from the back office as much as the operating theatre.
Griffin and diginomica/government meet at the Rewired Health conference in the early days of the Coronavirus pandemic in the UK. In the weeks that followed the nation was locked down and remote working quickly became a new norm for many sectors. Griffin said Microsoft Teams and video were in use, but there were still adoption miles to be completed.
Shocks to the system can drive transformation and new methods adoption, but healthcare, especially in the UK, has been undergoing major transformation for decades now. With a series of changes to the structure of healthcare, away from local health authorities to NHS trusts and more recently Clinical Commissioning Groups (CCG) as well as major technology changes such as the National Programme for Health IT (NPfIT). Griffin is well aware of the public sector suffering from change fatigue, but again, she believes the culture of the trust counters any exhaustion.
We have an open culture, there is no blame and there is an ability to take on challenges.
She adds that the camaraderie of the trust and its community is vital, describing how weeks before we met, Calderdale was once again feeling the ravages of flooding, which has hit the Calder Valley a number of times in recent years.
The successful adoption of digital methods is helping Griffin and the trust fight the symptoms of the digital skills shortage she reports.
People want to work in a trust that is digitally mature. Digital has also acted as a retention tool.
Griffin joined the NHS in 2009 and says taking on an MSc in informatics at the same time proved highly useful.
The MSc accelerated my learning and it built my knowledge on how technology could help the patient.
I’m not typical of a CIO, my background is selling food, underwear and chocolates!
Griffin says how her career in Store Management for Marks &Spencer had positively led to her Chief Operating Officer role in The Health Informatics Service that then led onto leading the technology agenda at Calderdale and Huddersfield NHS Foundation Trust.