Weeknote: 26 to 30 June 2023

What did I enjoy?

A chance to meet with members of the 111 online team in person as part of their monthly team day in London. I enjoyed the show and tell, including a proper live demo by one of the developers of the work he’s doing to integrate the service with NHS login. Later in the morning, I talked with the team about the various strategies and initiatives that our work is part of, and answered their questions about how we can contribute.

On Wednesday night, I went along to a Product Tank event hosted by Leeds Building Society, where my NHS England colleague Annie presented on ‘Small Steps towards a Product Mindset’. I also enjoyed the talks by product leaders at Asda and Leeds Building Society, and mingling with other product and UCD people based in the city.

What did I learn?

I started to see the edges form for a couple of important initiatives that will help us clarify the future direction for our Digital Urgent and Emergency Care (UEC) products and services.

Members of my team supported our colleagues who own overall UEC policy and operations to prepare for a workshop that took place on Friday afternoon. As part of that, I facilitated discussions to identify the main themes we need to explore around service design and digital enablers for NHS 111. The biggest items on the evolving word clouds from those conversations covered clinical decision support, service information, interoperability, and equity. On the latter, we discussed both digital inclusion and equity of healthcare outcomes that our national digital services play a role in enabling.

I also started to gain more clarity on a piece of work I want to kick off that builds on the work we’re already doing to integrate 111 online and the NHS App. I’m certain there’s a big issue we need to address for patients, and the next step is to gather a small team of experts to scope it further. This will need involvement from other teams, who are all busy with demanding commitments of their own. They’ll only be able to spare the time to take part if they can see that this is part of the answer to their own questions too.

What was hard?

I felt my team’s best efforts to adopt a new reporting tool in our directorate were unfairly represented when a report went to my boss’s boss showing us as not having provided a sufficient update. We’ve been trying to make this tool fit for purpose in partnership with the central team that owns it, and clearly there’s more work to do before we can rely on it as a single souce of truth for product oversight.

What do I need to take care of?

Creation of a shared team culture following our merger is being held back by the lack of fit-for-purpose collaboration tools. To be fair, this is really complicated stuff. Colleagues are working to fix the legacy organisations’ unique flavour of IT fragmentation, and it can’t come fast enough. But even when that’s addressed, we’ll still have to tangle with the innate clumsiness of Microsoft Teams, and its ugly grafting onto the gnarly rootstock of Sharepoint. That really matters now more than ever before.

In my career, I’ve been involved in several large-scale mergers, and there is always a phase where people find it hard to see the best in their colleagues from “the other side”. That would normally be overcome as people work together, get to know each other as humans, and achieve things together that form the basis for a new shared narrative. When we inhabit the same workplaces, we gain ambient awareness of what other people do, and discover that we have more in common than at first we perceived.

But this is the first time I’ve been in a merger where the participants had to do that delicate work remote first. Nerves are frayed and goodwill is already stretched. The frustration at not being able to collaborate seamlessly or gain ambient awareness of our new colleagues’ work reinforces a false narrative that those other people are less than competent, not prepared to co-operate, or have hidden agendas. When someone hits a roadblock that says “access denied,” or doesn’t get a reply because a message fell into an unmonitored inbox, do they only blame the technology or does some of the blame rub off on their colleagues?

At this moment in a merger, our prime directive should be to assume good intent. Working tools configured for segregation of information at the cost of open collaboration make that so much harder.