Weeknote: 11 to 15 October 2021

National Trust East Riddlesden Hall

What inspired me this week?

  • A couple of new starters to the Urgent and Emergency Care digital team in NHSX. I can see they’re both going to bring a lot to the work.
  • A good introductory meeting with the review team lead for our upcoming Gate 0 review. We’re fortunate to have been assigned a review team with a great range of relevant experience.
  • End-of-week chats with a couple of new joiners elsewhere in our Digital Transformaion directorate, including Kathryn, who is now on week 7 in her new role here.
  • An unexpected message from a former colleague telling me how helpful it’s been to have people at a senior level pushing for a service design approach.

How did I uphold the NHS Constitution?

In a meeting about a clinical decision support service, I reminded myself and others that the continued safety of such tools relies not only on the expertise of the clinical authors but also on the patients whose experiences and health outcomes contribute to its safety record and inform its continuous improvement. The NHS belongs to the people, and we hold the products we make in trust for them.

How did I make expectations clear?

  • I shared my biggest concerns about the programme with colleagues helping to prepare for the Gate 0 review. I can also use these to inform the key lines of inquiry that I suggest to the review team themselves (though of course it’s their prerogative to scrutinise anything else as well).
  • Some colleagues and I had demo of a new portfolio management tool that NHSX is adopting. I set out my clear expectation that I wanted to move away from sending documents and towards reviewing progress live in tools like this. But it has to be used by both the NHS Digital and NHSX teams overseeing our work, or it’ll just be another burden on top of the things we have to report already. As a small team, we don’t have time for that kind of duplication.

What do I need to take care of?

Stefan Czerniawski once noted that:

“There is a sweet spot in any job, or more generally in understanding any organisation, when you still retain a sense of surprise that anything could quite work that way, but have acquired an understanding of why it does…”

I reckon I’ve reached that point on at least some of the Urgent and Emergency Care digital work now. As I start to intervene to course correct on some of those things, I need to be mindful that:

  • there are still many others who have a depth of experience in this space that I lack
  • many of the problems we face won’t be solved by digital alone, and
  • even where I now insist we need to do things differently, everyone has been doing their best given what was known at the time, their skills and abilities, the resources available, and the situation at hand.

How many days did I get some exercise?

I got out for a pre-work bike ride every day this week :)

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