Weeknote: 4 to 7 January 2022

Gap in trees leading to a muddy field. A sign attached to a tree reads: "PUBLIC FOOTPATH Beware of Flying Golf Balls". The tree bark has grown around the sign
Went for a muddy walk around Roundhay

What did I experiment with?

A new set of questions for my weeknotes, hoping that if I strip things back and simplify, I’ll be better at publishing every week. Thanks as ever to Sam for the great collection of weeknote styles.

What was hard?

An awkward conversation wth some colleagues where we’re still not aligned on how we should work together. It’s frustrating but I’m confident that we’ll get there. From my 2021 lessons learned: Senior leaders need to be on the same page about the ways of working, as well as what work is to be done.

I also have an underlying feeling of how hard it’s going to be in the coming weeks and months to strike the right balance between practical digital support for pressured frontline colleagues right now, and getting on with the transformation work that we strongly believe will make things better in the future. It’s impossible to separate those things completely: people will only engage with us in shaping the future if they believe that we understand their needs today, and share their sense of urgency to fix immediate problems.

What did I enjoy?

Seeing the digital UEC team back together (vitually at least) after much-needed time off and illness for some of them. Also welcoming a new colleague, along with a couple of new staters who joined us in December. I had a moment of wonder in the first NHSX Digital Transformation team retro of the year, as I saw the mix of new and familiar faces, and thought about all the things this awesome group has the potential to achieve together this year.

What did I learn?

I sat in on a call with NHS colleagues from a regional team who were trying to figure out how to implement a new service model for the people they serve. They had contacted my colleagues in that national team to understand how to support it technically. It reinforced something I already knew: that we still need to do a better job of explaining our national digital work in progress and future plans to the people running services at regional and local levels.

What do I need to take care of?

I found a little time between Christmas and New Year to reflect on how things are going, and think about things I need to prioritise in 2022. No doubt these will evolve as the year goes on:

  • Start early in the year to have conversations about what we’ll deliver for winter 22-23 – Having been through almost a whole year’s cycle with urgent and emergency care now, I can see how important it is to take an early view of what we could do differently to help patients and frontline staff at their most pressured times – even when it seems we’re in the thick of one of those times right now. We need to create safe spaces where people can talk about all the things we could do, without yet being held accountable for delivering specifics. All of us, and especially senior leaders have a responsibility to look up and outwards, and be open to new ideas at this time in the annual delivery cycle.
  • Keep giving user researchers and patient representatives a bigger share of voice in senior level conversations – Reflecting on our assurance board just before Christmas, I realised how fortunate we are to have a place where colleagues get together to thoughtfully discuss user research and the complex cross-system issues it raises. We have skilled user researchers and service designers working on our services, and I want to hear more from them, especially in decision-making forums. In the rest of our work, we all need to stay close to what our service is like for patients and the public, as well as for frontline staff. I’ll take the opportunities I’m offered to visit services and hear first-hand from users. I hope my colleagues will too!
  • Move beyond a commissioner-provider model to a shared set of outcomes delivered togetherLaura Wade-Gery’s review has recommended “joined-up business planning and a more iterative dialogue that navigates between business needs, technology considerations, and budgetary constraints.” I firmly believe this should include a move to funding teams not projects, underpinned by a 3-year spending review settlement starting in April 2022. As senior responsible owner for digital in urgent and emergency care, I can be less prescriptive about specific milestones and deliverables – provided I am assured that teams have the right skillsets, a good understanding of user needs, and a direct connection to delivering patient and service outcomes.

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