Weeknote: 24 to 28 January 2022

Railway platform with motion blur in foreground, Victorian mill town in background
View from the train

What did I experiment with?

In an NHSX senior leadership team meeting, I had an opportunity to highlight some things we need to keep hold of as we move to a new chapter in NHS transformation. I think we’re still feeling our way into telling this story in ways that will make sense to our new leaders and colleagues in the merged organisation to come.

While we have not yet accomplished everything we set out to do, the turn towards user experence that the ‘X’ in NHSX embodied is the right one. When we start with what it’s really like for people – patients, families, and the staff who care for them – then we can unlock advances in patient safety, service efficiency, and ultimately health outcomes. When we miss this vital first step of understanding users, their contexts and their needs, then our good intentions, grand projects, and priorities are unlikely to survive contact with reality.

What did I enjoy?

A day out of the home office visiting the emergency department at Royal Bolton Hospital. It is so valuable for those of us in national roles to get out and about and see services in action. Thanks to all the staff there, and especially Dr Chris Moulton for picking me up from the station and being such a welcoming and expert guide.

What did I learn?

I learned lots from my day in Bolton. (Nothing I note here is a criticism of my hosts, whose issues are typical of many others.)

I realised just how much the “digitise, connect, and transform” elements of our strategy stand or fall together. We talk a lot about the need to invest in new kit, networking, and interoperable systems, but it comes to life when you see staff using multiple systems to book patients in, printing and scanning paper notes, squinting at tiny text on low-res screens, and waiting for data to flow through the hospital digitally more slowly than the patients can move or be moved themselves. There are fixes for all these things in the pipeline, but if they’re fixed in isolation, without considering the whole user experience, there’s a strong chance that improving one thing will make something else worse.

What was hard?

There were some misunderstandings and conflict within my team, arising from recent changes. I feel responsible for this as a manager because it’s my job to help my team interpret the uncertainty that we’re currently operating in. The open-ended nature of that uncertainty meant I had not provided some guidance that could have prevented the misunderstanding.

We had to cancel a meeting at short notice because all the key people who were needed in it had prioritised other work, but assumed it would go ahead without them. That’s a signal to me that there may not be anyone who feels overall ownership of this work, or the intent behind it.

What do I need to take care of?

We’re heading into another week of uncertainty for our teams. I need to manage my own feelings of impatience to move onto the next chapter for our organisation, and be ready to support teams whatever the week may bring. Alongside all of this, we have work to do for patients and frontline staff. I really hope we don’t get so distracted by internal change that we lose contact with the realities I saw in Bolton this week.

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