Health Technologies

“Curiosity has taken me a long way in life” Interview: Lorna Allan, CDIO, Northern Care Alliance NHS FT – htn

For our latest interview, we sat down for a chat with Lorna Allan, chief digital and information officer at Northern Care Alliance NHS Foundation Trust.

Hi Lorna, can you tell us about your role and its scope?

My role is brand new within the trust, and it’s at board level; I joined in September so I’ve been in post for eight months now. I have just under 500 colleagues across the informatics and digital team, supporting almost 21,000 staff members across the trust, from digital IT services through to data and analytics services. We support more than 400 different clinical applications and about 2,000 other systems and services.

There’s a lot happening at the moment – as an organisation we are still in the process of pulling the Northern Care Alliance together, which brings together services and colleagues from Salford Royal NHS Foundation Trust and The Pennine Acute Hospitals NHS Trust. We deliver healthcare to well over a million people across Salford, Oldham, Rochdale and Bury, as well as providing more specialist services to patients from Greater Manchester and beyond.

We’re working on how we bring all colleagues and cultures together  to really harmonise our approach and provide a clearer architecture and way forward for the organisation for all of our IT systems and services. That means working closely with clinical colleagues, the executive team and our care organisations to start to plan out the future. We’re looking ten years ahead – what does the future look like for Northern Care Alliance services and across Greater Manchester? We’re looking at what we need to do today, whilst planning for tomorrow.

What’s your favourite part of the role?

It’s a huge organisation, and what I love most is that I’ve been able to go out and about. I spend time working in all of our different locations, from going into our major hospitals to visiting our community teams. I really value the opportunity to turn up and work from any of our places and meet a whole range of colleagues, and see a direct correlation between what we do and the difference it makes to a patient and our communities. It’s a real buzz for me to be able to see the impact of our work – what we’ve done to help reduce somebody’s length of stay in hospital, for example, or make their outpatient experience better, or improve the therapy service that they receive.

Becoming CDIO

It’s been a 30-year journey! I started out as a novice techie, supporting IT and answering the telephone. Curiosity has taken me a long way in life. I was curious about how technology worked and how people use it, I’ve worked with really inspiring individuals who have taught me a lot and I’ve asked a lot of questions.

Gradually I’ve worked up the food chain – I became senior whilst working in the legal sector, but then I moved through financial services and a whole range of different sectors.  Technology is a great enabler across many different sectors and some of the challenges are similar but drive different ways of thinking.

Something that has helped me get to where I am today is having senior figures take an interest in me; mentoring, supporting, and opening my eyes to opportunity. There’s also definitely something to be said for avoiding the lure of imposter syndrome, and reminding yourself what you have done, where you came from and how far you may have travelled is important.  Having other people believe in you is so helpful with this.

You also have to just try to just give things a shot – have a go at something new and learn from it.

NHS versus corporate settings

I think the challenge is the scale that we have to operate at within healthcare and across the NHS. The communities we serve are so diverse and we need to provide services for everyone. In many corporate settings, you limit some of the challenges that diversity brings because you tend to target audiences for specific products and services. The principle and aspiration is, very rightly so, very different in public services. I previously worked at the biggest debt charity in the UK, Step Change, and we had similar challenges; you have a huge spectrum and scale of people and expectations that you have to cater for. I think that’s the main difference between healthcare and the corporate world.

The other challenge focuses on the scale of change and the need to be integrated with other areas across the UK. Whenever we do something in the Northern Care Alliance, we have to think about the impact across Greater Manchester; the impact on the NHS in the North West; and the impact on the NHS across the UK.

I’ve found that a main positive difference, however, is the openness with which the NHS and other trusts share their experiences. You share less in a corporate world due to the competitive nature of your product and your services. Working for the NHS has been a revelation in terms of being able to pinch with pride, to look and learn from others, to see who has tried something and take their learnings on board. The ability to share that information is really powerful and we hope to share widely with peers and colleagues across the NHS as we progress

I think that digital problems are the same when you come down to the basics – there is always some technical debt that needs attention. All organisations carry a degree of technical debt. It’s either systems that have been implemented somewhere in history that have not been maintained or are not sustainable, or it’s where an organisation has, for whatever reason, not fully implemented or leveraged a platform. For example, if I needed a car and I needed it quickly, I might get a car that has the basics but nothing else. It suffices for what I need it for in that moment, and I’ve made the informed decision to go ahead with it. I might expect that in a couple of months, I’m going to come back and add the extra bits in. But it doesn’t always happen, so you find you’re still driving a car with pieces missing, and nobody ever re-visits it. That starts to cost money and it is when organisations outgrow systems that no longer meet their needs.

Sometimes you need to make a conscious compromise about how fast you need to launch a service if you’ve got an urgent need – I think all organisations have to do that. That’s okay, but organisations should make sure that they note it down and keep a record of the compromise so that they can regularly check on it and make sure that it’s still okay. But you need to know when to take action. We’re seeing this at the moment in the Northern Care Alliance with legacy buildings and legacy systems; we have some selective choices to make and some fundamental changes to undertake. This all feeds into the development of your digital strategy.

There are always challenges around the age of systems, the integration abilities, the extracting of data. They are common issues across every organisation I’ve worked in.

From my experiences, I hope that I can bring the ability to think about projects in more bitesize pieces, to focus on iterative learning and development. I think the NHS has had a tradition of launching big programmes where you start something and deliver it in three years’ time. If I’ve learned anything from the sectors I’ve come from, it’s the importance of cutting things up into chunks and pushing for small, iterative change. Test and learn, test and learn – we need to involve patients and community and colleagues at the heart of change, to consult them when we’re thinking about what we want to deliver. It should be about releasing benefit earlier even if it’s not fully formed. It can be tricky in a clinical setting because obviously we take to take into account risk, but I think that is a big change that the NHS is starting to move towards. I can see signs of this happening and our goal has to be about being able to see and make progress that benefits the people we help..

Developing a digital strategy 

For me it’s about making it succinct and understandable for all colleagues. I want it to make sense to everyone, whether they are someone who works in the cafe, in the laundry, a porter, a specialist nurse or a consultant. They should all be able to take something from it and relate it to them.

I also think that strategies should focus less on the technical and instead look at where we think we are going to be, what we are aspiring to do, and what it means on an individual level.

It should recognise the starting point. You can write aspirational strategies that talk about things that are way ahead in the future, but we also need to understand where we are now. If we understand that, we can look at where we want to be and think about the route that connects the two.

I’ve not written a digital strategy for the Northern Care Alliance yet – we’ve started talking about it, but I think it’s vital to spend time learning the organisation first. You’ve got to use the language that the organisation understands, the terms that they use. It’s about ensuring that your strategy is realistic and relevant.

I also think that the strategy needs to evolve. You can’t write it, finalise it and then hold yourself to it. You need to keep looking back at it, checking, validating, asking if it’s right. We have to bear in mind that the world is changing around us much faster than it ever did.

At the Northern Care Alliance, we’ve started to talk about breaking the digital strategy down into three areas: run, grow and transform. Run is about getting on top of all the things that we need in order to operate smoothly, like stable WiFi and connectivity, the ability to log on from anywhere. Having brought the Alliance together with all the different systems, this is a challenge that we’re still tackling.

Grow is about taking run and making it better. How do I improve the WiFi, how do I make it quicker to log on, how do I get easier access to applications and start to consolidate them down so there are less logons for colleagues, or reducing the complexity of what systems someone needs to use?

Transform is the big ticket stuff. If run and grow are about improving the engine, transform is about fundamentally changing the engine for the better and that’s not just about digital, it starts with processes and people at the heart of any approaches.  Technology very rarely transforms organisations – the combination of people, process and technology however are the critical ingredients for success.

Developing the digital workforce

We’re carrying vacancies at present and we need to put a lot more emphasis on this area.

We have a degree of diversity across our current digital colleagues but it doesn’t necessarily fully reflect the communities that we serve and operate in and it’s important that we can attract and retain a fully diverse and inclusive colleague base. At the moment, working with my HR colleagues, I want to explore how we can evolve more apprenticeship schemes and put more investment into how we reach into our communities to better reflect them by employing and developing individuals locally.

As well as developing and home-growing our talent, we need to develop our career paths and think about personal development plans. In our department we have recently made improvements in the amount of individual annual appraisals that take place. I am pleased to see that 97 percent of my team have now had their appraisal – we were lagging a bit before, but that’s a big jump in progress. We’ve started to turn the dial but we have much more to do to ensure these are quality conversations and that we have great leaders at all levels.

At the start of May we had our first digital informatics people conferences. We split our teams over two days and got everyone together to talk about the future, morale and staff engagement. I want to do a lot more of that.

Hopes for the future

Today, we have a heavy footprint of patients who come into our hospitals and stay, and a wide range of community services to support those who need us. If I look at where technology is going, where it can be a great enabler, and the trends we are seeing already, it’s clear that keeping you out of hospital is a major priority. The UK will need to do more with preventative services.  If you do have to come into hospital then the speed at which you are supported and we can get you back in your own home with the right care around you is absolutely vital for the future. That’s both in terms of sustainability of services, and for the health and wellbeing of individuals too.

In five or ten years’ time, I personally think we will see a lot more wearables being used in the home and we’ll see a lot more self-diagnosis. We’ll see much more investment in digital devices that provide information such as our heart rate or blood pressure, so that people receive early warning signs and don’t wait until it’s too late and then require hospitalisation. I think that’s the only way that the NHS becomes a sustainable model for the future. Also, the more that you can empower an individual to self-manage, and the more self-aware we become, the less likely we are to walk into trickier health problems further down the line. That allows us to keep bed space and specialist services available for those who need critical care.

Even that is changing, I think; I look at the trends and I can see the changes in the level of monitoring that you can do when somebody is in a hospital bed. We can have diagnostic services running that can provide modelling and predictions, and that will ease some of the challenges around our clinicians. We’ve got very clever clinicians and nurses; we need to help them where we can, by starting to use AI and robotics services to predict the trend of what a person’s health pattern is looking like. I genuinely think the future is exciting and that digital services play a significant role – alongside specialist colleagues who we can better support to target their skills and capabilities

Many thanks to Lorna for sharing her time and thoughts.



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