Weeknotes: A year at #NHSX

by @edent | # # # # | 7 comments | Read ~320 times.

A year ago, I swapped my comfy job at GDS for a new role at the Department of Health and Social Care. So, this is a sort of informal end-of-year review.

It has been a fun and challenging year. Some of the things I've tried have worked, others less so.

The Good

Helped kickstart NHSX. I think that counts for something! A bit of that was procedural stuff like obtaining the domain name and convincing Twitter to give us the @NHSX name. Some of it was sitting in rooms while senior people turned to me and said "Terence, what do you think?" Then I said my thinks.

Obviously success has a thousand parents, and I was part of a great big gang. But it feels pretty wonderful to have helped launch something which - hopefully - will make a difference.

I'm all of a sudden working with very senior civil servants and politicians. It's not enormously different from the environments I've worked in before, but it is fun walking the corridors of power.

Writing policy and seeing it published and implemented is amazing. We haven't even scratched the surface yet - but there's a definite feeling that we're on the verge of doing something great.

I'm part of a fun and friendly team. I don't just mean my immediate colleagues - I mean everyone in both London and Leeds. They're all so generous with their time and knowledge.

There's a sense of mission. Improve the technology experience for patients and staff in the NHS. Simple to articulate, impossible to argue with, and an achievable goal.

I have a long list of achievements from the last 12 months.

The Bad

It's hard to write about the things that don't go right. Especially when you're still working on something. So I'll try for a bit of candour.

It can't have escaped your attention that there's a lot of Politics about. The recent General Election meant putting a bunch of work on pause while we waited for the results. That was frustrating.

Similarly, because healthcare and healthtech is so high profile, we get a lot of mud slung our way. When we make an announcement of something genuinely good, it's disheartening to see it unjustly savaged.

I made an ill-judged remark at a conference while in front of a journalist. It split the audience and earned me a snitty write-up in the trade press. Obviously I need to be more careful how I word things. I'm used to being off-the-cuff, but that isn't always sensible in a high-profile organisation.

There is too much for me to do. We're rapidly hiring, but I'm conscious of the emails I've not replied to, the documents I've only half-read, and the opportunities I've missed due to time constraints.

The Ugly

I don't deal with bureaucratic things well. ID cards, logins to expenses systems, meeting room bookings. I get overly grumpy when people say "that's just the way we do things". It's not in my nature to go "OK, I'll submit to this daft system."

I've got to remember that's it's not my job to fix everything.

I'm squeamish. I can't watch medical dramas on TV because of the blood, guts, and general body-horror. It turns out that I feel that way when sat in an anodyne meeting room discussing cancer care in the abstract.

Because health is so visceral, it's hard to detach emotion from your work. That's doubly hard when friends express their frustrations about the NHS. When I worked for a phone company, I was always happy to forward a friend's grumble about crappy service. I don't know if I can or should escalate complaints with medical care.

Data standards in the health space seem to be dominated by academic thinkers, rather than practical thinkers. There's lots of "this is how the world should work" and not enough "this is what users need".

I'm not a doctor. Nor any sort of medical practitioner. This has me at a disadvantage because I can't talk authentically about their needs. I have to equip myself with anecdotes.

I miss some of the international work I used to do. This role is - necessarily - focussed on NHS England. But I don't know if that's just my ego because I like talking in front of large international audiences.

What's next?

This was meant to be a year-long secondment, but has been extended. I've gone from being Senior Technology Advisor, to Head of Open Technology.

At some point this year, there'll be a new Director to report into. And NHSX will grow and grow. I need to grow as well.

We're not a funky start-up. And it's right that teams expand and evolve. But I do love the thrill of starting something up something new.

This role ends in one of two ways:

  1. Everyone "gets" open. The value of open technology is embedded in the culture of the NHS. In which case, job done.
  2. Not everyone is convinced. Which means endlessly having the same arguments internally and externally. That could be aggravating.

The question is, how close can I get to (1) before I'm exhausted by (2)?

Fun times ahead!

7 thoughts on “Weeknotes: A year at #NHSX

  1. Great reflections. Thank you for sharing, and for everything you’re doing to embed open technology in the culture of the NHS #KeepGoing

  2. +1 and good luck for 2020 👍

  3. So many relatable things.

    “I don't deal with bureaucratic things well …. I get overly grumpy when people say "that's just the way we do things".

    I become less patient with “the way we do things” the longer I am involved with the NHS. It’s worse when I stray into that myself.


  4. Matt Stibbs says:

    Let's hope long enough for you to write next year's as well. Rooting for the mission.

  5. Hilary Hall says:

    You (we) can do it Terence!

  6. Tony Yates says:

    I found myself nodding a lot while reading this. Hang in there!

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