Episode 2
How NHS trusts are using digital to transform everything, with North Bristol NHS Trust
North Bristol NHS Trust Chief Digital Information Officer, Neil Darvill, and Casey from Block dive into how digital transformation isn’t just about systems and infrastructure; it’s about giving clinicians the tools and environment they need to deliver outstanding care.
Block has been the trusted digital transformation partner for North Bristol NHS Trust since 2018, and this episode is packed with real insights on how technology is supporting healthcare.
Transcript
- On this episode of
Future, now I'm joined
Speaker:by Neil Darvill, who helps
steer North Bristol NHS trust
Speaker:from legacy tech and daily
frustrations to a culture
Speaker:of accountability and innovation.
Speaker:If you're curious about how
Speaker:to drive real change in complex
systems, this one's field.
Speaker:So Neil, thank you for joining us today.
Speaker:Welcome to the show. For
those who don't know you,
Speaker:tell us a little bit about
yourself, your background,
Speaker:and how long you've been in the NHS.
Speaker:- Thank you Casey. So
a little bit about me.
Speaker:I've been in the NHS since 1991,
Speaker:I think, and all my roles have been in
Speaker:digital transformation and leadership.
Speaker:Starting off obviously
slightly less senior
Speaker:and culminating into my current job,
Speaker:which is an amazing opportunity
Speaker:and privilege being,
Speaker:an executive level chief
digital information officer at,
Speaker:I think the third largest NHS group in
Speaker:the NHS in England.
Speaker:So a huge opportunity
Speaker:and a huge challenge,
really important work.
Speaker:- Brilliant. And tell us a
bit more about this, the,
Speaker:you know, the, the,
the group of hospitals.
Speaker:Tell me about how, how you got into that
Speaker:and was that something that
you shaped from the start
Speaker:or was that a coming together
Speaker:and you were found yourself in the right
Speaker:place at the right time?
Speaker:- I would love to think
that I was instrumental in
Speaker:that approach, but the reality
is we are hospitals
Speaker:and the driver for the
Speaker:coming together in a group
format is driven absolutely
Speaker:by our ambition
Speaker:to improve our clinical services.
Speaker:It has to be said that where
you have two hospitals working
Speaker:as a group, where potentially
the outcomes that you get
Speaker:for different levels of
service are different.
Speaker:So if the ambulance turns left,
Speaker:you get a different outcome than if the
Speaker:ambulance turns, right?
Speaker:Sure. And we consider that to
be completely unacceptable.
Speaker:So we have put all our efforts in
Speaker:to creating a joint clinical strategy
Speaker:that is now being used to form
all the reasons why we need
Speaker:to work really close together
as two separate trusts
Speaker:to deliver a very clear
patient-centric approach
Speaker:to improving the quality of
Speaker:- Care.
Speaker:Brilliant, thank you.
Speaker:And just for context, for
those who are meeting you
Speaker:and I for the first time
today, the relationship
Speaker:between Block
Speaker:and NBT is
Speaker:where things started back in 2017, 2018,
Speaker:when yourself
Speaker:and North Bristol were
on the procurement looking
Speaker:for a, a digital transformational partner.
Speaker:Tell us what got you
from the start of you.
Speaker:So you, you joined MBT in 2015.
Speaker:What, talk us through the process
of getting from that stage
Speaker:to effectively getting to a
point where you're looking
Speaker:for a trusted partner
Speaker:to move North Bristol into a
new transformational world.
Speaker:- So it's really important,
I think, in terms
Speaker:of having trusted partners,
Speaker:those relationships really critical
Speaker:to delivering high quality care.
Speaker:Even though it's a technology,
it's actually only valuable
Speaker:because it delivers high quality care
Speaker:and empowers the people who deliver care,
Speaker:you know, our clinicians.
Speaker:It gives them that environment.
Speaker:I think, I think when I started
my journey at North Bristol,
Speaker:there's a lot of, there's always a lot
Speaker:of transformation work needed when you
Speaker:go into an organisation
for the first time,
Speaker:particularly the one that's
had, you know, a fairly
Speaker:difficult time with its
digitization journey,
Speaker:It's digital maturity was very low,
Speaker:very paper-based in all of
its administrative processes.
Speaker:And I get the opportunity
to go in and to try
Speaker:and develop strategies
Speaker:that will take us into
a modernization space
Speaker:and deliver that, those improvements
Speaker:that our patients deserve.
Speaker:So as we proceed through that process,
Speaker:there's an element really
Speaker:of obviously creating capability
within the organisation
Speaker:to actually manage things properly.
Speaker:So that takes a piece of time.
Speaker:Then there is the fundamental culture
Speaker:and confidence change in the
organisational leadership
Speaker:to make sure that the
opportunities to get the investment
Speaker:to be in the prioritisation
Speaker:of organisational investment
Speaker:and delivery of improvements
takes time to develop
Speaker:that cycle of improvement and confidence.
Speaker:And then you get to the tipping point
Speaker:where actually then you need,
Speaker:because of the constraints
faced by, you know,
Speaker:an aged fragmented
infrastructure, you can't get that
Speaker:fast-paced, highly reliable,
Speaker:strong basis foundation of,
Speaker:basically access. So
that you get to the point
Speaker:where you need to resolve that challenge
Speaker:and that's often, as you say, done with
Speaker:a procurement with a partner
Speaker:and then obviously the
subsequent business cases
Speaker:and approval investments.
Speaker:And then of course the
easy part, you know,
Speaker:which is the massive implementation of all
Speaker:of those complex things.
Speaker:But the, you know, the real
benefit you see is everyday in
Speaker:clinic where our clinicians
turn up and sit down
Speaker:and turn on their computer and
it's there and it's working
Speaker:and it's reliable and it's not anything
Speaker:that they have to think about.
Speaker:We give them that environment
Speaker:so they can spend all their time in clinic
Speaker:thinking about their patients.
Speaker:cause the technology just works.
Speaker:- So you've been through a, a number
Speaker:of digital transformations
across few different
Speaker:organisations.
Speaker:I fully appreciate, you know,
from a technical perspective
Speaker:that it is that, you know,
once you get to that point
Speaker:of deploying the technology,
that is the easy bit.
Speaker:Tell me how do you navigate the internal,
Speaker:I guess, approval processes?
Speaker:The cultural change,
not just of the users,
Speaker:but of the senior board?
Speaker:I think there's, I don't think
it's too much of a stretch
Speaker:to say that there's many
people who are in your,
Speaker:position who find
themselves a bit daunted by how
Speaker:to approach their,
senior leadership teams and,
Speaker:the board and,
making that big change.
Speaker:So, you know, we've talked about some
Speaker:of those stepping stones from
a technology perspective,
Speaker:but what does it look like
behind the scenes for you?
Speaker:You know, taking the whole trust
Speaker:through all those
different approval stages?
Speaker:- So it is a, it is a tricky element
Speaker:to the role. Organisations
Speaker:you know, hospitals have
got you know, a definite,
Speaker:you know, definitive budget
Speaker:and lots of cost pressures on that budget.
Speaker:You know, if it comes down to, you know,
Speaker:buying a new CT machine
Speaker:or investing in an IT system,
Speaker:the decisions can be
very difficult to make.
Speaker:You know, I do though think that
Speaker:it's really powerful
when you're dealing
Speaker:a thing like a trust board
where you've got a group
Speaker:of people, very senior, very
experienced people who want
Speaker:to do the right thing, is one
Speaker:to give them an opportunity
to understand the issues
Speaker:because of course it is about
connectivity and access and,
Speaker:and service, but it's also about security
Speaker:and safety and control.
Speaker:So there are ways of
articulating those things.
Speaker:And one of the techniques that
I think is quite useful is
Speaker:you make sure that you transfer the risk
Speaker:from digital into the board.
Speaker:So you put forward the proposal
that says, actually we need
Speaker:to upgrade this system,
replace the firewalls,
Speaker:or do X, Y, Z, and this is the
benefit and this is the cost
Speaker:and these are the risks that we mitigate.
Speaker:And the board has to make
the decision of, yes, we
Speaker:prioritise that and you can proceed,
Speaker:or no, we choose to accept that risk.
Speaker:So I think my duty is
not to hold the risk.
Speaker:My duty is to offer the
opportunity for the risks
Speaker:to be considered
Speaker:and then mitigated where
they are unacceptable.
Speaker:And the board needs to be
empowered to take control of
Speaker:that agenda and make those decisions.
Speaker:And I think if you go through
a really methodical,
Speaker:well sort of informed process
Speaker:and take your board
members on that journey,
Speaker:you will get a really well-informed
set of decisions back.
Speaker:- Yeah, very good. So using that as the
Speaker:backbone of the
process that you've gone
Speaker:through a number of times
Speaker:and take you back to 2018, the
Speaker:first digital transformation
Speaker:that you embarked on with Block.
Speaker:Tell me, so this was over
in North Bristol.
Speaker:What was the catalyst for change?
Speaker:What did you see that
made you realise we need
Speaker:to bring fundamental change here?
Speaker:And tell me then not only
Speaker:what was the challenges you
were trying to overcome,
Speaker:but what did you see really as
the opportunity at that time?
Speaker:- So I think I've touched
a bit upon it already,
Speaker:but I think the, the
fundamental elements are that
Speaker:that organisation had the
technologies, you know,
Speaker:the underlying technologies,
Speaker:they just weren't working very well.
Speaker:There were several of them
Speaker:and they didn't particularly
work well together.
Speaker:And so that manifests itself
into slow performance on
Speaker:reliability, service interruptions,
Speaker:and of course we're talking
about service interruptions
Speaker:to things like 10 neli.
Speaker:So, things that are very difficult
Speaker:to justify in terms of safety.
Speaker:So you have an environment like that
Speaker:and you know, people
take different approaches
Speaker:and I'm sure they're all valid
Speaker:depending on the circumstances.
Speaker:But my perspective is, is that
Speaker:that is a fundamental unacceptable risk
Speaker:and we have to get the
organisation to the place where
Speaker:cementing those foundations
Speaker:and providing an
enterprise environment end
Speaker:to end every part of the organisation
Speaker:for every user every day is high quality,
Speaker:rock solid and safe.
Speaker:And therefore the only way to
do that is to put a case in
Speaker:to replace all of the old out of date
Speaker:and poorly work functioning
infrastructure, replace it
Speaker:with modern technology and,
Speaker:to go out to the market
to find a partner who shares
Speaker:that vision and wants to
work with you in that way.
Speaker:- So Neil, when we're talking
about moving towards a digital
Speaker:transformation, I understand
Speaker:that you've got the internal
approval processes to work
Speaker:through, you've then got the,
choosing of the technology
Speaker:and what's right for where.
Speaker:But I'm always conscious
that there's a huge number
Speaker:of people, you know
the backbone of,
Speaker:of any organisation or trust.
Speaker:And those people need to be inspired
Speaker:and taken along for that journey.
Speaker:And that journey can be a year, two years,
Speaker:sometimes a lot longer.
Speaker:How do you inspire that
Speaker:confidence in all those three
parts of Bristol?
Speaker:- So, I mean inspiring is,
Speaker:I'm not quite sure I'd
describe it that way.
Speaker:I think there's a couple
Speaker:of dimensions to that question.
Speaker:So the first for me, is in
terms of providing services
Speaker:to the staff,
you know, our clinicians,
Speaker:our nurses, our operational
teams, our divisional teams.
Speaker:There is an expectation, I think,
Speaker:and quite rightly, that
this stuff should be there
Speaker:and it should work and it should
work effectively for them.
Speaker:And I think the,
inspiration isn't so much
Speaker:about that.
Speaker:I think it's about engaging
with those people to make sure
Speaker:that the services and the
solutions you are providing
Speaker:match their expectations and their needs
Speaker:and the requirements for them.
Speaker:Cause they're ultimately, they're the
Speaker:people that deliver the care.
Speaker:So I think there's a
process of making sure
Speaker:that your stakeholder management
Speaker:and your relationships
really do work in terms
Speaker:of getting the information you need
Speaker:to provide the right solutions.
Speaker:I would reflect back though
that there's also another team
Speaker:of people, which is the
team that sit in digital
Speaker:who actually have
realistically the role
Speaker:of making this stuff work every day
Speaker:and being the responsive
frontline kind of interface
Speaker:between those staff and the digital.
Speaker:And I think the thing that's
often overlooked is that
Speaker:with any technological
transformation, you really have
Speaker:to work hard at empowering those people
Speaker:to have the confidence and
support them with training
Speaker:and development, learning
how to use new technology.
Speaker:It isn't about the technology turning up
Speaker:and people kind of scratching their heads
Speaker:and thinking, well what do we do?
Speaker:What do we do with this? Yeah.
Speaker:How do we, how do we make this work?
Speaker:How do we get the best out of this?
Speaker:There has to be that kind
of symbiotic approach
Speaker:where those people are
appropriately empowered
Speaker:with the right support so that, you know,
Speaker:the technology is able to be utilised.
Speaker:As I said, you know, I've said it
Speaker:before, that we're a hospital.
Speaker:The technology is irrelevant
Speaker:unless it really helps the
people who have the patients.
Speaker:- Absolutely, and I know, you
from knowing you in a,
Speaker:in a, you know, over three
years now you are, everything
Speaker:that you do for the the hospital group,
Speaker:the trust your people,
it's all outcome based.
Speaker:It's all about, you know,
Speaker:if we're not moving in the
direction of saving lives,
Speaker:then we're going backwards.
Speaker:- So saving lives sounds
a a little bit dramatic,
Speaker:but actually is real sometimes,
Speaker:but the, you know, so the
day-to-day benefits are
Speaker:around efficiency and operational safety.
Speaker:So we are able to manage our
waiting lists really well.
Speaker:We're able to get patients
seen as quickly as possible.
Speaker:We have those elements
of efficiency, you know,
Speaker:when you see processes
working really poorly with
Speaker:hybrid environments of
paper and technology
Speaker:and lots of different systems
to use and, and then poor wifi
Speaker:and slow access
Speaker:and spinning circles of
frustration on computer desktops.
Speaker:And when you see those
environments, you realise
Speaker:what an impediment it can be
to, for our clinicians to do
Speaker:what they want to do as
well as they want to do it.
Speaker:So, you know, the
opportunity is clear.
Speaker:- And do you think, is there a risk
Speaker:that our clinicians have become used to
Speaker:that level of service?
Speaker:This isn't across Bristol now,
this is just across the NHS
Speaker:and do you think that acceptance
Speaker:that this is just the way it is,
Speaker:is causing issues within the
amount of patients we're able
Speaker:to see across, you know,
across a year, for example?
Speaker:- So, I'm fortunate to have quite a lot
Speaker:of experience across
quite a few organisations
Speaker:and I think what
you learn from that is
Speaker:that the environment that people work in,
Speaker:they very quickly become assimilated to
Speaker:and then start making
workarounds are within.
Speaker:I remember in one job I
had slightly smaller job,
Speaker:but the service desk operated a
Speaker:a fault response
performance where everything
Speaker:that was logged with the
service desk was actually
Speaker:fixed within two hours.
Speaker:And therefore I used to get
emails from disgruntled doctors
Speaker:who were waiting half a day.
Speaker:And I've worked in another organisation
Speaker:where the average fixed time was a week
Speaker:and I got emails congratulating
me on amazing performance
Speaker:from doctors where it
was fixed in two days.
Speaker:So it isn't that necessarily the service,
Speaker:it is the environment in
which people are basing
Speaker:their comparison.
Speaker:You know, people will think
a service is good if it's
Speaker:slightly better than they expect.
Speaker:The reality is though, that
I have to be
Speaker:the custodian of those standards so
Speaker:that we are moving towards standards
Speaker:that are not necessarily those
that people have got used to,
Speaker:but are actually standards
that we would be proud
Speaker:of in terms of industry
performance with our technology.
Speaker:- In the words of Jurassic
Park, life finds a way,
Speaker:and I think, you know, when you've got
Speaker:hardworking people just
trying to do the best they can
Speaker:and systems don't let them
get the access that they need,
Speaker:workarounds unfortunately
become quite a common practice.
Speaker:We see that a lot with security
as well, a lot of shadow IT
Speaker:outside of the digital team.
Speaker:A few come across that and,
how do you deal with it?
Speaker:- So you're right, people do find a way
Speaker:and often in some organisations,
particularly those
Speaker:that have not necessarily
had strong, cohesive
Speaker:senior digital leadership,
you tend to find
Speaker:that people have ambition
in clinical teams
Speaker:and departments and divisions.
Speaker:They have those ambitions
and they go away and try
Speaker:and fulfil those ambitions
the best they can.
Speaker:You could almost argue that they
Speaker:have achieved progress despite
Speaker:the corporate enabling
of a digital service.
Speaker:The reality is though is that
Speaker:that's often done in
a very fragmented way,
Speaker:often done quite poorly,
doesn't reflect things
Speaker:around information
governance or cybersecurity.
Speaker:But the biggest concern
is of course you have all
Speaker:of your clinical information
fragmented into many,
Speaker:many different places, much
Speaker:of which is not access accessible by many.
Speaker:- Yes.
- And therefore,
Speaker:and that often that tips
into this shadow IT concept
Speaker:where data
Speaker:and systems are managed
outside of corporate awareness,
Speaker:which actually could be very dangerous.
Speaker:So I have a very clear view
about the fact that we have
Speaker:to be absorbing those variation,
Speaker:running bigger systems, doing more
Speaker:and eliminating fewer
systems, doing specifics so
Speaker:that we get all of our data into
Speaker:as fewer places as possible.
Speaker:So it's readily available to be accessed
Speaker:by our clinicians when they need to,
Speaker:and it's data collected at all
points in a patient pathway.
Speaker:So that's what we have
to do as an ambition,
Speaker:but obviously sometimes
we're starting from kind
Speaker:of the opposite end of where
we would sit with that.
Speaker:- So we work with a lot of trusts
Speaker:and health boards across the UK
Speaker:and we really see quite
a difference in terms
Speaker:of the way in which digital leaders
Speaker:approach the market quite honestly.
Speaker:And often I see procurement run in
Speaker:the choosing and selecting of a partner,
Speaker:but who knows best procurement
Speaker:or digital from
Speaker:what I've seen from the way
in which Bristol operate,
Speaker:those decisions are chosen
Speaker:and made at the digital
level, not procurement.
Speaker:If you agree with that, how
have you navigated it to be
Speaker:that way within Bristol?
Speaker:- So, what's really important
is to recognise that
Speaker:procurement is an essential component
Speaker:and the expertise needed in procurement is
Speaker:absolutely valuable in making
sure you have a compliant
Speaker:legal, legally acceptable
reasonable processes.
Speaker:So there is no doubt they're
an essential part of any
Speaker:procurement purchasing exercise.
Speaker:I think the thing that I'm very keen
Speaker:to make sure happens is, is
that the expertise that's needed
Speaker:to ensure that the right
things are being procured,
Speaker:that has to be present in the process.
Speaker:So it's really important
to get the balance
Speaker:where the procurement team are empowered
Speaker:with all the information
they need to make sure
Speaker:that the right things are being purchased
Speaker:and then the procurement
expertise kicks in to make sure
Speaker:that the processes that are used
Speaker:to do the procurement are the right ones
Speaker:and that they are
appropriate for that process.
Speaker:- Yeah, totally agree.
Speaker:2% of Bristol's annual budget
goes towards digital, so it's
Speaker:therefore incredibly important
that you make maximum return
Speaker:and biggest impact from that investment.
Speaker:How do you prioritise
Speaker:and select, you know,
where that money gets spent
Speaker:periodically, at least every year?
Speaker:- Okay, so I think a bit of clarification.
Speaker:So 2% of revenue is the
base budget for digital,
Speaker:including all the elements,
Speaker:the components within a digital service,
Speaker:everything from transformation
to switchboard to help desk
Speaker:and in between, that's fairly
Speaker:low as a percentage in real terms compared
Speaker:to other large hospital groups,
Speaker:particularly university hospital groups.
Speaker:However, we operate in a way
Speaker:where we're significantly
supplemented with capital funding,
Speaker:so non recurrent investment each year.
Speaker:So the net spend, if you
like, is slightly more.
Speaker:So I wouldn't want to
allow my finance colleagues
Speaker:to fidget when they were
seeing this described
Speaker:because there is a reasonable
level of investment
Speaker:that does stack up well with our peers
Speaker:to enable us to do that.
Speaker:But nonetheless, it is a scarce resource
Speaker:and we do have to go through
a process of prioritisation.
Speaker:And to be honest, I don't think
we are not doing as much
Speaker:as we could because of the, the funding.
Speaker:If we had more investment,
Speaker:we could certainly do more things,
Speaker:we could increase the pace, you know.
Speaker:I've got a fantastic team of people
Speaker:and the quality of the
work we do is excellent,
Speaker:but with a supplementary
investment we could certainly go
Speaker:faster or indeed have
a bigger portfolio
Speaker:of projects in flight.
Speaker:And I think, you know, that's the,
Speaker:the negotiation opportunity
against other priorities
Speaker:that the organisation has
to deal with. In terms
Speaker:of those priorities and
that prioritisation process
Speaker:it has to be stakeholder driven.
Speaker:You have to have links
into your organisation,
Speaker:to your divisional clinical
Speaker:and operational leadership
so that we very much listen
Speaker:to the priorities
Speaker:and the requirements that
are coming from that.
Speaker:And then of course
supplement them with
Speaker:our own requirements to make sure that
Speaker:there are solid foundations
Speaker:and cybersecurity is not
neglected and upgrades are done
Speaker:and all those other things as
well as then some of the other
Speaker:transformational and operational
delivery type elements.
Speaker:- Brilliant. Yeah. So
Neil, I have the luxury
Speaker:of working day in day
out with the majority
Speaker:of your digital teams
Speaker:and across all their different
Speaker:functions, they do a hell of a job.
Speaker:You know, a big part of
that is their approach
Speaker:to the leadership that you and
and your team have brought.
Speaker:You know, I'd love to get your
thoughts on, you know, we,
Speaker:we see that they embrace the
partnership way of working,
Speaker:which is just absolutely
crucial for the success that you
Speaker:and the team have driven.
Speaker:Talk to me a little bit about
your experience of the team
Speaker:and you know, what the rising stars
Speaker:and what you see amongst
those guys is
Speaker:as real game changing.
Speaker:- So I mean the, the starting point is,
Speaker:is you can't really achieve anything
Speaker:unless you have the right people.
Speaker:So it's really around looking after
Speaker:and looking out for the people.
Speaker:So I always have focused on making sure
Speaker:that our teams are informed
about what's happening,
Speaker:they are involved and
engaged in decision making.
Speaker:They have training
Speaker:and development programmes,
even in frugal times
Speaker:where we're struggling to
find investment for things.
Speaker:I never remove the training
Speaker:and development budgets for
our, either our technicians
Speaker:or for some of our leadership
team so that we continue
Speaker:to grow the capability and the expertise
Speaker:and the team spirit across the division.
Speaker:I think what I'm really proud
Speaker:of is when we have things
like our staff survey
Speaker:or we look at our HR statistics
Speaker:around things like staff
turnover and length of service.
Speaker:We have an incredibly stable environment
Speaker:and the team of people we have have been
Speaker:with us for a long time.
Speaker:I think they obviously that must describe
Speaker:that we either pay them too
much or they really enjoy it
Speaker:or a combination of both.
Speaker:But genuinely we are
very fortunate to have
Speaker:a fantastic group of people.
Speaker:The attitude and the culture
Speaker:and the, you know, the whole vibe
Speaker:of the team is right from my perspective.
Speaker:And I think all of those things
are demonstrated in the fact
Speaker:we get really positive
feedback from the team and,
Speaker:and I think, you know, empowering
people and trusting them
Speaker:and allowing people to, you
know, innovate and to fail
Speaker:and to learn and all of
those things, you know,
Speaker:just create those types of environment.
Speaker:And I'm very fortunate to have a
Speaker:great team that does well in that.
Speaker:- I think it's a fantastic
policy, you know, at times
Speaker:of austerity when funding
is strapped, maintaining
Speaker:that training and that coaching
Speaker:and that personal development.
Speaker:You know, as you can
imagine, we work with lots
Speaker:of different customers.
Speaker:I speak to lots of different
customers every day
Speaker:and staff turnover is a big problem
Speaker:and it's how do you keep them?
Speaker:And it's funny, we, we joke
about the the money side
Speaker:of things, but actually
it's, I'm finding more
Speaker:and more it's about the
educational piece to anything
Speaker:that almost furnishes that
for them, keeps them inspired
Speaker:and, stimulated in the role.
Speaker:So it's great to hear that.
Speaker:- And in the technical
environment, of course,
Speaker:providing people with the
latest technology to work with,
Speaker:being at the kind of cutting edge of,
Speaker:learning those kinds
of skills is a great,
Speaker:very desirable environment for people.
Speaker:And so, you know, we are not stale
Speaker:and static continue to
innovate in those areas
Speaker:and I think, you know, the staff do
Speaker:well in that, in that space.
Speaker:- So Neil, you've talked
us through the innovation
Speaker:and getting the digital infrastructure
Speaker:right across the trust.
Speaker:We've talked from 2018 up to today.
Speaker:Tell me what's coming next?
Speaker:- So what's next is really
more of the same, really
Speaker:the strategy is very clear.
Speaker:We, I touched on it earlier,
Speaker:but it's around making sure
that we utilise our systems
Speaker:to the full, we make them
as simple as possible.
Speaker:We converge, simplify,
reduce the number of places
Speaker:where data's held
Speaker:and give people a really
functional environment.
Speaker:And of course that's very easy
to say in a sentence even,
Speaker:even though I didn't say
it very well, it's easy
Speaker:to say in a sentence, but
actually is a great deal
Speaker:of work involved in hundreds
of systems that are in play
Speaker:and how do you systematically
deal with all of
Speaker:that variation, all of
those separate locations.
Speaker:So we're on that journey
of literally going through
Speaker:and expanding the use of our
bigger systems and reducing
Speaker:or stopping the use of
other systems or merging two
Speaker:or three systems that do the same thing
Speaker:into one version of that.
Speaker:And all of those successive elements
Speaker:that the strategy defines
as creating an environment
Speaker:that our clinicians have
described to us as their,
Speaker:their requirement really, which
is to have all the data in
Speaker:as fewer places as possible
Speaker:and as simple environment
to use to access it
Speaker:and record to it.
Speaker:So we're on that, on that journey
Speaker:and you know, we are fairly
digitally mature now, you know,
Speaker:I'm proud to say a couple of years ago we
Speaker:completely eliminated all
the paper health records
Speaker:and so now we're only dealing
with the occasional bits
Speaker:and bobs of paper
Speaker:and fundamentally a great deal
Speaker:of our clinical practise
is now using the digital
Speaker:environment, which of course is supported
Speaker:by our infrastructure.
Speaker:So yeah, I think we're,
we're well on the journey as,
Speaker:as I think I said earlier,
Speaker:it'd be great if we could
accelerate that and do more,
Speaker:but actually considering
what we invest and,
Speaker:and the progress we've made,
Speaker:I think it's, I think
it's quite impressive.
Speaker:- Very much so. So Neil, as a
result of the transformation
Speaker:that you've put in place
over in NBT, you know,
Speaker:what would you say is the one thing,
Speaker:the one positive outcome
that's come from that?
Speaker:- So that's a tough question.
Speaker:I mean, I would say we are more efficient.
Speaker:I would say that, you know,
we are more, you know,
Speaker:we have more standardised
approaches to things
Speaker:with limited variation.
Speaker:But if you were to push
me to say one thing,
Speaker:I would say we are safer.
Speaker:- So Neil, looking back
over your career so far,
Speaker:if you could go back
Speaker:and tell Neil Darvill from 15 years ago,
Speaker:or even today, you know, people
Speaker:who are newly appointed
into their their CDIO
Speaker:or digital director role,
Speaker:what advice would you give them based on
Speaker:everything you've learned to date?
Speaker:- Advice? Well, I'm thinking
back to my, the first job I got
Speaker:where I was an executive member
of the board was in: Speaker:So I'm not suggesting I've
broken any world record,
Speaker:but I'd be really amazed if
there was ACDIO out in the
Speaker:NHS that had a longer executive tenure.
Speaker:So, so email me.
Speaker:But I think the advice I would give is,
Speaker:if you're not in the position
Speaker:to make the right influences,
work on the people that are
Speaker:and get your messages into the mix and try
Speaker:and empower your organisation
to understand the issues
Speaker:and the risks and the
challenges that you are facing.
Speaker:Because often people, you know,
Speaker:certainly very skilled people
who are working perhaps,
Speaker:you know, one or two levels
down in the organisation,
Speaker:they will hold those risks and
they will manage those issues
Speaker:and it will mean that it's barely visible
Speaker:at the most senior level.
Speaker:And that's where organisations
then get into trouble.
Speaker:So it's about not being
tempted to hold those risks
Speaker:and to make those issues
disappear, but to deal with them.
Speaker:But at the same time, you
have to make communication key
Speaker:and allow the board to be aware
Speaker:of the challenges that
you're managing. Yeah.
Speaker:- So look, Neil, thank you
so much for, for coming
Speaker:and meeting us today and talking
us through your experiences
Speaker:and what you've seen and what you've done
Speaker:and really looking forward
to seeing, you know,
Speaker:how the future pans out too.
Speaker:Just a couple of very
quick last questions.
Speaker:You're clearly, you know, one
of the most inspiring people
Speaker:that I've worked with, you're very driven
Speaker:and you're a thought leader.
Speaker:So I want to know where do
you get your inspiration
Speaker:and what, what gets you
outta bed in the morning?
Speaker:- So I don't work in the
NHS as a coincidence.
Speaker:There's lots of parts of the NHS
Speaker:and all of them are really important,
Speaker:but I wouldn't work anywhere
else other than in a hospital
Speaker:because when you get to walk
Speaker:around the hospital into
the clinical areas, talking
Speaker:to the clinicians and do
that on a regular basis,
Speaker:you just see what an amazing,
amazing service it is
Speaker:with these really dedicated individuals.
Speaker:And I just get a kick out
of being part of that.
Speaker:So I wouldn't work anywhere else.
Speaker:- Yeah. Brilliant. Thank you.
