Interview Series: Toby Avery, Chief Digital and Information Officer at Surrey and Borders Partnership

In our latest interview series, Angela Sharda speaks to Toby Avery,  Chief Digital and Information Officer (CDIO), Surrey and Borders Partnership NHS Foundation Trust about his vision for technology, how strong leadership skills can help shape the workforce in the NHS and how vital it is to put people at the heart of his work.

Toby Avery is CDIO at Surrey and Borders Partnership NHS Foundation Trust and has been in the role since April 2019.

Tell us about your vision for technology in your organisation?

We are on a journey moving from a world where we think about IT as a back-office service provider to an essential function of clinical practice.

Now we need to work out how we move along that maturity spectrum to get to a place where we are working digitally as natural as possible.

For example, you wouldn’t expect a nurse not to know how to use a pen and paper, so, therefore, why would we expect a nurse to not know how to use technology to do their job.

How do we make digital an integral part of clinical and operational practice?

For us, there isn’t one single answer to that but one of the key things that we are working on is thinking about reimagining digital with our workforce.

Historically, the workforce has had IT systems that are not fit-for-purpose that have been dumped upon them but we now need to turn that all around and we need to get into a room with our clinical workers and the administrative workers and redesign the systems.

The biggest thing that we are working on is how we can move along this journey of getting these experts into a room, working together to reinvent how we deliver healthcare.

We have had some success with that and some failures with that – which is all part of the game. We are experimenting on new ground in the NHS and this space.

I often use the example of Apple, why do I use an iPhone? Because, in my opinion, it’s easier to use than an Android. But how do we get to that stage where our healthcare technology is as easy to use as an iPhone? Well, our mantra is to put people before the technology – their experience, their knowledge and the safety of people using our services.

How can problems in the tech space be overcome?

My default mantra is – people before technology. I think that we can solve most of the tech problems within the NHS if we get the people problem solved within the NHS.

We need a competent and effective digital workforce, we are using tools that we have never used before in the NHS, so we need the skill set and capacity to be able to push that forward. Recruiting against the private sector is a challenge within itself, the NHS can’t pay the same rates.

We have a shortfall of around 100,000 nurses in the NHS at the moment but are we ever going to catch that up? I don’t know. But the question is can we get the rest of the nurses that we do have within the NHS digitally enabled but this a real leadership challenge and a culture challenge.

If you don’t have a leadership voice in your trust then even if you do have the shiniest piece of technology it won’t be worth it.

Which innovations over the last 18 months are you most proud of?

We have tapped into Microsoft and we have today launched our flu campaign, historically patients would have to fill out a form but we have created a very simple flu app which is being launched today (1/10/2019).

A nurse is able to view the real-time data and this is just one example of a few apps that we are working on. We are looking to leverage this platform for clinical and administrative use.

We have been using EPRs since 2009 but innovations such as this is a route to drive out paper.  There challenges that will come with this app but it’s about having the right people in the room to have that conversation.

The way we think about these innovations is what is in it for the staff – the nurse, administration staff and doctors. But if you’re unable to answer that question there will be further barriers ahead. I think once you have a solution of ‘how are we going to make this work’ then challenges can be faced and negatives can be turned into positives.

Have you seen any innovations change the way in which primary and secondary care work together?

We have been working on a scheme, Time for Dementia and we have had very positive research come out of this.

One patient had a suspected UTI so the nurse phoned up the patient, called the GP and arranged antibiotics. This helped the patient from avoiding a two or three week visit into an acute ward for a dementia patient. So, we have a free bed in the acute ward, saved GP time and saved money.

Again, it’s all about putting the person at the centre of what we do. The answer is not to diagnose the patient but to take a set of indicators and a clinician will make a decision on what they should do next.

These indicators allow us to make decisions in a pro-active way before patients get to us.

What would your advice be to other organisations who want to adopt a more tech-savvy approach?

Start small and scale – find something that you can drive value out of even if it for a team of five people, develop it, work with the team, co-design it with them, create success in that team and then look at how you can scale that out to other teams and services.

You have got to have credibility, a lot of IT departments don’t have credibility, a lot of IT departments are seen as a back-office systems where no one ever compliments or thanks them but they do shout out when it all goes wrong.

So, you need to start a catalogue of credibility and do it initially with small scale value offerings that you are able to later expand, grow and build on.

What is in the pipeline for 2020?

We are working on our digital strategy at the moment. Our strategy will involve very little technical language as it is all about people for us.

We will focus on delivering better technology healthcare outcomes, safety, and efficiency but most importantly putting people at the centre of our strategy.

We are in the business of healthcare not in the business of data centres. Our job is to deliver better healthcare outcomes and mine, in particular, is about how I can utilise to support our clinical work.