Interview Series: Andy Callow, Group CDIO at Kettering and Northampton hospitals

As part of our interview series, we recently caught up with Andy Callow, Group Chief Digital Information Officer for Kettering General Hospital NHS Foundation Trust and Northampton General Hospital NHS Trust.

Having stepped up to his current role only a few months ago, and his previous one just before the start of the pandemic, Andy was able to offer us a unique perspective on digital leadership in times of national crisis.

But our chat wasn’t all COVID-19 and remote working-related as Andy, an enthusiastic blogger on all things digital in the NHS, gave us his thoughts on digital representation at board level, his Group’s strategy, the politics of making cups of tea and why NHS Chief Information Officers (CIOs) should get themselves onto Twitter.

Hi Andy, tell us about your recent role-switch

“Yeah, I’m now the Group Chief Digital Information Officer for Kettering and Northampton hospitals. I’ve been in this role since December. But previously, I was the Chief Digital Information Officer for Kettering Hospital and did that for about 18-19 months.

“I sit on both boards of both trusts and I’m accountable for the technology strategy and delivery for both hospitals. It’s actually my first time in an acute part of the NHS.

“I previously worked for NHS Digital and, most recently, was the Programme Director for the NHS App. I had the fantastic opportunity to take it from Jeremy Hunt’s brain-child into the app stores, in around 12 months. I worked with a brilliant team across NHS Digital, some great suppliers and NHS England, in order to make that happen.

“But during the course of that year, I started to spend some time in different hospitals, through a leadership programme. And I started to see some of the challenges that were actually happening on the frontline.

“It sparked my interest and [I] decided there was more to what I wanted to do, rather than being in the ivory tower, sitting in the centre and [realised] the trusts were where things were really happening.

“I think everyone would have recognised that Kettering was a very digitally immature hospital. But as a board we committed to a big digital programme, which has really accelerated the trust’s digital experience over the last 20 months, or so. We’ve really gathered momentum and staff believe that things are happening now.

“Northampton is a more mature digital hospital, they’ve done more along the way, but practically what hasn’t happened is joining up those systems to make a single entity.

“The challenge for the next 12 months or so, is to try and align our electronic patient record programmes and work towards a single record.”

Any new digital programmes or initiatives that you can tell us about?

“Last year Kettering publicly published our cloud-first policy, which we think [makes it] the first trust to do so. The Northampton one will be following shortly.

“At Northampton we were allocated as a Robotic Process Automation [RPA] Centre late in 2020. We’ve mobilised very quickly to demonstrate the potential for RPA in our own Trusts, but [are] also supporting up to 10 other trusts around the country to access a common library of processes.

“[Also] at Kettering we worked with London North West University Healthcare NHS Trust (LNWH) and Madetech to develop a Virtual Visiting solution that is really focused on user needs. We’d tried a number of things including Google Duo to link patients to their loved ones, but it was too complicated for the ward staff, patients and families. The bespoke development really works with patients and we’ve had some great feedback. That code is now open source for others in the NHS to use.”

How has the pandemic impacted your role?

“Towards the end of 2019, I was starting to recruit into my senior team…my Head of IT was actually employed for about eight weeks before I physically saw her for the first time.

“At that time, I was only at Kettering, but very early on the exec team took it in turns to be in the COVID-19 incident room. So that was a very different aspect to my role than I ever expected.

“I’ve also been part of the Gold operational calls every day, directing the hospital’s response. So, again, just getting into some of the day-to-day decisions that are necessary…that I probably wouldn’t ordinarily have done unless we were in a crisis situation. So very different.

“I think the exec teams from both trusts have tried to be visible on the wards, doing regular visits. That’s obviously needed to change from an infection point of view [but] we’ve tried to support staff in different ways. We have several all-hands calls each week, where the exec teams speak and people have an opportunity to raise questions.

“And then more recently, I’ve done some hands-on stuff. So, I’ve taken the tea trolley around the wards and learnt how to use the terrifying looking sterilisers in the ward kitchens. It’s been good banter with the patients when I’ve not made the tea sufficiently strong enough.”

What are your current priorities?

“We’re in the process of developing the group digital strategy. Three priorities are emerging: the first is building great foundations – aligning our clinical systems to create a single patient record and not forgetting to do the basics brilliantly; the second is moving towards data-driven decisions…as our EPR grows that gives us more data to use to provide insight, prediction, prevention; the third priority is around upping the offer to patients…we want to give them more control of their care, to be able to make appointments, do virtual consultations, have more support from the comfort of their own homes, have access to their records, be able to choose how we correspond.

“We did some consultation around the future of the hospitals…in the patient engagement sessions it came out really quite strongly about how patients have benefitted from not having to cope with car parks, having to work out how to take time off work or arrange childcare around appointments…being able to do them virtually has really helped them.

“As consumers, we expect to be able to do a lot more of that in our lives. And I think the NHS as a whole has not really done a great job at keeping up to expectations in the internet era.

“If you think you’re going into hospital and already you’re concerned…the extra tension of having to park, and then maybe you’ve got mobility issues to actually get from where the car park is to where your appointment is…social distancing where you’re waiting and concern that you’re actually in the right place. All that sort of stuff is just not what people need on top of an already worrying situation. It should be something we’re able to offer more and we’re looking to up our expectation so that we do 50% of our consultations [as] virtual.

What are your views on digital representation at board level?

“I did a blog post on this last year. I did some research on all the trusts within the NHS to see who was on the board – and only 22% of trusts have a CIO on the board. I looked to see who’s got a social media presence and there’s really only 22 of the 226 trusts that have a CIO who’s got any meaningful Twitter presence and only two CIOs that have got any blog presence.

“So, I think it’s a pretty poor picture, really. If we want to demonstrate to organisations that having a CIO on the board is important to digital transformation, then I think the onus is on us as a body to behave in a way that we’re super professional, shown as leaders in our profession and able to show how the impact of digital transformation can make a difference.

“I think that starts with communicating and people not engaging, sharing or learning from each other, shows how far we’ve got to go. I think some of the reason why there aren’t CIOs on trust boards is because a lot of the people are acting as old-school IT directors and haven’t really understood that digital isn’t just rebadged IT.”

Are you working on anything in digital inclusion at the moment?

“One thing that we’re doing to address that is that we’ve got a brilliant band of volunteers across both hospitals. And we’re looking to expand that…have a segment of them to be our digital volunteers. So, they actually will work with patients and show them how to use a device or how they might be able to do a video call with a relative, so they become more confident.

“Some people who might want to volunteer but might not feel comfortable about doing certain things, wouldn’t be uncomfortable about showing people how to use technology. So, it opens up a new possibility for a different sub-set of volunteers.

“Our volunteers are absolutely superb; we have some people who get up at 5am in the morning to be able to get to the hospital in time to be able to direct patients to the right place…they help across the whole NHS tremendously.”

What challenges are you facing with implementing digital programmes?

“So, we’ve got a big challenge in order to try and align our patient systems across the two hospitals – we’ve got over 220 clinical systems. And some are the same but lots of them are very different. So, as we move towards having a single patient record, we move towards having a strategy that can reduce those systems or integrate, that’s going to take some time.

“Similarly, only a proportion of those [systems] are collected in our data warehouses. So, again, reporting, visibility and being able to drive those data-driven decisions…we need to do more.

“There’s some very practical stuff, which is around making sure our email systems around our two hospitals are aligned and our staff can see each other’s calendars and basic things like that…it’s a pain for people [but] it’s a relatively easy to thing to solve compared to the clinical systems. It’s another thing that we want to try and do as early as possible this year, as we come more together as a group…we’ve only existed for a relatively short time as two hospital groups. That’s an important part of our journey.”

What else are you focusing on in 2021?

“I think the [digital] strategy will go to the boards in March. We’ll set out our plan. We’ve got some principles [these include putting users first, designing for simplicity, working in an agile way, doing things once across the Group, and communicating and engaging throughout].

“We’ve got a number of themes within that…but what we’re trying to do is apply the principle of one for both. It’s what we’re talking about within our teams as we move together. So, I think there’s a lot of overlap where we have got the same clinical systems or are moving to the same one …so we’re doing one software release rather than multiple, using one set of training materials, supporting staff in the same way across both.

“So, lots to align and we’ve got a massive ambition for the whole Group in trying to do more clinical cooperation, so patients get a consistent experience regardless of which trust they go to.”