In our latest interview in the series we sat down with Kam Sidhu, Interim CIO at Tees, Esk and Wear Valleys NHS Foundation Trust.
We talk about the various digital programmes in-flight at the trust, digital literacy, digital inclusion, strategy, learnings and lots more.
Can you tell me about your role and background?
I’ve been at Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV) for just over a year now. I started in the NHS as a nurse and did that for 10 years until I moved over to a service improvement/change management role, to then working in IT. I’ve worked in IT in both the private and public sector for around 17 years now, which does perhaps show my age a little!
The majority of my work in both sectors has been around portfolio/programme management which then transcended into senior management and managing multiple specialities across different teams in and out of the NHS, with my background predominantly in acute trust settings.
There are more teams at TEWV than I expected, and we have in-patient and out-patient areas plus the localities: we are spread from Durham and Darlington, to Teesside and down to North Yorkshire and York – it is quite a large patch with 7,500 staff! Initially, I came into the trust as Deputy CIO, then more recently I have been fulfilling the role of Interim CIO.
What digital projects are you currently working on at your trust?
“Systems and Technical Areas”
There has been a combination of infrastructure and system projects; the EPR programme is the big one! Traditionally mental health trusts had EPRs before acute trusts, we had an EPR here called ‘Paris’; we are now moving to ‘Cito’ and we are co-creating this EPR with the supplier and the end-users.
There is a far greater emphasis now on patient/clinical pathways to develop what that system looks like, and in around 18 months’ time we will start looking at the patient portal and doing work in terms of engagement around it. We also have the EPMA programme, and again we are working with the supplier and the end-users on this. The ‘LAN Refresh’ is also something we are working on to improve the management and maintenance of the network, and also the rollout of additional WIFI to eradicate black-spots – this project is running until June next year.
I have recently commissioned a ‘Digital Maturity Assessment’ as we are rewriting the digital strategy, where there will be more of a focus on population health data and telling the patient journey, as well as self-service – one of the obstacles we’ve had to overcome is helping people understand what ‘self-service’ actually means, and so we are conducting some awareness training around this in getting people to state what kind of information they actually need for their delivery of care or provision of service.
The challenge we have is that there are northern and southern integrated care systems (North Cumbria Health and Care ICS / Humber, Coast and Vale ICS) and both have different strategies, pace and priorities; we need to make sure we provision these. Also, when it comes to population health data, it is about access, and we obtain access at different points – it is about creating a picture about the whole patient journey rather than a report that states “your in-patient journey has done something”. An example I often use is where there is an incident on a ward, say a medication error, we need to look at the whole picture, where we pull data from multiple sources such as the EPR, Datix, and other places, rather than a report from a single system and find out what was going on that led to the error.
I read recently that one of the ten drivers for the NHS was ‘automation’. I remember bringing automation into an organisation which was part of the community trust around 10 years ago; it has moved on since then: at that time, it was digital paper and pens where an admin team member would transcribe all the notes made by clinical staff and enter those into the system. We are looking at automation through the lens of an ‘accelerator site’ where we will develop the business case with the accelerator.
Something I’m quite passionate about is digital inclusion and I think there is a massive drive in the NHS to look at Digital First; we are widening the gap in terms of access where one of the challenges is dealing with the multiple issues of digital inclusion, such as the lack of skills, confidence in using devices, and digital poverty. We are looking at several projects at the moment with a couple in pilot phase.
Most of the focus is around how we make sure we do not exclude patients and carers. We are also working with universities on this where we have mapped out digital poverty, are asking the right questions to the patient rather than making assumptions. We are not going to plug every gap and we do need the mindset of the frontline workers to shift slightly on this in terms of understanding digital access of patients and carers.
“Three Strategic Elements”
We are basing our strategy on three elements: firstly, building strong foundations or strengthening existing foundations, for example MS Teams which has been rolled out at pace where a lot of the functionality is not yet being used. Virtual Office is also something we have been working on, this is unified communications and rolling out N365, moving away from desk phones and collaborating more effectively with existing and additional functionality.
Secondly, we are building capabilities both at system and staff level, to support systems that are becoming more complex and need to be interoperable, understanding what the future of reporting is, and do we have the skills to work with population health data and to conduct trend analysis more effectively rather than just looking historically.
Thirdly, we are striving for excellence; raising the profile of TEWV around the work we are doing here by being responsive and innovative. One of the great pieces of work that one of the team members had completed was a report of a locality map, where you could drill down and see where the Covid-19 trends were – the map was turned around in rapid time. Similarly, with Attend Anywhere, we had noticed that HTN had reported on trusts rolling the system out and we were the second highest user of the system. We want to shout about this!
What are the key learnings for you from those aforementioned projects?
The digital skills and literacy, the understanding of the terminology; different organisations have different understandings and different cultures and so for me it has been a challenge understanding the culture of this organisation.
One of the pieces of work we did when pulling together the strategy was that when we spoke to patient groups there was an assumption that people were going to say “we need lots of tech”, but actually it was more about the digital literacy of the staff and patients that we need to focus on. I’m doing some work with HR on this, in looking at how we change and empower staff to acquire skills, but also going forward looking at what do we need to do differently; for example, should we be including digital skills alongside numeracy and literacy in job descriptions.
Also, one of the key lessons from Covid-19 is fully exploring the technology we already have and realising the complete benefits of it, as well as exploring the core functionality. Some of the MS Teams meetings I attend see participants sharing screens, using chat functions, and generally running those meetings smoothly, whereas in some meetings there are people scrambling around for papers and the roles of people for that meeting are confused and unclear – who is taking minutes etc. So we need to address this.
A key learning for me is that we are not exploiting the full functionality of the tech that was rolled out during Covid-19. The other learning is the estimation or underestimation of people’s digital literacy skills and how do we address those gaps – it may be as simple as testing employee’s digital skills when they are new to an organisation.
What project have you been most proud of over the past year?
That is a hard question! We had two projects when I started at the organisation – the Cito project and the EPMA project. To me it didn’t make sense to have two different streams of work, and so it was about bringing those together and persuading the organisation to invest in the EPR programme and bring the skills of the two groups together. The success for me was joining the two mindsets together, to bring that business case together, to get it costed and for the trust to sign up to it. As a result, the trust now has an EPR programme and that was probably the proudest moment.
In terms of a project, that is difficult to say because I haven’t been here long enough!