Interview Series: Tremaine Richard-Noel, Head of Emerging Technology at Northampton General Hospital

HTN chatted with Tremaine Richard-Noel, Head of Emerging Technology at Northampton General Hospital NHS Foundation Trust (NGH), ahead of his upcoming appearance at HTN Now June 2021.

Before his live webinar session on Thursday 17 June at 3pm, where he’ll discuss robotic process automation (RPA) and its application within the NHS, we caught up with Tremaine to find out more about his role, his ambitions and what other initiatives and projects he’s working on.

It’s been a busy time for the 29-year-old, who is also Programme Director of the NGH Automation Accelerator – an innovation programme that focuses on supporting automation adoption – and has seen his star rise recently, after being listed by Forbes Magazine as one of the top 30 leaders under the age of 30 in the Science and Healthcare across Europe category.

Tremaine was nominated and made the shortlist due to his work at NGH, which includes the development of a digital automation for 24/7 oxygen monitoring, a solution which was created in under 24 hours to help staff during the COVID-19 pandemic.

Aside from creating time-saving digital automations and featuring in Forbes, Tremaine has also been kept plenty busy by his day-to-day responsibilities, which involve supporting trusts across the UK to adopt intelligent automation.

Hi Tremaine, tell us about your roles at Northampton General Hospital.

I’ve got two roles. One is Head of Emerging Technology – as part of that I look at all things new. I say ‘new’, but a lot of it is just trying to up-skill us into the 21st century; I’ve been looking at AI and, more recently, RPA, which we usually refer to as intelligent automation.

I’m also the Programme Director for the NGH Automation Accelerator. I manage the team, which has grown since we got some funding from NHSX to about 30 people, which is a massive expansion.

Back in December, we started off looking at just our trust. But then, with the funding, I think we’re now working with – at last count – over 20 trusts. With automation, there’s loads of processes that replicate in some form across multiple trusts – so when you’re looking at things like HR, it’s not 20 times the effort, it’s just pooling different parts of different departments together and helping them work together and working with our team to up-skill their own team.

It’s really interesting – I find that sometimes it’s a mix and match of RPA and some other technologies as well. When people come with a problem, we help with a solution, but it isn’t always the same. We started that in January and it’s been a bit of a whirlwind, I’ve blinked and we’re halfway through the year.

You were featured in Forbes Magazine recently, mainly for your work on oxygen monitoring robots – how did that happen?

Last year, effectively what had happened was that when we had Hugo Mathias as CIO, a use case came up around oxygen challenges nationally. Hospitals had declared incidents – not because they were running out, but because demand on the system in terms of flow was high.

The idea was we could get somebody to log in once an hour or twice an hour 24/7, which you can imagine wasn’t the best solution. Hugo Mathias, our CIO at the time, knew that I had RPA experience, but we had no bots running, no system, and yet we got it live within six hours. The benefit was that this was an area I worked in day-to-day, so we got that set up rapidly.

We then got funding from NHSX, and Forbes Magazine approached me to say I’d been nominated and shortlisted [for the top 30 leaders under 30 feature]. You have to give your whole life history and then you don’t hear anything else, when it goes live is when you know. It’s been a fairly crazy period since then with loads of people approaching us to find out about what we’re doing, and we’ve got more visibility in the NHS, as well.

It’s the best party list you can imagine, when you look at all the others. When they do the in-person party, it’s going to be a crazy time.

Tell us more about the NGH Automation Accelerator – what do you do on a day-to-day basis?

Our day-to-day is to support trusts who have started with RPA – to avoid reinventing the wheel and maximise economies of scale across the NHS. It’s a technology that automates processes and lots of our processes are similar from trust to trust. Our teams are made up of business analysts and developers. We’ve expanded already into helping trusts, who are interested in this technology, to start correctly.

However, our ambitions are quite big; we want to keep growing and we’ve become self-sustaining. We’ve grown to the point now where we can support trusts ongoing and we are working within the NHS, for the NHS. So, it keeps money within that would otherwise be spent on this externally, meaning we can be more cost-efficient. We have a lot of free services and a professional services arm that keeps everything ticking over, so it’s a nice set-up that really helps growth.

We are taking on 10 new trusts per quarter – world domination isn’t far off [laughs].

What have you found to be the biggest barriers to implementation?

I think some of the challenges have just been around that it’s an area that’s new to lots of people. There are a lot of common mistakes – trying to learn it yourself and not having the right resources and capabilities – from the outset. So, when you go across and say ‘we have a support team, it’s free’ – there don’t tend to be many barriers at that point.

The challenge is often around the misunderstanding of what it can and can’t do. I’m slightly biased but it’s because it can do so much – that’s often a barrier. Where do you start? Because it can automate anything, that’s great, but there are staff out there with really high pressure on them. So, let’s start there and reduce some of the admin to free up time for more care. There’s a lot of prioritisation that we’ve put in place to give our NHS colleagues the maximum benefit in the minimum time.

There’s a lot of talk of fear and that side of things but I think that’s when they actually go off and launch it. The people that we talk with are in tech or CIOs: they’re the people who are implementing, so they understand it.

What we also help with is that we don’t call it RPA, we call it “intelligent automation”, because RPA doesn’t mean anything to anybody and when we say ‘robotic’, you think of the terminator, or physical robots. So, we think carefully about how we word things, and we talk about the ‘adoption’ of automations – which people relate to positive things, like fluffy cats and dogs, rather than a robot.

Do you have any examples or case studies to share?

One key one is around merging patient records and our pathology systems. That saves around two people’s full-time equivalent of just sitting there and going through that. Another one is to try to reduce onboarding down to one hour – you submit a form, and everything is done. You complete one form and it’s signed off and you’ve got everything printed automatically. As part of that, we’ve built automations that create new NHS net accounts, acting director accounts, all of the IT set up.

There are also interesting things around clinical coding and also adding people to clinical systems – working to get clinicians speedy access. Also, some cleansing in the HR systems – there’s lots of data quality improvements that can be made, so we’re looking at how we can adapt that. One of the key things through COVID was also payroll, so we’ve built an automation that puts people into ESR payroll to create resilience in that area.

What are your other upcoming projects?

This hasn’t actually been formally announced yet but we’re building an automation [to work with] the Workforce Race Equality Standard. In the NHS, it is shown that BAME staff are 24% more likely to go through the disciplinary process, which is crazy. I was thinking, ‘how can technology help?’

So, we’ve actually built an ‘equality bot’ and the idea is digitising the disciplinary process. Before, it was as easy as a concerned manager dropping an email and now you have to go through a process and tick the relevant boxes to indicate that it’s something to proceed with. Where the bot comes in is that it checks for any protected characteristic in the staff record.

It was triggered by the Race Equality Standard but it’s bigger than it. It goes off and checks and then it will escalate to a senior HR partner, which is the current guideline that is almost impossible to do. What would normally happen is people track this on a spreadsheet, write down the name of the person and in a couple of weeks, months or even yearly, they will do their report. They just treat everyone the same, which you could say is a good thing, but it is a bad thing in this instance, because it doesn’t change the problem.

We’re in the process of finalising that at the moment, which is exciting. I don’t know if I’d call it an ‘anti-racism bot’, but more ‘technology for good’. Effectively, as people we are flawed in that we don’t always have enough time; nobody has time to think about how to do this from the bottom up and improve an entire process. By getting an automation to do it, you remove all of that – set a process up, make it the best process possible, but you don’t have that variance, it’s connected, and it does it for you. Automations are designed and built to be unbiased.

I’m hoping to launch it in a couple of months, we’ve just gone through the design process and met with the team. Because it’s on ESR, it’s got the potential to be rolled-out nationally. There’s nothing stopping that.

What would you say are the main benefits of intelligent automation adoption?

Not to use a cliché but: removing the robot from the human. The idea is that we don’t do all these repetitive tasks that we don’t like doing and use technology to free up care time. If you manage to achieve 20% efficiency, you’ve got 20% more doctors in terms of care time.

Also, it acts like a catalyst. If the best way to ensure great data and systems is having a team of hundreds of people sitting there, moving data, with automations you can make that a reality. Suddenly you’ve got data in the right place at the right time and things like AI can really kick in. Some of the local initiatives like the shared care records can become even more exciting, we can actually make sure the data is flowing.

For patients, it means an end-to-end connected journey. Because you can build automation in a matter of months it means you can take particular pathways. If patients move from this A&E to that A&E, how does that data flow? Normally, that’s a massive transformation piece of work, but we just assess the investment and build it. It might have a year’s life until a solution is put in place but it’s still really good that there’s something in place.

How can people find out more?

We have our centre, but we also have a website we’re about to go live with. It’s in user acceptance testing at the moment. It’s a Community Hub for anyone in the NHS to access ideas and thoughts around all the resources you’ll need to start your [RPA journey] and tap into that support.

At the moment, someone can call us up and the next day we can set up a workshop – people are pretty excited at the speed we can move at, as NHS speed isn’t always speedy.

We have an Outreach and Engagement Manager, Harry, who works with the trusts to make sure their journey is smooth and they get all the support they need.

Find out more about implementing RPA by attending Tremaine’s session on Thursday 17 June.