Interview Series: Niamh McKenna, CIO at NHS Resolution shares her leadership learnings

As part of HTN Now September 2021, as well as sharing live webcast sessions from health tech experts and industry voices, we’re also releasing a three-part series formed from interviews with leaders within the NHS.

Here, we chat to Niamh McKenna, Chief Information Officer (CIO) at NHS Resolution about how she joined the organisation, her tips for applying to leadership roles, and her learnings so far – plus a few podcast recommendations to inspire aspiring NHS leaders.

Hi Niamh, tell us about your career path and how you became a CIO

I joined NHS Resolution last summer, after a long time – about 26 years – working in the consulting industry. I very much ‘jumped to the other side’, as it were. I worked across many different industry sectors in my former life but had spent the previous four years working in health, specifically. From that, became interested in healthcare and it was an industry I could relate to, so when this role popped up it looked like an amazing opportunity.

I had come across NHS Resolution, briefly, as I met the CEO and the Chair. I was presenting and had the opportunity to get to know them. They were a slightly niche part of the NHS, so really fascinating and with an interesting mission. When this role came along, it just seemed like an opportunity to make that jump into the public sector. For me it was quite good timing – I wanted to put my money where my mouth is and deliver something, as opposed to helping someone deliver something. I wanted to have that accountability and work in a sector that I feel an affinity with.

I’m not a clinician by background, so I’m limited in some ways. Health is a wonderful industry to work in but I can’t go and be a doctor. So, this was a way I thought I could do something, and use my skills in a way that’s meaningful, to help NHS Resolution. I always feel very humbled by all the amazing clinicians and professionals, they do such amazing work and so many seem to combine research, digital and clinical work. It was nice to think I could contribute.

How has your first year in the role been? And what are the challenges?

It’s been great. I have to say, it’s an organisation that has been really open and welcoming – it’s a lovely thing to join an organisation that says ‘great, you’re here – we really want to change and transform, can you help us?’

That has made the job an awful lot easier because you’re not trying to push against a closed door, it’s an open one. I think in terms of challenges, it’s just taking the time to get to know the people and the organisation. It has been, inevitably, a bit challenging in COVID times. We’re not a frontline clinical organisation, so we’ve been working from home – per government guidance – for most of the past year. I couldn’t meet colleagues, sit in a room, and get to know people, or go and observe things and shadow people.

It becomes a little bit harder but, in hindsight, it’s been helpful because it forces you to take a lot more time with that induction. It’s funny, as I was advised to read a book called ‘The First 90 Days’ [by Michael D. Watkins] – but I think I spent the first 90 days just getting to know people.

One of the other things you notice when moving from the private sector to the public sector, is that there is a level of governance and scrutiny and process that has to be done, followed, and is there for good reason. But even though you know it exists, it still comes as a little bit of a shock. You find yourself having to go through a bit of a learning curve and take your time, and not over promise and under-deliver. You need to build a contingency for last-minute, extra approvals.

As for the rest of it – it’s been tremendously exciting to come in at this stage. We had a very strong mandate from the board, to transform our core systems. We’re still just starting that journey, but we’ve achieved quite a lot. We’ve been out, engaged with the market and shaped up what we think we want from a system now.

There are a lot of things the organisation hasn’t had to think about before – what is our cloud? What is our strategy? What are we trying to do? And what sequence should we be doing things in? It might not sound like a lot but in a year, we’ve achieved an awful lot.

How has your leadership style developed since joining?

We’re lucky because – right from the top – from the CEO down, there’s a huge focus on the welfare of staff and the environment. It’s a very caring organisation. When I joined, we were in lockdown, and they had already put in place lots of measures around checking on wellbeing and making sure everyone was able to remote work.

In a way, I was able to just slot into that. What was interesting was getting to know the team and them getting to know me – it’s a two-way thing and not just about me ‘leading’. I have spent a lot of time on things like getting to know them with ‘coffee and chats’ – I do two a week with individual members of the team – and I work my way through everyone.

We do ‘town hall’ group sessions, they’re important. I was bringing two teams together – business intelligence and technology – so the directorate itself was also new. We had to do an awful lot of communication and sharing with each other.

I also try and share personal things. I do ‘Friday Thoughts’ every week – sharing a little bit about what I’ve been up to work-wise. I also include ‘brain food’ and ‘soul food’ – brain food is something I’ve been reading, a podcast I’ve been listening to, or something interesting and thought-provoking, and the soul food is usually something I’ve been doing like a yoga app or a podcast on wellbeing or health. Sometimes it’s just a recipe I’ve found that I liked. It’s about giving a bit of yourself in an environment when you can’t chat in the same way. Showing that human side is important.

Speaking of podcasts, which ones would you recommend for our audience?

There are a couple that I really like. Dr Rangan Chatterjee’s ‘Feel Better, Live More’ – he’s a good one for the ‘soul food’ and lots of bite-size things. Who knew that breathing through your nose brings all these health benefits? As he and his guest pointed out – it’s free and easy and everyone does it all the time…it doesn’t cost a lot to invest in some breathing [laughs]. That’s a great one.

The other one I like is Peter Attia Drive, he’s a doctor and his podcast you have to listen to two or three times, as he gets quite technical. He does a lot of things around the science of training, blood glucose and insulin intolerance. He’s an athlete as well, and trains very heavily, so I use it as inspiration.

Can you tell us about your ideas for staff training and a ‘base curriculum’?

I’m sure readers of HTN will be in similar positions, but we are trying to juggle so many balls – we’ve got to transform but still got to keep the lights on. We have a team that, in two- or three-years’ time will supporting new technology, but today they still have to support the technology we currently have.

So, we have to get the training plan right. We need to get everyone up to a base level of knowledge on core tech – cloud and data analytics fundamentals. We found a site that delivers it all virtually and we’ve been developing curriculums against our core technology stacks and by teams. The business intelligence team have now got a base curriculum and the same with our engineering and service desk teams. They’ve built it up and, from that, people then tailor their own [plans].

It’s early days but the reception has been great, and I think we all need to role model it. Last week I took the cloud fundamentals proficiency test and told my team what my score was. We all need to do it – it’s not just about me telling others what to do, I must do it myself.

We’ve also done ‘Focus Fridays’, once a month. I send out two calendar invites – one for the morning and one for the afternoon – and I ask people to accept one. All it does is hold the time in your diary [for training], it’s that simple. It’s just about me prompting people and saying, ‘I’m endorsing you and encouraging you to take two hours, once a month, to invest in some training’. We’ll see how that works.

What’s been the biggest success this year?

We’ve had one that isn’t quite fully scaled out yet but which I think will have a really big impact. It was borne out of my induction, when one of my colleagues said I should speak to a clinical researcher. So, I had a chat with a lady who explained some challenges around the safety and learning function, whose job it is to try and identify ways in which we can improve. It’s important that we try and learn.

[At NHS Resolution] people say, ‘I’m bring this claim because I want some resolution and I don’t want this to happen to anyone else’. So that function is important, and the clinical researchers look for where improvements can be made. She told me it was hard for her to find that information, in order to do the research. Just to find the document set took her an incredibly long time. I thought there has to be an easier way – we can get an AI and read the documents and tell you which ones are most relevant.

We did a proof of concept for a few months, with a subset of documents, and it’s worked beautifully. It’s one of those things that’s fairly standard, it’s not unheard-of technology, and we’re not breaking new ground but it’s game-changing for them, as it would have taken them weeks or months to do [manually] but will now take them a day.

That’s the kind of thing we all work in the NHS for – if I can shave a few weeks or months off somebody being able to research to find an improvement and then they can issue that out earlier, maybe someone will benefit. That’s incredible.

What else is in store for NHS Resolution?

The big one coming up is our core systems transformation. We’ve got some old, lengthy systems that run most of our day job – claims handling, advice and appeals – and we’re going to transform and basically replace those systems. I call it a ‘heart and lung transplant’ – it’s a big transformation because these systems underpin everything we do. That will take most of my energy over the next couple of years. We want to get this right, there are no second chances – it’s a big decision for the organisation and there’s a lot riding on it.

We’re hoping these new systems will allow us to make changes – so when we see opportunities it becomes easy and we don’t have to wait, and we’ll also get much more information and analytics about what we’re doing. We are trying to move the organisation from a very traditional model of delivery to one that’s a bit more agile.

I’d like to get something out this financial year and then we’ll just have a cadence after that, dropping in a functionality, rather than one massive milestone.

What advice do you have for people looking to get into NHS leadership roles?

There are a few things. People sometimes don’t realise that the recruitment process in the public sector is quite thorough, so if you’re interested – even if now is not the right time – go and download a few of those job descriptions and sit down with that and map yourself onto it. Have you done all the things that it’s asking for? Does your experience map? That’s quite a useful exercise because it allows you to spot gaps. More senior people can forget to do that because people know you – and you may not have applied for jobs in the recent past. I hadn’t written a proper CV for years or thought about what I wanted to do and why.

Also, talk to people on the inside. I talked to a couple of wise people, and I just said, ‘do you think I could do a job like this? Yes or no – and no is ok, tell me.’ Some people need a push, so having others say they can see you doing that [job] is helpful.

The final thing I would say is that there’s a lot of passion and motivation in the NHS. I think you must be passionate about it. This is not an industry where you can coast, these jobs are hard and high-profile, so just make sure you’re doing it for the right reasons – there’s nothing worse than feeling like you’ve made the wrong move. Make sure you feel motivated and, if you haven’t got exposure to health, get exposure, to check that it’s really an industry you want to work in.