Interview, Secondary Care

Interview Series: Guy Dickie, Associate Director of Digital, Leeds Teaching Hospitals NHS Trust

Earlier in October, HTN caught up with Guy Dickie, Associate Director of Digital at Leeds Teaching Hospitals NHS Trust to talk about the new data platform, its Patient Administration System (PAS), Project ‘Paper Lite’ and a new approach to digital programmes.

Hi Guy, tell us about your role and your background

I’ve been in the Trust for 18 months now, I joined 10 days before the first lockdown. We have a team of just under 300 people, so I’ve only actually met 10 per cent of them in person and, even then, only a few times for most. It was definitely an interesting time to join!

I served 8 years in the  British Army as captain in the Royal Artillery, where I served in Bosnia and various other places. Then in my late twenties, after starting a family, I wanted a new career that had that also moral component, a purpose to it, and to make a difference somehow. To achieve this, and have a challenging career at the same time, I settled on the NHS.

My career started with four years in primary care where I was Head of Commissioning for Leeds North East PCT, before moving to the National Programme for IT as a Programme Director. Following that, I worked for various commercial companies such as PwC and Johnson & Johnson, working on  fixing complex problems in health and care, before my role now as Associate Director of Digital at Leeds Teaching Hospitals NHS Trust.

Could you take me through some of your digital programmes you’re working on?

One of the largest is our Patient Administration System (PAS) improvement programme. The PAS needed some love, care, and attention – 51 downstream systems rely on it and the Trust’s patient flow is literally managed through the PAS.

In July we upgraded the hardware, so the PAS was switched off on a Saturday morning, and back on Sunday. It was the first time we switched off PAS for 15 years, so we were slightly apprehensive!  The next stage in this programme is in December this year as we upgrade the software. Minimising the impact on our users is key so it won’t be a big bang launch; we plan to release new functionality stage by stage.

Another large programme is the Leeds Teaching Hospitals Data Platform. We want a data platform that everything feeds into and people can self-serve, almost like Google Analytics. At the moment the data is there, but it’s hard to get hold of and to make the best use of.

By introducing a new data platform, individuals can more easily access and  interrogate the data to meet their needs. It will help us with modelling, forecasting, analytics, trends and lots more. We’re also making our raw data available to our research community. We’re a teaching hospital, so a lot of people we collaborate with want that data.

We started work on the design and build in July this year and want a minimum viable product to go live in March – April 2022.

We picked our top 10 data sources to start with. Our aim is for this to be quite high-end – the capability you would expect of an organisation of this size. Once we’re up and running, the future stages might be to  join up with primary care, community, the council and universities.

A further programme is Project ‘Paper Lite’. The Trust has a strong ambition to be paperless and, like other Trusts, make use of digital records. Over the years we’ve found it hard to do that so, in April last year, we initiated a new project to stop supplying paper records and to digitise our backlog.

We had a team of what we call ‘messengers’ – picking up paper records and delivering them to the clinicians who requested them – but during COVID we decided the time has come. We didn’t want the team to potentially catch COVID, or transmit it, so we said let’s make a commitment to go paper lite.

Once we stopped supplying paper records, very quickly there was a 95 per cent reduction in paper moving around. We’ve now got that up to 97 per cent. As part of that we made a commitment to collect any paper records from around the Trust. We have stated that we will collect and scan them in within 24 hours and we actually quite often do that in four to eight hours. So far, together with our outsourced partner. we have scanned 51 million records since April 2020 but there’s lots more to do.

This meant we have been able to repurpose part of the Clarendon Wing at the Leeds General Infirmary, handing it off to pharmacy colleagues for another purpose. We also set ourselves an aim to release back estate from the Chancellor Wing at St James’s Hospital by 10 per cent but we’ve done 15 per cent so far – well ahead of plan.

Could you take me through your approach and methodology for managing digital programmes?

18 months ago, our portfolio was unclear, and there was no single way of commissioning Digital IT for projects. This could mean we might commit to set up something and not actually be resourced properly – meaning other projects could then also suffer.

DIT has a defined scope of work and a budget that matches that. There was no common way of executing a project in a consistent way. So, we introduced a methodology called the project delivery lifecycle cycle (PDLC), which takes project management theory, amended for local conditions with common sense.

We also introduced a commissioning system, the gateway into the process. This is where anyone can submit an Expression of Interest (EoI). The Project Delivery Office (PDO) engages with the requester to understand the request in more detail and we triage from there. It then goes to Request for Work (RfW) – so there’s absolute clarity on who has requested the work – getting the right signoffs. This is explicitly clear what outcomes each project is to deliver, how it is funded, resourced and governed.

As part of this process, we articulate how it may improve clinical care and patient experience, improve efficiency or save money, decrease risk, or help achieve regulatory compliance. Then there is the technical assessment that covers infrastructure and networking, and also resourcing. So, there are six stages to the process and a gateway at each one.

Once live, the Project Managers provide an update at a Project Review Board each week and then on Friday they submit a project Highlight Report. This is issued as a pack to anyone who wants it. This helps transparency, accountability and scrutiny – it’s clear what the outcomes are and what the scope is.

It’s a hugely exciting time to be in IT at Leeds Teaching Hospitals – we have achieved a tremendous amount over the past 18 months, and this is just the beginning. We are going to revolutionise how we do informatics. There’s a backlog of 60 projects to work through – including improving our medical records and our work on two new digital hospitals, which are four years away.