Interview: Chris Mason, CIO at Wirral University Teaching Hospital NHS Foundation Trust

Chris Mason, Chief Information Officer at Wirral University Teaching Hospital NHS Foundation Trust (WUTH), joined HTN for our latest interview.

WUTH is one of the largest and busiest acute NHS trusts in the North West of England, serving a population of more than 320,000. Operating three hospitals at two sites – Arrowe Park, where the Wirral Women and Children’s Hospital is also located, and Clatterbridge General Hospital – WUTH sits within the Cheshire and Merseyside Integrated Care System.

Chris discussed the career path that led to him becoming CIO, some of the digital projects he is currently working on, how to make digital transformation work in a healthcare organisation, and more.

The role of CIO

I love my role. I work at my local hospital, in a department that I have progressed through since I started 14 years ago. We’ve got a great team of talented, committed individuals and I couldn’t ask for anything better – it’s really rewarding.

I head up a team that covers a number of areas including information governance, medical records, clinical coding, business intelligence, project team, clinical analyst team, and the technical services that cover server, network and desktop. We cover the help desk for the trust, too, so it’s quite a wide area.

Our role covers every aspect of the trust’s operations, and with the pandemic accelerating the importance of digital healthcare, we also have number of significant projects, from enabling video consultations, to developing one digital patient record, and developing and integrating our systems.

We produced a new digital strategy in late 2021, which was a large piece of collaborative work with our clinical and corporate divisions. This year, we’ve now got our operational plan in place, and we are delivering it for this financial year which is really exciting. Our staff have really bought into it and we’ve got a good vision for the future.

We’ve always been at the forefront of digital to a large extent and the organisation understands the value of technology as a key enabler. We’ve got a great board who are very supportive. Ultimately, we are here to deliver better healthcare. It’s not about the technical services, but their purpose is to make the healthcare the best it can be to give clinicians the best tools to do their jobs, improve outcomes and deliver the best patient care.

We’re part of Cheshire and Merseyside ICS. There’s a great network of CIOs at the ICS and we do a lot of collaboration in terms of our ICS digital strategy, which we are working on currently. We’re promoting data sharing, sharing technology platforms and a greater level of interoperability across the region.

In terms of our projects, we’ve got a fantastic relationship with our clinical and corporate divisions, but we make sure that we don’t lead them. Our work has to be digitally enabled but clinically led. In the future, I would see the digital side become part of clinical strategies over time, rather than having a strategy all of its own.

The route to CIO

I joined WUTH as a project manager in 2008, with my first project focusing on the implementation of the outpatient patient administration system. Working as a project manager gave me a good breadth of knowledge of what is happening within healthcare and within the trust.

I was promoted to Programme Manager in 2011. I led the project team in turning off our major legacy system and the move over to our new Electronic Patient Record (EPR). In 2017 I moved to our service improvement team as a Senior Programme Manager, so that meant I moved out of informatics for a while. That was a great role as I got to witness a lot of the results from our IT work within the operational and clinical environment.

From there, in mid-2018, I moved on to become Service Improvement Lead, back within the informatics department. A lot of that work was around benefits realisation for the Global Digital Exemplar programme, and looking at process redesign within the informatics department, as it was called at the time. We’re now called the digital healthcare team and we’ve had a full rebrand – I think this has given us a real identity within the hospital and makes the link directly between digital and healthcare.

In July 2019 I became Deputy Director of IT and Information, and I was offered the CIO post as an interim. I was interim during the COVID-19 period, which was a very difficult time but also provided a great learning curve for me, particularly around the responsiveness of the service. I became permanent in December 2021.

So that’s where I am now. I’ve built up a lot of good relationships in the organisation in my time here, which is really helpful. I think starting off as a project manager rather than in a specific technology role has benefitted me, as I’m not highly technical – I can talk about technical work in a non-technical way to a variety of people.

Current projects

There is so much that we are working on – I could talk about it for hours. It’s an extremely busy environment.

I’ll share some of the projects that span the foundational elements in our digital strategy: innovation, education and digital intelligence.

We’ve just undertaken a major EPR upgrade – which wasn’t about having a front-end impact as such, it was an opportunity for us to look under the bonnet as it were and pave the way for a lot of our future developments. A vast amount of effort has gone into this project, across the team.

We’re looking to empower patients, so we’ve already got a patient portal that we use for tracking with our cancer patients. We want to increase the roll-out of the portal, which would have a lot of benefits for the elective recovery programme. So, one of the pieces of work that we will be doing is expanding that portal to give it a far wider reach than it has at the moment and incorporating a lot of the Wirral population in signing up.

We’re also in the process of implementing a new PACS (Picture Archiving Communications System). This will mean that we are aligned with our partners across Cheshire and Merseyside ICS, which will give us more strength as a region. That’s a big project with lots of work from ourselves and the radiology team.

We plan to do some specific pieces of work around optimisation of our EPR, so we’re particularly looking at alerts and a far more comprehensive way of presenting them to clinicians. We’re also looking at inpatient referrals and how we can standardise a lot of our workflows. As we’ve moved forward with the EPR, you obviously learn the best way of using the tools, so we’re refining those now and making standardised recommendations based on best practice.

From an infrastructure side, we’re looking at replacing our wired network. That will obviously have benefits in terms of cyber resilience, but also it will strengthen our wireless work too. Most of our medical devices are wirelessly connected to our EPR, so there’s a big dependency upon that infrastructure being as resilient and robust as possible.

We’re working on robotic process automation (RPA), so we’ve got some of our corporate services from across finance, HR and business improvement to look at streamlining their processes and maximising productivity and efficiency. We are currently looking at which processes to prioritise for RPA.

There are also some exciting new ventures in the ICS in terms of the Cheshire and Merseyside Surgical Centre. There’s a lot of infrastructure work and a lot of system design that needs to be in place to ensure that everything runs smoothly. We have a similar programme of work focused on updating our urgent and emergency care – we’re bringing a lot of local services under one roof and there’s a lot of technical, application and integration work happening there so that we are ready for those new ventures. I think these streams of work are also helping the team get a lot of insight into how the front-end services work, which is obviously a massive benefit.

Then there’s the data warehouse. Now, we have a data warehouse that runs off our clinical EPR. We’re looking to bring that in-house and design our own data warehouse. We plan to bring in some of the data from the corporate areas so that we’ve got everything in one place.

Last but not least, we’re working on the implementation of a learning management system. We’re committed to improving the training of clinical and operational staff, and I think COVID-19 has brought about new ways of working in terms of training – we’ve not been able to get people into classrooms, which has traditionally been the way we’ve done things. So that’s opened up a lot of additional avenues to us. I think people are more accepting of remote learning and that’s helped us in breaking down some of those barriers. We’re getting together a list of core competencies across all of the clinicians.

I think the key message here would be that as a clinical or operational staff member, in order to do your job and record the care that you are giving, it is essential that you are well versed in our digital systems. So now digital is an integral part of a clinician’s training. So, I suppose we’re trying to take away the notion of ‘the digital aspect’ and show people that digital is just part of the clinical job now.

Making digital transformation work

Our aim is to provide our clinicians with the tools that they need to provide the best care. In a digital healthcare IT department, we are focused on delivering those digital elements, which is great, but I think it’s important to emphasise that digital only provides the capability.

We have to invest in our people, we have to give our clinicians and operational staff the time to help with design of our systems so that the outcome and solutions reflect their requirements. We’ve got to equip them to use the tools and make sure that we are giving them the best chance of utilising the systems to their full potential.

As I mentioned previously, all of our projects are clinically and operationally led, and digitally enabled. That leadership has to come from the top; there has to be clear and concise messaging from the top, and it needs to be disseminated to all levels. It can’t be an IT project that is led by IT, it can’t be seen as something that we are forcing clinicians to use.

A very important point is that, in effect, the fact that it is technology is irrelevant. You are providing a solution to a problem. When you are talking to staff about the system, that has got to be highlighted. When we do a presentation on a project, it’s great to have the digital staff to lead the technical side, but ultimately when a clinician stands at the front and tells the other clinicians how this solution is going to change things, that messaging is far better.

Finally, you need good people and good relationships. We’ve got to have a good understanding of each other’s side of the picture.

Challenges and solutions

One of the main challenges that we face is delivering a strategy whilst also keeping the digital platforms and the usual work going on a daily basis. I think demand is always going to exceed capacity, to some extent, and so you need good governance in place to prioritise.

We now include clinicians and operational staff in the prioritisation process. We don’t gather as an IT function and decide where the focus of our staff is placed, we talk with divisions and get them to prioritise their pieces of work. Then a digital and clinician team sit down together to discuss what to prioritise, based on set criteria – what risks we are trying to mitigate, what benefits we are trying to deliver. Our risk management department is involved in the process too. We assess each piece of work with a score together, and that prioritises the work for us.

Sometimes divisions will come with a priority request that they think is the most important piece of work, but after they’ve listened to everyone else’s request from across the organisation, they go away understanding the reasons why their work might not have been prioritised at this time. The process has a lot of buy-in from the divisions and that has really helped us to focus efforts efficiently. In the past, our attentions would switch regularly based on priorities coming in and that in itself can be inefficient.

If people are invested and committed to ideas that they have helped prioritise, then when those ideas turn into projects, I think people tend to be fully committed and buy into them. Starting this right at the beginning and getting people engaged pays off in the long-term.

I think in general; the digital field can face workforce challenges. We’re looking at how we can attract new talent to the team and transition staff over from other industries. Digital staff are in high demand. We like to grow our own where possible and in terms of progress, using myself as an example – staff can see that I’ve had the opportunity to move through the team, which I think sets a good example in terms of progression.

We are committed to creating the best working environment where we can retain talent within the department, too. We got some new offices recently so as people are coming back in following the pandemic, they’ve got a good environment and I think that is definitely helping to attract people to come in and work together. The new branding, our clear strategy and sense of identity is another aspect of that, too.

On people

On a similar note, we’ve put a lot of work in with our people. We’ve recently held values and behaviours sessions within the team, and we’re creating a pledge to all of our staff to lay out how we want the team to run going forward.

We recognise that people are our biggest asset and we’re heavily investing in them – not just from a financial perspective but from a time perspective as well. There are lots of things you can do in terms of mentoring and coaching which don’t necessarily cost a lot financially, it’s just about committing to taking that time.

As I said earlier, I think having good, supportive and accessible environment is key. I’m involved in various networks throughout the hospital, such as the Sunflower Network, which looks at hidden disabilities. I commissioned a patch of sunflowers in the garden at our digital healthcare team headquarters to represent our dedication to accessibility, and to improve the physical space for staff. In doing so, it’s also a way of supporting their mental health and wellbeing.

We’ve recently been awarded level one accreditation for the Informatics Skills Development Network, on their Excellence in Informatics programme, which provides a lot of standards aimed at promoting development of informatics staff. So that covers infrastructure, personal development, career planning, professional development, workforce planning and people management. Level one is around having a lot of those processes in place and the next stage focuses on the embedding of all of those processes.

We really want to make this work for all of our staff – they’ve worked tirelessly through very difficult times, and they’ve been fantastic. Investing in them and making sure they are happy at work – that’s our real priority going forwards.

Many thanks to Chris for joining us and sharing his experiences.