HTN was joined for a webinar exploring the role of the CIO now and in the future by a panel of experts including Ravi Sahota Thandi, interim operational CIO at The Dudley Group NHS Foundation Trust; Kate Warriner, chief transformation and digital officer at Alder Hey Children’s NHS Foundation Trust and #1 in the CIO 100 rankings; and Rhian Bulmer, chief customer officer at Radar Healthcare.
Our panel shared their own experiences, discussed the role of the CIO in supporting and developing digital maturity and skills, delivering 10-Year Plan priorities, and what the next 5 – 10 years will look like. Also noted were emerging technologies and opportunities, along with ways of realising digitally-enabled system working.
Ravi offered a brief introduction to her role as interim operational CIO at Dudley with responsibility over digital, data, and tech teams. “We’re a medium-sized acute and community trust, with GP practices also within our footprint, so we cover the whole journey in terms of the patient. I have the absolute privilege of leading a team of about 109 staff across this department, and that includes everything from IT operations through to digital transformation and delivery, cyber, business intelligence, and informatics.”
Rhian talked about her work with Radar Healthcare, offering a quality, safety, and risk management tool that has modules across compliance, workforce compliance, audits, incident management, feedback, freedom to speak up, and more. “Our quality audits look at the quality and safety of an organisation and pull all of those different datasets together to get a true view at either organisation, department, or function level,” she explained. “Over the last year, we’ve started adding a new pillar to our product and platform, looking at patient and service user experience, digital consent, and so on.”
“One of the things that has emerged in terms of my role and remit at Alder Hey is the trust-wide transformation and improvement agenda,” Kate shared. “We see about half a million children and young people every year, and we have a whole suite of services from community and mental health to general paediatrics, urgent care, and specialist services. We are based in Liverpool, but we have quite a wide reach, including national and international services.”
The journey into the CIO role
Kate referred to her journey to becoming a CIO as “unconventional”, noting her background as a musician. Her first introduction to the NHS working as a ward clerk in a local hospital whilst at university before moving into a position in primary care, summarising notes and coding on GP computer systems. “I was really fortunate to get an opportunity to do a Masters in digital health, and the rest is history – a whole range of roles in digital programmes, training, project management, and then more strategic commissioning and leadership, joining Alder Hey in 2019 as the chief digital officer.”
“My experience was similarly unconventional,” said Ravi. “I’m a lawyer by background and only started working in the NHS in a gap year between college and university, in medical staffing at Glenfield Hospital in Leicester.” After getting her degree, she worked in the private sector doing acquisitions and mergers, before taking a role back with the NHS in service transformation in 2009. “That was redesigning services and looking at what that meant for local populations, and since then I’ve been very fortunate to work across primary care, community, mental health, children’s services, NHSE, and the Department of Health.”
After taking what started out as a transformation role, her journey took her into managing a digital programme, Ravi continued, “and I took night classes to get up to speed and learn about digital, data, tech, software coding and development – it’s not been a very linear journey, but I’ve been lucky that the opportunities have come about that have fitted my skillset at the time”. She joined Dudley in 2021 initially as the director of digital portfolio, becoming interim CIO in June 2024.
Rhian also shared how her journey into the health tech space began “by fluke”, taking a temp job with EMIS after finishing university, then becoming a technical writer. “I really enjoyed understanding the systems, but because I was quite an outgoing person, I wanted to be able to get out and about with people on the frontline. I became field-based and started working with different organisations across a range of sectors, but there has always been a focus on growth, and I realised anything I ever achieved was based on customers being happy or loving the product.”
Getting that right in healthcare is integral, Rhian went on, “and that’s certainly our focus at Radar Healthcare, making sure our customers are happy and are using the system to the best of the model blueprint that we have, looking at how we can support them in doing that”. The best part of her current role is offering that support around system adoption and seeing the positive results for service users and patients, she considered.
Digital leadership now and in the future
Thinking about what the CIO role looks like at the moment, Ravi highlighted how stressful it can be with the changes that are happening in terms of the group-level working across the NHS and the sheer speed with which new technologies are being adopted. “I think the role has changed,” she acknowledged, “because it used to be fine to sit in a CIO role and be a subject matter expert, but that’s no longer the case. You need to be so much broader now, to have that strategic intent and understanding of what’s happening in your organisation.”
There’s also the need to think about your personal responsibility as a leader, according to Ravi, including looking after your team and their development. “That’s been the real shift, as it’s been really easy for people to get into a role and then stay in it, but now there’s more cognisance of impact and leaving your organisation in a good place. We’re moving more into soft skills and talent strategy, looking at how you lead workforce transformation and embed digital literacy.” In the future, there’s likely to be a shift to working more broadly across the system and becoming an “orchestrator of digital, data, and tech, at scale,” she added.
“If you look back to 2015, the CIO role was very different,” Kate reflected, “and it will definitely have changed again in another ten years’ time. It’s less technical than it perhaps was and more about transformation and business. The external piece is much more prevalent than it was, internally there are board executive expectations, and I think that will continue to grow.” Strategic leadership is becoming more of a focus, she continued, and figuring out how digital, data, and technology can support the ambitions of your organisation. “Technology is now mission critical, and the role of the CIO now covers a key piece on people, workforce, and culture, thinking about what skills you need to meet those ambitions.”
The CIO needs to be a champion on the board for the wider digital, data, and technology remit, Kate told us, “and certainly in our local system, all of the CIOs lead portfolio areas for various things, like I’m SRO for AI in Cheshire and Merseyside, and it’s where you play your role in your local system and a leadership role across your ICB”. There’s a huge role also to be played both locally and nationally in driving the digital agenda and workforce development, she noted.
“The CIO role is probably one of the most important leadership roles because of the swathes of information and insights coming in over the last few years, and exposing all of the important details that sit within that data is going to be huge,” said Rhian. “And we’ve seen, if you take the example of data analytics, that no matter how efficient that is, no matter how brilliant the dashboards that get built are; it needs that leadership oversight to be able to interpret it.”
We’re currently on a precipice with AI, Rhian went on, “And we need that leadership to deliver at pace and ensure we can work harmoniously with this data and use it to our benefit. If you look at it on a strategic level and then look down at all of the elements or functions that sit within that, the CIO role is integral to organisations moving forward”. Radar Healthcare’s tools may sit across different elements of an organisation, but ultimately they end up being pinned together by a role like the CIO, she considered, in taking all that information and working with it from a strategic point of view to embed in strategy.
Preparing for the future
Kate mentioned Alder Hey’s Vision 2030, which was underpinned by the vision of revolutionising models of care using technology, and how quickly technologies such as AI have emerged and taken off. “We now have eight-year-olds using ChatGPT, and their expectations of us are in the stratosphere in terms of what they want us to deliver,” she shared. “We put a strategic piece together in our AI strategy which launched in the summer, with the aim of getting a coherent vision together. Our commitment through the strategy is essentially to empower colleagues, staff, our children, young people, and families with some kind of AI assistant.”
This work was about recognising that “AI is no longer a vision for the future, it’s actually here”, Kate said, and the accompanying responsibility to use that for good. Key themes emerged, such as enhancing care for children and young people, as well as how families navigate services, and empowering colleagues with things like Ambient Voice. “Ambient Voice has been a really magnetic technology,” she told us, “and when you’re deploying tech, it can often be that encouraging and negotiation, whereas with this, it has a transformative effect in making people’s lives easier. We’ve then got something around transforming outcomes for our patients, and we’re going live this week with a predictive AI tool in our paediatric intensive care unit that we’re excited about.”
“The speed of adoption has been incredible,” reflected Rhian, “when you think 18 months ago we were just considering AI as something that could help write your emails and check your grammar, but now it’s part of everyone’s day-to-day life.” Radar Healthcare’s system is set up with modules offering insights into different areas like maternity services, workforce compliance and training, or adherence to policies and process, complaints, incidents, and more. “You can then look at audits across the service and see where your risk sits within the audit, and it’s these kinds of “crystal ball” analytics that let you look at things like financial impact or operational impact if you continue on a certain trajectory.”
This can help to inform future steps and support a continuous improvement cycle, Rhian stated, and the next step will be building AI into that, with ongoing discussions around either getting AI to actually perform analysis or just to complete some of the work needing to be done in advance. “Putting AI in to look at analysis is good to a point, but unless you’ve got strict data rules about where it’s looking and what it’s going to interpret, it still needs human oversight,” she added, “So feedback from our customers is that it’s better to be used to help complete things, automate background processes, and that kind of thing.”
The perspective from Dudley is slightly different in that there are a range of services to cater for as a community trust, Ravi explained, and an important step has been developing a three-year plan, looking at where the organisation wants to go and how that is enabled with digital and data. Results from the digital maturity assessment have provided a benchmark to understand our current position, “and some of that hasn’t been sexy. It’s been the basics, the infrastructure, the skills gaps, as well as getting things like EPR automation in place so that the data coming in is good,” she said.
Clinicians wanted EPR integration with Ambient Voice Technology (AVT) and didn’t want to copy and paste, according to Ravi. “We were clear that we weren’t just going to buy a product; we were going to work in partnership with a third-party supplier and make sure what we were delivering was fit for purpose. We’re leading on AVT procurement for the Midlands, and we’re regularly sharing what we’ve done with other organisations.” The other real difference to digital maturity has been using the Skills Framework for the Information Age, she added, which has helped close identified skills gaps. “It’s not a linear journey, and it’s not always the shiny new stuff; it’s making sure you have the basics right and the foundation there to build on.”
Successes and opportunities from digital
The NHS is always criticised for being behind other industries when it comes to technology adoption, Kate considered, “and grasping the AI piece and really embedding that into our clunky processes is an opportunity to change that”. The shift to digital in the 10-Year Plan helps with top-down and board buy-in, she noted, “and I think in the medium to long term, the opportunities are in empowering the general public in how they access health and care services”. Tech such as AI chatbots, automation, and robotics will transform the way patients can interact with services, and the ways staff work will likely look very different in ten years, she suggested, “and we need to keep on top of our workforce skills to make sure we can keep up with the pace of change”.
Demand is currently outstripping capacity for digital teams, Ravi told us, so prioritising what is important to your organisation is key. “We’ve done a lot of work to understand what digital investment means to the organisation, costs avoided, and so on, and having that ability to track those benefits is central to achieving the visibility and transparency that is important in being a leader.”
We’re likely to start to see more consolidation of systems due to a lack of bandwidth for leaders to consider all of the available options that are out there, Rhian noted. “I think systems will work together more, to be able to present the data together, and that will come through from having really clear data strategies at exec level, outlining exactly what we want to see, and from that it will become that waterfall effect. We’ve noticed how we deliver our projects has changed significantly, because it was always frontline user and data input led, but now we start our projects with what it is that we want to see and work backwards from there.”
Reflections and areas of learning to date
Our panel reflected on their journey to date, with Kate highlighting: “I’m most proud of the difference our teams and our services make to our children, young people, and our staff. The camaraderie, the culture, the teamwork, and just the sheer dedication and commitment of our people to doing amazing things.” Walking around the organisation and seeing first-hand the difference that her team’s work makes is “incredibly rewarding”, she said, “and it makes me really proud to do this job”. The biggest learning has been never being complacent, “as you can always improve, and don’t be afraid to recognise that there are things that can be done better – that contributes to a positive improvement culture – as a leader, setting a strong vision and just being kind to people is essential, because people will always remember how you made them feel”.
Ravi agreed that seeing the impact being made on the organisation, the teams, and the patients is one of the key sources of pride in the role of CIO. “Seeing the team develop and grow is a real privilege,” she commented, “and I think the hallmark of being a good leader is that your team is progressing and having a tangible impact.” In terms of learning, “just because something hasn’t been done, that doesn’t mean it can’t be done”, she considered, “sometimes you have to be brave, go with it, and surround yourself with people who are going to champion that”. Resilience is another important factor, along with having the right network.
“I’m most proud of the work we do with organisations to make sure that the customer voice is at the centre of things, and balancing that with innovation, working collaboratively with different people and organisations to deliver our products and services,” Rhian told us. “It’s where you get all of the stakeholders working together to create something beautiful, where tech helps support and solve problems, and isn’t just there for the sake of it.”
We’d like to thank our panellists for taking the time to share these insights with us.
