EHI interview: Frank Hester

Frank Hester received an OBE in the New Year’s Honours for service to healthcare, after 16 years as chief executive of TPP, one of the main players in the primary care IT ecosystem.

The company he also helped to found hit the one million patient mark in its SystmOne database in 2003, and now has about 36 million patient records, covering half of England.

In addition, it offers a suite of software that has expanded to include community hospitals, mental health, social care and an EPR core system – EPR core – that allows hospital trusts to access patient records from across the country.

From God to the machine

Yet Hester could well have taken a very different path. “I originally trained to be a priest,” Hester tells EHI in an interview a few days after the Honours were posted.

“That was because I wanted to make a difference in the world, and when I came out, I had three interests. One was theology; but I didn’t think I’d be a great theology teacher.

“Another was music, because I was in a number of bands; but I didn’t think I’d make a living out of it – sadly.” In the end, it was the third of his pastimes – IT – that won out; a passion that he’d developed as a 14-year-old, coding computer programs.

Hester says his decision to focus on healthcare computing was also influenced by his wife, who was working as a GP and struggling to use the limited software that was on offer at the time.

“I was always inspired by her and her friends, and I thought what they were doing was wonderful. I thought that someone needed to come along and create a system that could join up information better – but I never thought that would be me.”

While working on the mainframe computer system at Halifax Building Society, he made a number of “little starts” with different friends, before forming TPP with university friend Satvinder Virk in 1998.

The pair won their first contract with the Airedale primary care trust in 1999, connecting GPs to the local diabetes service. Hester says the deal was thanks to a “real meeting of the minds” with the Airedale group, and kick-started a frenetic first few years for the company.

“We were just driven to make a difference. I would literally work through the night – I’d fall asleep at my keyboard, wake up, and just carry on.”

Making a difference

TPP’s heartland is still the North, Midlands and East; not just because it is based in Leeds, but because it worked with Accenture and CSC to roll out its system as part of the National Programme for IT in the NHS in these areas.

However, the company doesn’t just have its sights on other parts of the country, but on other parts of the world. TPP has taken part in a number of trade missions to India, China and Brazil to promote UK businesses.

Even so, Hester says his proudest accomplishments include managing to negotiate the inclusion of hospices in the local service provider contracts.

He’s also proud of developing a health IT system for English prisons after being “bullied and inspired” to do so by colleague Dr Susan Wishart. CSC installed SystmOne in 57 prisons in the NME, before TPP won a contract to roll it out nationally in 2010.

Indeed, by his own account, Hester can get very emotional about these achievements. He describes a recent visit by health secretary Jeremy Hunt to Donisthorpe Hall Care Home in Leeds, which is using SystmOne’s care homes solution.

“When Jeremy Hunt came out and went round talking to patients, I sat in the room next to this quite elderly lady. I didn’t realise she was one of the patients we’d kept out of hospital, but I started talking to her and her daughter about what it had meant for them.

“I had to restrain myself from breaking into tears – it’s impossibly moving to think the software that we create can make such a difference to people’s lives.”

Free yoga, free fruit

TPP gets a lot of coverage from its local paper, the Yorkshire Post, which has chronicled the significant investment in its Leeds headquarters.

The company hired its first three employees in 1999, but is now finalising the construction of a new £20 million HQ that will be able to house over 600 staff.

The company also features regularly in the Sunday Times ‘best 100 companies to work for’ lists; with those employees (average age 25) enthusing about the “no-long-hours” culture, free massages, yoga, circuit training, and fruit.

In his interview, Hester stresses that he does not see the OBE as a personal accolade, but as a tribute to all of TPP’s staff, as well as the doctors and nurses who have inspired the company’s work. “I’m just the figurehead, but this represents the efforts of so many people to make a real difference.”

Hester adds that he has had to become less hands-on in recent years: he says he stopped writing code about three years ago to take on a “more ambassadorial role” leading TPP forward. “My natural home is with the code, so it’s been quite a change.”

To show just how much of a change, the normally super-confident Hester says of the trade mission to China: “I remember ringing my wife from the Heathrow Airport toilets, saying, ‘I don’t think I can get on a plane with the Prime Minister’, because I’ve never mixed with these kind of people before. As always, she talked me through it.”

Joining it all up

TPP won its first, major acute trust contract in 2012, back in Airedale, when Airedale NHS Foundation Trust decided to implement its patient administration, A&E and bed management functionality.

Two years later, the company made a significant move into mental health, Plymouth Community Healthcare NHS Trust decided to become the first to adopt the SystmOne mental health module.

The company is also working on a number of integrated record projects in areas such as Bradford and Plymouth again, and Hester says the company will continue to broaden beyond primary care to meet the demand for joined up care.

“Mental health, social care, secondary care, all of these places are going to move off paper and have real electronic records, and we’d like to be part of that – maybe we won’t be the system that they all use, but we’d like to help drive that change.”

After all, he points out, whether it’s in England, the Middle East, a developing country such as India, or a new powerhouse such as China, the future of healthcare will not be written on paper.

“All these countries share the same vision of sharing care records. Even if we’re not successful, at least we will have helped to drive change in those countries as well.”