The secret blog of an NHS CCIO, aged 39 ¾

The secret blog of an NHS CCIO, aged 39 ¾

In the first of an occasional series, our secret CCIO blogger, aged 39 ¾, shares their personal reflections of the first meeting of the NHS Digital Academy.

Right, off to London for the first three-day residential training of the new NHS Digital Academy. The Digital Academy, not to be confused with the O2 Academy in Brixton, is the new blue-chip training initiative for NHS digital leaders.

It was set up in response to Professor Robert Wachter’s 2016 report Making IT Work, and the big digital cheeses at NHS England are terribly excited by the whole thing.  More on how excited later.

Imperial College London, the University of Edinburgh and Harvard Medical are being paid a cool £4 million to provide training to 300 current and future NHS digital leaders over the next three years. 

The Academy is being led by Rachel Dunscombe, who combines the role with being group CIO at Salford Royal NHS Foundation Trust.

There was a whole selection process you had to go through, with personal statements and the like, almost like applying for medical school again.  But taking part is pretty much mandatory for folks from Global Digital Exemplars, and they are particularly keen on CCIOs taking part.

Like I said, it is high profile, promised to be interesting and I was looking forward to it, even though taking three-days out of clinical work back is a big chunk of time and effectively wrecks your week. And there’s three of these three-day residentials over the year plus a pile of homework.

So what was it like? If you follow these things on Twitter, you would have got a flavour and seen some of the photos.

No doubt you have heard of the basic structure, but what we had was two sessions on the modules, plus a day with the ‘SQIL’ programme at Harvard, plus a few lectures and ‘interactive exercises’.

SQIL it turns out isn’t something that needs a topical ointment, but stands for the Safety, Quality, Informatics and Leadership programme at Harvard Medical School: a “one-year programme consisting of three in-person, 3-day workshops, live interactive webinars, pre-recorded lectures and peer collaboration”. Sounds familiar…

Excitement all around 

My main reflection is that the various organisers are clearly very excited. I can say this confidently, as they kept telling us how excited they were at every turn.

Unfortunately, in their excited state, they’d rather forgotten that all of us, as prospective students, don’t have the same level of knowledge and understanding about the course as they do.

As well as a lot of excitement from the organisers, it was obvious the course has been planned very rapidly.  One sign of this was that we students only got access to the ‘Blackboard’ portal — the place we are meant to access course information — a few days before. To be honest I don’t think most people even had a chance to look at it.

And while it was clearly an introduction session, the content was lacking in a bit of detail. For example, they had a session to ‘introduce the module co-ordinators’, and they each said “I am the leader of module one” but didn’t reveal what module one actually was!

The upshot is that by the end of the three days, I think most of us were very little the wiser about what we would actually have to do practically — and some more details on that would have been very welcome.

We did get some wise words from the great and the good (Lord Darzi probably the biggest name) which was interesting as I’d not heard them speak in person before. However this was all very high level stuff and I’m wondering how to apply to the real life problems I’ve got back at the base.

For me at least, and I recognise I may be in the minority, the module introduction sessions were also very superficial and they had concentrated on style and an experiential approach.  There were no PowerPoints, instead there were enormous ‘conference’ style module stands which you were encouraged to walk around… not least by there not being enough chairs to sit down on.

Getting stuck on post-its

There were also innumerable pointless post-it note exercises and sticking sticky dots on to the boards. Being completely honest, I didn’t really think I learned anything much from these. They aren’t really my thing (and my heart sinks when people roll out flipcharts at meetings) although I can understand the underlying motivation to gather ideas and engage people in discussion.

There were also quite a few of the fairly generic ‘leadership skills’ exercises, for example making paper planes, building towers out of cardboard and other similar fashionable activities but I’m not sure how much one really learns from them.

The best bits 

The best bits were when there was some actual content delivered from the various academics, and then there was a quite complicated negotiation simulation which was really good although not perhaps specific to digital health stuff. I actually found it quite a relief to go back to more familiar ‘classroom’ learning and it was particularly good to hear it from some high-powered academics.

Mixing with the SQIL students, an international bunch, was interesting up to a point, but the gulf in culture/knowledge of the UK system was unfortunately a bit of a barrier. So any attempt at discussion usually ended up in having to explain what CCGs, CQC, NICE and all the other acronyms actually were!

Things will surely get better

I don’t want to be too hard on them as it was a first go and done with very little prep time. However, my overall feeling was that if people are going to take three days out like this then it needs to be worthwhile, and I think you could deliver a lot of solid content in three days rather than the sort of thing we actually did.

I am hoping the next two sessions will be much better. I am going to feed all this back to the organisers, as I don’t think I was the only one to think this.  And I’m sure I won’t be complaining about lack of content once the homework starts piling up.

Very serious indeed

My final reflection is that although we have heard quite a lot about it, I’m not sure that many people had twigged about how seriously Imperial College are taking all this.

Throughout the three days there was some very strong language about assessments, lack of extensions and contracts. They are very serious and very business-like about the whole thing.

I hadn’t really realised this myself. So there will probably be a bit of a shake down as I suspect at least some people doing it don’t quite know what they letting themselves in for.  I’m not sure I do yet, either. We shall see.

 

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8 Comments

  • I suppose the danger of any anonymous blog in such a prominent form of media for digital and health is that it is one voice and can have degrees of bias either positively or negatively and those ripples can affect others perceptions, including those that may be deciding whether they wish to take part in the next cohort.

    I admire anyone who comments in a social space, it takes bravery at times and it is good that to generate debate you need different voices and views, but my issue in this is one of balance. I fully respect their view, and hope they get more out of the programme as it continues and evolves.

    If I was asked to write the article this would be my view…I realise that there will be much variation between the original secret blogger and my view and actually that is right as it reflects also the variation and complexity in our NHS.

    In the first of an occasional series, our secret blogger, aged 44 11/12 shares their personal reflections of the first meeting of the NHS Digital Academy.

    Right, off to London for the first three-day residential training of the new NHS Digital Academy. The Digital Academy, (certainly not to be confused with Police Academy films of the now distant past), is the new blue-chip training initiative for NHS digital leaders.

    It was set up in response to Professor Robert Wachter’s 2016 report Making IT Work, and the big digital cheeses at NHS England are terribly excited by the whole thing. More on how excited later.

    NHS England are investing £4m in 300 current and future NHS digital leaders over the next three years to springboard digital transformation and to stop the old repeating model of squeezing people into not-fit-for-purpose-technology, to one of people first before technology…I for one am excited about the chance to change the game.

    In brass tacks and simple maths, that’s an investment of £13,333 for every single one of us and so far that seems a bargain for the wealth of information, access and different thinking we are getting access to. This is being delivered by heavyweights such as Imperial College London, the University of Edinburgh and Harvard Medical and they know what they are doing in this space.

    The Academy is being led by Rachel Dunscombe, who combines the role with being group CIO at Salford Royal NHS Foundation Trust.

    There was a whole selection process you had to go through, with personal statements, telephone interviews, essays for some and the whole process from my perspective was very polished. I have had less rigorous job interviews.

    I hear it said that it is pretty much mandatory for folks from Global Digital Exemplars, but 50% weren’t from GDE’s and that is a powerful message of equity for us as digital leaders. I am sure the GDE fellows appreciate the need to change core thinking in the digital space as much as the others and the need for formal recognition and acquisition of digital leadership skills.

    I was really pleased to see the majority of the Academy were clinicians from a wide range of types and organisations which led to rich discussions and felt more balanced than I expected.

    Like I said, it is high profile, promised to be interesting and I was looking forward to it, even though taking three-days out of work back is a big chunk of time and effectively wrecks your week. And there’s three of these three-day residentials over the year plus work every week.

    It is leading to a serious qualification and the need to be seriously committed really struck home when I was there. That said I am up for the challenge, I want to learn as much as I can to be a better digital leader and change the space we work in health and social care.

    So what was it like? If you follow these things on Twitter, you would have got a flavour and seen some of the photos.

    No doubt you have heard of the basic structure, but what we had was two sessions on the modules, plus a day with the ‘SQIL’ programme at Harvard, plus a few lectures and ‘interactive exercises’.

    SQIL it turns out isn’t something that needs a topical ointment, but stands for the Safety, Quality, Informatics and Leadership programme at Harvard Medical School: a “one-year programme consisting of three in-person, 3-day workshops, live interactive webinars, pre-recorded lectures and peer collaboration”. I liked the fact the format seemed to be the same.

    Excitement all around
    One reflection is that the various organisers are clearly very excited. I can say this confidently, as that excitement was reflected in the discussions I had with fellow ‘Academites’ through the three days and since. There is a sense of something very different in this programme, so different to anything I have experienced in my career in the private and public sector. There appears to be genuine commitment from the top to make this a success and they seem to be understanding the need for doing digital right by investing in leadership to guide the way.

    I think it is understandable that there was some of us who as prospective students, don’t have the same level of knowledge and understanding about the course as they do, but that grew and will continue to grow. We are co-creators of this course as well as consumers and that is a very exciting model.

    As well as a lot of excitement and support from the organisers, to my view it was not obvious the course has been planned very rapidly. There was a professionalism to the residentials. The setting helped, but the flow of us through the content was rapid at times, but always informative and I learned something at every session.
    That may be because I didn’t know much to start with of course…

    Not everything went to every plan and I would have been shocked if it did, but they were small things. There was one PowerPoint session that didn’t appeal to me and my learning style, but I know you can’t be everything for everyone, and on balance I think they got it right and importantly it will evolve.

    It already is evolving and feedback though a ‘discussion café’ is being acted on rapidly for the good of all. I find it very hard to think of other examples were issues are resolved so quickly and professionally. There are lessons here in how we provide our services and how we respond to feedback.

    I know some colleagues will not have liked the access to the ‘Blackboard’ portal not being available beforehand, but I found that to be fine. They provided us with content through email and gave us a link to a book prior to the start of the course and that was more than enough. There were teething problems with access for a few but they were quickly resolved over the course of the three days. It seemed that quite a few of us had read the content and the book beforehand with others catching up while we were there.

    It was an introductory session in part but also a chance to network with people who want to make a difference in a digital model for health and social care. It was also hard work and took me out of my comfort zone on quite a few occasions but was relevant and worthwhile.

    I thought the introduction through the modules was informative and left me thirsting for more when each module starts in the future. It didn’t need extensive detail but eased us onto the same page as we were all in different places before we arrived. I left each session knowing broadly what it would be about and anymore would have been overload.

    The upshot is that by the end of the three days, I think most of us were very tired but a bit more informed on what we would actually have to do practically and that has grown over the three weeks of study since.

    We did get some wise words from the great and the good (Lord Darzi probably the biggest name) which was interesting as I’d not heard them speak in person before and I found it inspirational and re-emphasised the point the centre takes this very seriously. I came away with a wealth of information and ideas on how to apply to the real life problems I’ve got back at the base.

    For me at least, the module introduction sessions were very good and they concentrated on style and an experiential approach, so we could get an idea of the variation we face across the whole of health and social care with the experiences we heard from each other. After all the problems we face can only be solved as a system not as individual silos as history has shown. Thankfully there were no PowerPoint’s, instead there were enormous ‘conference’ style module stands which you were encouraged to walk around…and it was good that there were not many chairs as it encouraged us to interact. I spend too much time sitting as it is…

    Unstick thoughts with post-its
    There were also several post-it note exercises and sticking sticky dots on to the boards. It was good to interact and see the wide variation we had in a cohort of 100. It also was refreshing to be able to think and place those thoughts to be shared. I got more from other people’s contributions and shamelessly have stolen some of them to use in my areas. I know this won’t be everyone’s ‘cup of tea’ but it is less about the model of delivery in the post-its and more about the content and diverse debate.

    There were also quite a few ‘Quality Improvement’ exercises, for example making paper planes, building towers out of cardboard and other similar activities. Now I may be being a generalist but being English (terrible stereotype but don’t like to make a fuss?) and an introvert it takes a lot of my energy to work in this way but I found it very worthwhile by ‘feeling the fear and doing it anyway’. It wasn’t about the paper or towers, it was about understanding variation and having a method to iterate through an improvement to quality cycle. I have taken learning from those sessions and used them to varying success back at the ranch…but then again I am odd as I do love all things quality improvement and can bore people on the works of Deming, Taichi Ohno and other gods…

    The best bits
    The best bits were when there was some actual content delivered from the various academics, and then there was a quite complicated negotiation simulation with colleagues from the academy and Harvard Medical school which was really good and I found specific to digital health stuff.

    Back at my Trust, I have negotiated differently since and it has been transformative. The negotiation exercise was the hardest thing I did at the residential and caused some anxiety beforehand, but it is one of the most worthwhile things I have ever done. Some will have found it a relief to go back to more familiar ‘classroom’ learning and it was particularly good to hear it from some high-powered academics. This is what I mean about balance…I think they did well by mixing the learning styles.

    Mixing with the SQIL students, an international bunch, was interesting and can see how the gulf in culture/knowledge of the UK system could be a bit of a barrier. So any attempt at discussion usually ended up in having to explain what CCGs, CQC, NICE and all the other acronyms actually were! But that made me change my language and speak in general terms but we had a shared purpose that was to provide better health and social care for people across the world. That was powerful.

    Things will evolve and only get better
    I can’t be too hard on them as it was the first cohort, done with in reality very little prep time. However, my overall feeling was that as people are going to take three days out like this it was absolutely worth it, and I thought it was a good mix of solid content, interaction and exercises.

    I am hoping the next two sessions will be even better and from what I have seen so far I am sure they will. I have fed this all this back to the organisers, as I don’t think I was the only one to think this. And I’m certainly not complaining about the lack of content now we are into week four of the studying.

    Very serious indeed
    My final reflection is that although we have heard quite a lot about it, I’m not sure beforehand that many people had twigged about how seriously NHS England, Imperial College and others are taking all this.

    Throughout the three days there was some very strong language about assessments, lack of extensions and contracts. They are very serious and very business-like about the whole thing. Which is only as it should be. I want to make sure I get and give as much for that £13,333 invested in me, so I can put more than that value back through digital means into our health and social care system.

  • As the editor of Digital Health I’d just remind everyone that there is a long tradition in both journalism and academia of dissenting views (sometimes anonymous) offered to stimultate discussion, precisely what this column has begun to do.

    And surely it would be surprising if a group of smart individuals all agreed with eath-other on every point. Isn’t questioning and discussion a key part of how we all learn?

    While it makes some criticisms I certainly don’t read the column as an attack on the NHS Digital Academy, which as the author says has achieved a remarkable amount in a short time, but as one student’s view of their initial experience, offering some positive and less positive views, and suggestions on how they’d like to see it evolve.

    Surely 8/10 is a good mark?

    Jon Hoeksma

  • Well I guess the need for better leadership and teamwork could not be more ably demonstrated by the blog and the negative comments. I too am on this course and it is very well put together. The materials and structure are very clearly laid out,informative and engaging. For those that want to engage and learn. For those who thought no work would be required or simply aim to tick another education box perhaps the effort required is too much? Well done to the faculty and organisers for putting all this together in a year and ironing out the inevitable teething troubles of cohort 1. You have always been there when asked for help.

  • I am also 39 3/4. But that’s about as close as we get on this one. I have been impressed by the responsiveness of the course to adapt and change as we all breathe life into it. I say all, because I think we (the cohort) are also collectively responsible for it.

    The content is engaging and thought provoking.

    With respect to Imperial being serious. If the work was easy and we all were guaranteed to win, then whatever diploma we got out of it wouldn’t be worth the paper.

    I am sorry that your perception of the course wasn’t a positive experience , such a shame!

  • The tone of this “blog” (never seen an anonymous blog before and certainly not one that is published weeks later) is not clear. Is this an attempt to support, undermine or truly reflect the course?
    To expect the leaders to be anything other than excited after months of hard work and a want to positively motivate the attendees reads as if the author is clutching at straws for a complaint.
    The lack of chairs is a ridiculous observation – attendees had sat through presentations and the overviews of the modules were conducted in fresh ways with participation – not perfect but engaging all the same – and all feedback has been acted upon almost immediately as we get up to speed.
    The “online cafe” is humming with discussion and feedback and positivity regarding the module 1 content. Long may it continue.
    I hope the anonymous blogger amongst us has the wherewithall to reflect upon this course as a true test of achievement and not just a CDP type event where you turn up and grab a certificate. It is a diversion from the norm.
    Residential 1 was an intro to high level principles of the content and the network of fellow students – it worked as well as can be expected and was enjoyable. The activities were more than simple contests or skill. Networking and peer support is a big theme here. Get with the programme and let’s see how your next ad-hoc blog results. Maybe when your a forty something you’ll be able to see the bigger picture!

  • A disappointing review and not my experience. Yes some of the interactive sessions were not the best but much of the other content was excellent and the chance to interact with the learning sets highly valuable. The overall mood among attendees was optimism and excitement with most people seeming to have very much enjoyed the course and keen for more. The negotiation exercise was a great simulation of what can happen in a board, tough and thought provoking. I can’t wait for the next 3 days in Salford. The weekly reading list since finishing is punishing, but they’re rapidly iterating and we’re all coming to a common reasonable workload and way of working. Blackboard is taking some getting used to, but it’s not bad and the interactions with our learning set is proving to create some strong relationships. So far I’m loving this course. I’m looking forward to the next 11 months. Congratulations to all the organisers. You’ve done well.

  • I would encourage you to forgive the excitement of the organisers if you can. 15 months ago they sat in a room in Skipton House fantasying about a world class leadership course for those in Digital health & Care, and here we are now with 100 folks sitting down for their residential……..Is it a perfectly oiled machine purring at 3000 rpm yet? Well possibly not, but in my 28 years of NHS service this is the first time ‘the centre’ in all its glory have sought to invest in the leadership of my profession. I can be nothing but grateful for that and hope the inaugural participants can see that their opportunity is to learn and also help this course improve for their peers in future. Imperial may well be being funded for this but a lot of volunteers have put in a lot of effort to get this out of the ground too. I am definitely proud to be one of them.

  • This is a pretty fair summary of the DHA residential course. It is pretty difficult running a course for the first time and as you say some things worked, others did not.

    From an educational point of view they confused ‘interactivity’ with ‘participation’. Adult learners will teach themselves if you structure it right, and get the students to do the talking, not the teachers.

    The subsequent online activities have been well delivered, although the learning aims and objectives for each stage have not been spelled out clearly.

    That said, the course tutors seem to know what they are talking about and are passionate about their subjects and if they are a bit excited then that is good! 8/10 so far….

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