Standards and legacy infrastructure key to transformation says Quinn

Delivering national architecture and standards are one of the key priorities for NHS England going forward, NHSE Chief Information Officer John Quinn told an audience at the Healthcare Excellence Through Technology 2023 (HETT) conference on Tuesday. 

Quinn, who was previously executive director of IT operations and enterprise services at NHS Digital, took over as interim CIO in January and was named to his current position in June.

In a keynote “fireside chat” with conference attendees at the ExCeL Centre, he acknowledged that the health service is also struggling to overcome the burden of legacy technology, referring to “a bit of underinvestment over time on infrastructure itself,” a problem that threatens to drag the NHS backwards. 

He noted that 40% of spending by integrated care systems (ICSs) goes on legacy infrastructure, while they only have 3% of revenue to invest in transformation.

He said he has a mission to put digital, data and technology at the heart of transforming the NHS and in helping senior officials in government and the health service to understand the importance of good service design and delivery by NHS England.

At the same time, he said, much of the success of transformation will depend on investment in people. 

“It’s not necessarily the things that we do but the way we get them done,” he added. Part of this challenge will depend on ensuring that there is adequate professional development and remuneration for the roughly 100,000 digital professionals working in the core public sector, he said. 

“I think its development is pretty important. Standardisation of the profession will help us make the case for clarity in funding and salaries, but that’s going to be a long journey,” he said, adding that he has made it a priority of to ensure that digital professionals are supported.  

Digital health professionals as a whole are to be congratulated, Quinn said. “It is going to be the most exciting profession for the next few decades,” he said, although he observed, “at some point that blurring of the line between who is a digital professional and who is a professional is going to continue. The upskilling of everyone is very important”. 

Seeking a different relation between centre and frontline

Quinn also returned to a topic he had discussed in a keynote speech at Digital Health Summer Schools in July, when he referred to the need to reduce the perception that strategy is dictated to the frontline from NHSE. 

“I’m really keen that we get a different type of relationship,” he said. “What we need to do is to bring the talent of the frontline into the thinking of the centre.” 

Asked about his outlook for critical systems infrastructure over the next decade, Quinn said strategic decisions will have to be made about how much can be done in-house.

“If we are running our own data centres and then building new data centres, I think we are in the wrong place, and we need to signal that there is a different world out there,” he said.

“Running an infrastructure and moving into the cloud or, better still, taking software as a service is a signal to the market,” he added, noting that the more “friction-free” the opportunity, the better.

Quinn predicted that there would be “disasters in technology and security” lying ahead, and that the health service would learn from its responses. Breaking up large digital investments into “chunks” would help avoid the likelihood of mistakes, he added.