Joe’s View: NHS IT, the soft stuff is the hard stuff

Christmas is usually a time for reflection and spending time with family. As December 25 fast approaches, Professor Joe McDonald finds himself thinking about “big hair” and what he wants from Santa this year. 

It’s Christmas 1984 in my sister’s terraced house in Wallsend, in the North East and we are playing “Do They Know Its Christmas” on repeat while Christine prepares dinner for the whole family.

For younger viewers “Do they know it’s Christmas” was a charity record (a single song printed in analogue format on a 6 inch plastic disc) born out of a famine in Ethiopia and a movement led by musicians Bob Geldof and Midge Ure, spread among the music industry which produced a huge response in the country and spawned a big event, Live Aid, recently featured in the recent film Bohemian Rhapsody.

As usual we sat down for dinner hours later than planned and with good deal more blue Nun on board than was wise. The table was lavishly decorated as Christine produced the dreaded turkey with a flourish.

Now because it’s 1984, Christine is sporting “big hair” as modelled by many of the popstars at the time. Hair was back-combed into an enormous haystack and then fixed in place with an industrial amount of hairspray.

I will never forget the wide eyed look of astonishment on her face as I threw a pint of beer in her face, followed by several other members of the family.  Serving the turkey her big hair had caught on a lit candle and went up like a Christmas tree. Thankfully, due to the rapid action of everyone at the table the only casualty was Christine’s hair, equally thankfully we hadn’t yet served the brandy.

Now, Christine was a force of nature, five years older than me, smarter than me, louder, braver more passionate, more caring and dedicated and angry. She was a passionate socialist and inevitably ended up politically active in the labour party. She once physically attacked a dinner lady at school who was trying to bully me into eating cabbage. “Joey doesn’t eat cabbage!”

Social injustice angered her to the point that she founded an advice centre to help the disadvantaged of her area, fund raised to grow it, worked in it for 20 years and eventually it became so beloved of the local population that it was taken over by the local council.

Christine took well-earned retirement but unfortunately died only a few months later. Only the good die young they say. My hero. I guess we all have some empty chairs at the Christmas dinner table, I hope you remember yours as fondly as I remember Christine.

So whether you are building an advice centre, feeding the world or just putting out a small fire there is no doubt that coming together to solve shared problems is powerful medicine.

Time for reflection

After stepping down as chair of the CCIO network this year I have been reflecting on the growth of that network and crucially trying to build another network in the North East and North Cumbria to support the development of our regional integrated care record, The Great North Care Record.

Having taken the lessons from the national network development we have been able to stand up an almost 1000 strong network of supporters of GNCR so that when we need to get a message out to all organisations, we have the means. More than 1% of NHS staff in the region have joined, if centurions were good enough for the Roman Empire they’re good enough for me.

We hired Marcus Baw to duplicate the success of the national network in deploying an affordable open source discussion platform where we could share views, get feedback and develop the common language and culture we required to get 372 General Practices , 11 Acute Trusts, 2 Mental Health Trusts and an ambulance Trust all going live on an HIE in the next few weeks (having already been connected via MIG for 2 years).

While Newcastle Upon Tyne Hospitals are doing the technical work of the sociotechnical task that is GNCR, we deployed  a tiny central team across the region to do the “socio” bit, the  “soft stuff” to grow the social power required to solve problems together rather than in siloes.

They grafted for four years to make us ready to be an overnight success this year.

Wish list for Santa

I follow Hadley Beeman of NHSX on twitter and had an interesting conversation with her recently. She often tweets about her activities with W3C (The World Wide Web Consortium), which is an international community where member organisations, full-time staff, and the public work together to develop web standards.

I look at how we have struggled over standards and interoperability in NHS IT and mentioned to her my envy about the strength of the social movement that sets the standards for the web.

She replied: “You’re right about the soft stuff – it definitely takes a social movement! 90% of it is people; 10% tech. The NHS has a great set of communities who are well suited to collaborating when they’re not in the same place. There are commonalities with the W3C I think.”

So OK Santa, here’s my list. I want

1. A regional Soft Stuff team
2. A national Soft Stuff team
3. In a world where one city can find the money for £400 million pounds worth of EPR could we find the means to connect a) and b) into a social movement on a national instance of Discourse which already exists rather than developing yet another short lived network which is unlikely survive a general election. The CIO/CCIO instance of Discourse is on its third election and the GNCR instance is on its second.

Maybe we can come together to build the social movement we require despite recent events. 90% people; 10% tech.

I wish you a merry Christmas and a collaborative new year.