A love letter to lil ’ol Kettering

Friday was my last day working at Kettering General Hospital, and on Monday I’ll be the Digital Director for Buckinghamshire Healthcare NHS Trust (BHT). I’ve loved my time at Kettering and thought I’d explain why.

Digital stuff

KGH already had an aggressive approach to Digital as the peerless Andy Callow was their CDIO (and is now Group CDIO for the University Hospitals of Northampton — which is primarily KGH and NGH). You can read the Digital strategy and the Cloud strategy to understand the context I was working in.

I was a custodian of the continued rollout of the EPR programme and many other folk deserve the credit for this — but it was pleasing through Covid times to continue the rollout of Vitals, Patient Flow, Careflow Connect and ePMA, and to make e-COF mandatory. BHT are a client of System C and there will be lots I can take from what we’ve done at KGH and use at BHT. I expect lots of mutual aid!

Of the things that probably wouldn’t have happened without me, or without my significant shaping at KGH are

• The introduction of Robotic Process Automation (RPA) with NHSX and Foundry 4 in the depths of the first wave of Covid — initially to automate the Covid Sitrep process but then following on to support Outpatients appointment booking and Clinical Coding. You’ll hear lots about the NGH RPA Centre of Excellence (and they’re lovely people) but KGH got there first 😉. You can read more about introducing RPA at KGH here.
• We also built on the work done in Sonia Patel’s previous Trust to introduce a Virtual Visiting service at KGH. This was fantastic and a lil emotional. In the first wave (and also now) physical visiting was cancelled and (for example) people at the end of their lives had inadequate ways of talking to their loved ones. It was also built using the NHS Digital Service Manual and with some fantastic people (Hi Jess) at Madetech. You can read more about Virtual Visiting at KGH here.
• The speed at which we moved to Cloud. Gifted funds by NHSE/I/D we did great work with Phoenix and Microsoft, fantastically supported by Jas and Mary.
• And more recently I was the Product lead for ‘Bed Tetris’ — ‘right bed for the right patient at the right time’. This work was inspired by a tweet by Andy but delivered with Faculty AI and NHSX. This was a POC but hopefully with further funding will become an operational service. You can read more about Bed Tetris here.

You can read more of an overview of our activity in 2021 at KGH in ‘12 days of Xmas’.

Agile stuff

I’ve been working in an Agile fashion since about 2010, and in my time at NHS Digital we were wholly Agile and wholly working in the GDS style.

But KGH (and NGH) were absolutely not used to Agile ways of working (and I suspect most Acute Trusts aren’t). I truly hope they will continue in this fashion (👀 Dave and Dan… p.s. why aren’t you on Twitter?)

Two weeks in to my time at KGH Covid hit, and I said to Andy ‘shall I wrap my arms around our response in Digital?’, and of course he said yes.

So I went on my journey of trying to explain Agile and introduced what I thought would help — not being slaves to an Agile methodology but using tools and techniques that would ‘fit’ and not be too much of a culture shock as the world was spiralling.

• So we started using a Kanban board (thanks Jas) to manage our response, and have continued since (below is a screenshot of a board for the Health Intelligence team)

• We had daily stand-ups and we used retrospectives (which was used much more widely in the hospital thinking about our response to Covid)
• We introduced prioritisation and planning and T shirt sizing but this really difficult when you’re balancing BAU activity in a serious operational service with significant change projects.
• I didn’t manage to appoint a User Researcher but I did my own observational analysis in an outpatient clinic and shadowed therapists, ward rounds and observed wrist surgery in the OR (I didn’t feint)
• And I continued on my journey of using great texts of management to support colleagues — namely ‘Let it Go’ (as in be yourself) and ‘Do the next right thing’ from Frozen, and of course ‘everything is awesome when you’re part of a team’ from the Lego movie. As a parting gift the Director of Finance bought me these figurines:

There’s things I’ll definitely want t try and evolve more at BHT such as being in a state of discovery, more user research (surveys, observation and user testing with patients and staff) and more UCD — not just implementing software developed by third parties.

And there’s the loosely coupled stuff I’ll continue to promote in working in an Agile or Product centred state — captured in my Roman Pichler blog which mentions the importance of communications (listening not talking), rightful speech and gaining consensus.

(At KGH this esulted in running training courses at KGH for 60+ colleagues of the IT team where most of them talked for the first time about emotional intelligence…

And more seriously we arranged for a dozen close colleagues to do a 2 day training session on ‘Building cultural bridges’ to help people become more aware of diversity issues, something I’m still surprised the NHS struggles with given the diversity of it’s staff base . This was a great two days and also a bit emotional).

The Covid stuff

I can’t deny this — I joined KGH in March 2020 just before Covid hit. Two weeks in I was in silver command and then in an alternate rotating Blue/Red Exec team rota to guard against the whole senior management team being taken out by Covid.

We’re still living with it but it’s a challenge to remember how unknown, and terrifying things were in the first waves of Covid.

The pic above is of me, the Chief of Surgery, the now Medical Director and two volunteers (one I think the daughter of our HR Director) delivering Easter Eggs on April 11th — the peak of the first wave. I think this significantly affects my view of my time at KGH. We lived through a lot — from the early impact of Covid, the changes we had to make in Covid times and then the work we had to do to stand up our Covid vaccination service which was the start of seeing a light at the end of the tunnel.

They were extraordinary times, we did extraordinary stuff, and many people lost loved ones through this time and it was my privilege to support them in that.

People stuff

And then of course there’s the people. It always comes back to the people.

Kettering is a town like many others, and the hospital is very much a community one. People who work in the hospital generally live within the catchment area for the hospital. So they know each other, their families work in the hospital and are treated in the hospital and many people who work there had their kids there. And there’s a real authenticity to it, a real absence of ‘airs and graces’ which I loved.

So it’s a real family feel, and a really strong knit community.

I learnt a lot from the folks of Kettering General Hospital and the resounding memories are of the strong women I was privileged to work alongside and observe. From the super competent, confident and caring red uniformed women of the heads of nursing, to the matrons, the sisters, the nurses in charge, the nurses and therapists and the HCAs. And there were many more — too many to mention — but to the people of KGH, and particularly the strong and characterful women I met who only had the care of the patients, their families and staff as their focus I’d like to say thank you for accepting me.

And there were people who (it appears) I genuinely helped — in their career and personal development and who I will continue to keep in touch with.

There’s many people I could name and if I do there’s many I’ll miss. But I’d like to thank Andy for offering me the opportunity — for letting me be me — and to Debbie for embracing me as part of the Exec team (and definitely tolerating me!). And there was the fantastic Digital SLT I worked with and too many other names to mention of people I met around the hospital — but you know who you are.

I’ll miss you Kettering, I learnt a lot from you, about how a hospital works, but more fundamentally about people and the struggles we all deal with. You’ll have a place in my heart forever.

From the 10th January I’ll be the Digital Director at Buckinghamshire Healthcare Trust — serving the community need from sites at Amersham, Aylesbury and High Wycombe. There will be new things to learn, and it’s my intent to take my experience at Kettering to help in my work at Bucks, so my intent is not to be as a stranger at lil ‘ol Kettering!

Thanks lil ol’ KGH. Love you x