Aaron Powell has placed technology at the heart of the organisation rather than simply being its handmaiden. He not only demonstrated the substantial risks associated with a lack of investment in an aging and hard-to-maintain technology estate, but also the opportunities that could be realised by placing technology centre-stage. He secured more ICT staff and a £30m budget for a technology transformation programme, and got that programme at the top of the priority list for the entire organisation.
Name and job title
Aaron Powell, chief digital officer, NHS Blood and Transplant.
How are you influencing the products, experience and services your organisation offers to its customers?
NHSBT is a complex organisation whose primary responsibility is the recruitment and retention of blood, organ and stem cell donors, the manufacturing of blood components and other products, and the allocation of organs for transplant. My appointment as chief digital officer in 2015 coincided with NHSBT recognising that being digital first offered substantial opportunities to improve the experience of our donors and the efficiency of our operations.
We have launched a portal for donors to book appointments to donate blood around the country; 1 million donors will have registered to use it by January 2016. It's a remarkable milestone achieved in just two years, with over 3 million digital transactions and 50% of appointment bookings going through the portal, as well as a 3% increase in attendance from donors using it.
Under my leadership, we launched a mobile-friendly electronic offering system for organs to transplant centres. This enables clinicians to view the details of available organs on mobile phones and tablets, highlighting the critical information to enable them to make decisions quickly. Over 90% of organ offers are now viewed electronically. We are revisiting our digital strategy to prepare for the next stages of our development. Alongside our technology transformation programme, this will seek to understand the opportunities presented in an increasingly connected world, and look for exemplars in manufacturing, customer experience and real-time matching algorithms to provide new services to donors and hospitals.
How as CIO have you driven cultural and behaviour change in your organisation, and to what extent?
My main influence has been in placing technology and digital at the heart of the organisation rather than it simply being seen as a supporting function, and in moving towards an agile delivery approach to keep pace with developments. Prior to my appointment, technology was seen largely as an enabler, allowing the operational business units to function. As such, investments made a number of years ago to develop effective technology solutions and deploy a robust infrastructure had not been continued. Our technology estate was aging, becoming increasingly difficult to maintain, and failing to keep pace with external developments.
I was able to demonstrate the substantial risks associated with a lack of investment, but also the opportunities that can be realised through placing technology at the centre of what we do. As such, I have secured additional headcount for the ICT function, substantial investment (over £30m) in a technology transformation programme, and getting that programme at the top of the priority list for the entire organisation.
Importantly, we have recognised that we cannot deliver the scale of change required in a traditional waterfall approach. I have introduced an agile delivery model, which, it is fair to say, is still taking hold. But the language of the organisation has changed from questioning the value of an agile approach to asking how each function, including our regulatory functions, can work in a more agile way.
Define the key business outcomes that you have delivered over the past 12 months and their impact on your organisation's performance
We have improved the attendance rate of donors by 3% through the use of the donor portal, improving donor session efficiency. We have increased the rate of transactions carried out online so that over 50% of donors now book appointments electronically, reducing costs and contributing to the reduction in the costs we recharge to hospitals for processing blood. We have relaunched the organ donor register so it can handle opt-out as well as opt-in registrations in support of the changing legislation in Wales. 22 million people are now on the register and 2015/6 is on track to be a record year for the number of organ donors. We have reduced the number of business-impacting IT outages by 50% over the last eight months.
Describe how you have used organisational and third-party information to provide insight that has benefited your organisation, its customers and products or services
Internally, we have surveyed users extensively to inform a new end-use computing strategy, which will be rolled out over the coming months. We have used performance information to redesign some of our services to reduce contention and ensure that manufacturing operations are not affected by external use of technology services. We have reviewed completion rates for sign-ups on both the blood donor and organ donor websites and redesigned both to raise rates of sign-up. In the case of the organ donor site, we worked with the Department of Health and the Cabinet Office to complete end-to-end A/B testing and behavioural insights research. We work with Ovum, our advisory partner, to understand trends in the marketplace, which have informed our ongoing strategy. I also meet regularly with my counterparts in other Department of Health arm's length bodies to discuss areas of cooperation and also broader insights.
Describe how you organise and operate IT and how this aligns effectively with business strategy and operations
IT is broadly split into development and operations functions; the former works on our substantial technology transformation programme and the latter ensures our existing systems are stable and performant during the transition. Working across the two areas, I introduced a performance and business management function responsible for monitoring overall performance and management of strategic suppliers. I have also introduced a service management function to ensure that the business interface is properly managed and that technology services are driven to meet the business need. At an SMT level, we are each nominated to serve as business partners for the operational directorates and sit on their senior management teams.
Describe your role in the development of digital strategy in your organisation
Historically, the digital strategy was owned by the communications directorate and focused on the customer experience and social media. Following my appointment as chief digital officer, I have taken ownership of the digital strategy, working closely with colleagues in communications to broaden it – still focusing on providing an excellent customer experience but recognising that digital transformation of operations is also necessary to enable that front-end experience. We are widening the digital strategy this year to focus on blood, organs and tissues in a connected world – recognising the different interpretations that the word 'digital' brings.
Describe how you use and promote technology to redesign the processes, services and structures of your organisation to enable it to become more efficient and customer-focused
Like many organisations we invested in developing end-to-end line-of-business applications for our business units in the late 1990s and early 2000s. These application have served us very effectively, but are now recognised to be at the end of their useful life and have become increasingly complex, difficult to change and maintain, and unable to integrate with modern technologies and digital capabilities. I have led the development of a new technology framework, focused on the replacement of these legacy systems with modern, commercial enterprise applications, operating across the organisation and supporting the efficient sharing of data and business processes.
We have therefore commenced the selection and integration of a CRM, enterprise manufacturing and planning capability, and a business process management system. These technologies are being selected on the basis of their ability to meet our business need, but also the extent to which they support interoperability through APIs, and the ability to interact with customer-focused digital solutions at the front end. The board has supported this framework, along with an architectural decision-making process to ensure consistency.
The framework is centred around using software as a service as a preference, and we are developing a cloud strategy to ensure we make efficient and secure use of cloud services. It is also underpinned by a movement to an agile delivery approach. We have adopted the Scaled Agile Framework to deliver this enterprise-wide. I brief the leadership team (about 130 staff) on our technology programme regularly, as well as on the performance of our existing systems. I have established a regular blog for my senior team and me to inform the wider staff about our progress.
How do you engage regularly with your organisation about your team and the role of technology in the organisation, and what impact is this having?
I regularly brief the leadership team by means of a newsletter email. My team and I publish a weekly blog to the wider organisation, providing insights on what we are doing and how we operate. We also have a new intranet, which is used for particular news stories.
How do you use social networks to engage in conversations across the industry about the opportunities and challenges technology is creating?
I regularly meet with my counterparts in other Department of Health arm's length bodies to discuss opportunities and challenges. These meetings are regularly hosted by industry suppliers (who also attend the meetings) and so enable me to get both an industry and sector view of what is happening. I attend regular dinners and other social gatherings with colleagues and suppliers. I have attended two CIO magazine events in the last year.
How do you bring the organisation together to explore and discuss technology and its challenges and to develop stronger alignment of the technology function with the full business?
With 6,000 employees this is a challenge! At our Leadership Congress in the past two years we have had conversations and workshops on technology and our future plans. We have interviewed over 100 staff, representative of the different parts of the organisation, to inform our new desktop strategy. As an executive team we have a formal visit to one of our key sites every two months, and a full afternoon is spent working in one of the business units – I use this as an opportunity to also discuss our technology requirements with frontline staff. I regularly visit blood donor sessions to observe our technology in use and discuss its performance with staff.
Describe how you keep up to date with developments in technology and IT management
I subscribe to a number of industry magazines. I work closely with our IT advisory partner, Ovum, to reflect on trends and developments and participate in its industry congress. I attend government and healthcare sector conferences and have participated in discussions and workshops.
Provide an example of how you have developed the diversity and improved the culture of your team
This is an area where we need to do more work. We recognise that we have a limited number of women in the ICT function and, at the senior level, little ethnic diversity. We recently worked with a researcher at the University of the West of England to review our recruitment processes and the way we describe our roles and the impact it may have on diversity. We are now working with HR to change these processes, introducing simpler 'role profiles' rather than formal job descriptions for the purposes of recruitment, and including more 'day in the life of' type descriptions of what we do.
Describe how you collaborate and influence the organisation and its leadership team
As a member of the executive team and board I have regular opportunities to discuss the role of technology and influence senior colleagues. During the development of our Technology Strategic Framework, all the executive team were interviewed and discussed the proposals in workshops. We have led seminars on agile development approaches during executive team away days. Importantly, the delivery of the improvements under the technology framework is being led by the business.
Two substantial programmes are aimed not only at replacing the technology, but recognising the opportunities to change business processes and structures in order to deliver maximum value. The senior responsible owner for each programme is the relevant executive director and the programmes are led on a day-to-day basis by staff within the operational teams, supported by our PMO and IT resources. My role has been to establish and lead the framework, and then embed it within the organisation for the operational directorates to lead on their own programmes.
Tell us how you have developed your own management, leadership and personal skills
Prior to taking on this role I participated in NHSBT's senior leadership development programme, a comprehensive programme centred around 360 feedback and an understanding of personal style. I also collaborated in a cross-sector leadership exchange with other public sector bodies. I have established an IT advisory board for NHSBT with current and former CIOs and CTOs from the public and private sectors, and use that as a mentoring group in my own development.
What new technologies are you investigating, tracking or experimenting with?
We are actively looking into machine learning to inform the development of our systems and matching algorithms. We have established big data as one of the key themes of our R&D strategy, which has historically been almost entirely clinical, and we are working with universities and industry to develop this programme further. We have discussed wearable technologies with a number of providers as a way to prompt people to donate blood but also to track their health after donating.
Our entire strategy is centred around implementing enterprise applications, and our new digital strategy is considering the IoT in the context of blood and organs in a connected world. As an organisation, we are monitoring developments in 3D printing and, particularly, how it might affect or inform the work of our tissue and organ donation programmes, including whether we could manufacture some of our products. We recently worked with the National Air Traffic Control Service to discuss how drones technology might change the way we deliver blood to hospitals.
How do you decide where to apply the best technological approach?
Broadly, we seek to understand the opportunity and carry out an initial feasibility study, including potentially piloting an approach. We then assess it against our regulatory requirements, Government Digital Service technology and service standards and principles, and discuss it with colleagues internally, with suppliers, and with our contacts at the Department of Health. Our stated preference is to use contemporary technologies and cloud-based services, and we have had considerable success doing so. In terms of development, our approach is to maintain delivery capability and ownership internally, while working with external partners to augment our resources and provide additional insight and expertise where needed.
Do you give yourself and your team time each month to assess or learn about technology vendors outside of the established providers?
Not as much as I would like. We do this, but it is primarily through broad horizon scanning and internet research and discussions with suppliers who approach us with an interesting proposition, but there is no formal programme and it is often more reactive than proactive.
Describe your sourcing strategy and your strategic suppliers
Our sourcing strategy is changing. Historically, we have managed all our operations internally and used third partners in a supporting role only. We are moving more to a position where we seek managed services arrangements for much of our day-to-day operations. In terms of development of new technologies, we are looking to develop strategic partners with implementation partners for each of the core applications we will use, working alongside a delivery partner providing architectural insights and integration capabilities.
Our current strategic suppliers are:
- Vodafone for our networks and telephony provision.
- NTT for our security capability.
- Savant for our core blood supply application.
- Sapient, which has worked with us on the development of digital services such as the blood donor portal.
Describe the technology innovations that you have introduced in the last year and what they have enabled
We have upgraded the blood donor portal to make it more efficient and reduce its impact on operations; this is now being extended to remove reliance on paper donor health check forms. We have piloted a Windows 8.1 desktop using Surface Pro 3s at one of our sites, introducing more flexible working and greater mobility. We have rolled out Windows phones to all staff with a requirement for them. We have provided iPads to blood donor session staff, allowing them to access online resources for donor safety and complete session performance reports. We have developed an iPad application for specialist nurses for organ donation, replacing 75 pages of donation forms.
We have introduced a comprehensive transport management system, including vehicle tracking and telematics, dynamic route planning, and delivery scanning and tracking. It has resulted in greater efficiency, better tracking, an increase in overall mpg for our fleet and financial benefits of over £1m. We have introduced a planning and control system for blood stock requirements, including the introduction of vendor-managed inventory for eight pilot hospitals, allowing us to ensure that we have the right stock levels at all times and reduces workload for hospital staff. We have implemented technologies that allow us to integrate our bone marrow registry with others internationally, significantly improving the likelihood of a match being found for patients in need of stem cells internationally.
What strategic technology deals have been struck and with whom? What uniquely do they bring?
The most recent of these is our agreement with Vodafone, which has recently been renewed. We have established this as a key service, providing increased connectivity and bandwidth to all of our core sites, rolling out Windows phones to all staff who need them, developing a mobile connectivity strategy for mobile blood donor teams, and upgrading the Wi-Fi provision at all of our offices. Over time we expect to exploit other capabilities such as integrated telephony and collaboration tools.
Another recent deal was with IBM for its business process management suite. We are now making use of this suite to document and automate our processes in critical areas (especially where we have previously relied on people remembering 96 manual steps!), to automate our organ allocation algorithms so that they can be modified more quickly to effectively allocate organs and save more patients on the transplant waiting lists, and to measure process efficiency.
Rank in order of importance your sources for innovative technology suppliers
1 Analyst houses. 2 CIO peers. 3 Consultants.
Has your organisation detected a cyber intrusion in the last 12 months?
Is cyber security led and discussed by senior management?
When did you start your current role?
I was appointed interim director of ICT in October 2014, becoming appointed chief digital officer substantively in July 2015.
What is your reporting line?
Are you a member of the board of directors?
What is the annual IT budget?
How much of your IT budget is capital and how much revenue?
90% revenue. We capitalise only large-scale infrastructure investments.
What is your budget operational/development split?
Approximately 60:40 currently, but the percentage of spend on new developments will increase substantially over the next three years and this ratio will flip.
What number of users does your department supply services to?
Are you finding it difficult to recruit the talent you need to drive transformation?
Has recruitment and retention risen up your agenda as a CIO?
Does your IT organisation operate an apprenticeship scheme?
Being developed for 2016/17.
How many employees are there in your IT team?
Are you increasing your headcount to bring skills and the ability to react to needs in-house?
What is the split between in-house/outsourced staff?
Effectively about 90:10. We use external resources for specific projects but the majority of development and services are delivered internally.