Given that Stephen Docherty has a background in the gaming industry and entitled his masters dissertation "Why Are IT Leaders Not Given More Prominence?", it should be no surprise that he has taken IT from classic to innovative in just 15 months. It's now more about adopting a service management culture and less about managing tin, allowing the function to add value by spending more time with staff across the whole trust to improve the way we deliver services.
Name and job title
Stephen Docherty, chief information officer, South London and Maudsley NHS Trust.
How are you influencing the products, experience and services your organisation offers to its customers?
By digitising the NHS workforce at South London and Maudsley NHS Foundation Trust. By becoming the number one trust in the country to adopt Office365 while others discuss information governance and think what to do. By helping the workforce adopt the technology and collaboration tools, by working with the main clinical system provider to develop a new model for hosting the mission-critical system which allows us to innovate on top of the platform. By creating apps and digital interventions (the Centre for Translational Informatics) that will change the way we deliver services and allow service-users to interact with their health record and care plan. By developing a digital observation platform (in progress) to remove paper and automate alerting based on scoring of assessments. We aim to allow clinicians to be able to spend more time with patients and to evolve and improve their services.
How as CIO have you driven cultural and behaviour change in your organisation, and to what extent?
I made an immediate impact on the IT department and research organisations by bringing in energy and pace, with an attitude of getting things done and breaking down barriers, while challenging the inherent culture. I have also been taught about culture as part of my master's in information leadership (via David Chan at Cass Business School), which has been of great benefit to me and my team. This also helped me design a short course in conjunction with training partners in cultural awareness for my IT management team, which has been cascaded down the ranks – my dissertation was titled "Why Are IT Leaders Not Given More Prominence?"
Having a background in the games Industry has allowed me to bring about a different culture and drive a vision for the trust in terms of how it communicates, how it can create digital interventions, how to just get things done. I am known as someone who means business and drives change across the trust.
Define the key business outcomes that you have delivered over the past 12 months and their impact on your organisation's performance
I have only been in the role for 15 months but in this short period I have stabilised and restructured a failing IT department that was providing a shocking service which was affecting productivity across the organisation. I set out a strategy which would allow for the adoption of cloud-based services to increase productivity such as Office365. I agreed with the CEO and chairman to replace 2,000 aged PCs with mobile devices to allow trust staff to be more mobile and deliver more services in the community.
I also conducted a major review of data and information flow across the trust which has resulted in removing superfluous layers of activity, getting towards a 'single source of truth', and delivering data visualisation, which is now helping the trust with activity and capacity planning as they enter into contractual discussions with clinical commissioning groups (CCGs). We are also working with Microsoft to develop our business intelligence in Azure and we will be one of the first customers to preview the new Azure UK platform.
I developed a framework, leading to the launch of the Centre for Translational Informatics (CTI), which aims to provide a research and clinical informatics environment that delivers real-world improvements to service users and clinicians by generating insight into big data, and through the implementation and evaluation of digital interventions in clinical care and systems. We already have some prototypes developed, and gaining momentum and interest across the NHS and beyond.
Describe how you have used organisational and third-party information to provide insight that has benefited your organisation, its customers and products or services
I have used a lot of survey information and NHS benchmarking data to help me with developing the IT strategy, but also to ensure that the NHS cuts or cost improvement plans are not applied to IT, which allows my teams to continue to deliver the two-year IT transformation plan.
I can't take credit for this next item as my team rolled it out just as I started, but they should be credited for it: the development of a portal (along with Guys & St. Thomas, Kings College Hospital, and Kings College) that allows clinicians to view the record of any patient in their care who may have a record from any of the other partners' clinical systems. The team has recently been adding GPs to the system to create a joined-up or 'unified' record which benefits patients.
We have recently developed an IT service and support model for our research system, which has allowed other Trusts to take advantage of it. The research model takes a copy of the patient database and anonymises the data, allowing trusts to query and gain insight (using NLP) from the big data. My team (not me) has also created a data linkage model for research – for example, linking the national pupil database with data from our children and adolescent mental health services. I have given the team direction and guidance on developing service models and they have done a great job.
Describe how you organise and operate IT and how this aligns effectively with business strategy and operations
I have several departments with heads and senior managers for each: clinical information systems, operations, information governance, business intelligence, clinical informatics (research) and an empowerment programme.
We have gone from classic IT to innovative IT in the 15 months since I joined, which is more about adopting a service management culture, and less about managing tin, allowing us to add value by spending more time with staff across the whole trust to improve the way we deliver services. We implemented a balanced scorecard and publish this. We meet as an IT SMT every two weeks as well as one-two-one sessions. We have a quarterly IT conference attended by the chairman and CEO, which has been successful in building a positive culture. We are fully aligned with the strategic objectives. We are also developing 'work hubs' across the sites, which will allow for mobile working or 'touchdown' points, which supports the trust strategy.
By digitising the workforce and developing an app that will allow patients to interact with their care plan and health record, we are supporting the five-year forward view set out by the NIB. We have rolled out a significant number of Wi-Fi access points for patients too.
Describe your role in the development of digital strategy in your organisation
I am actively driving this with many of the points raised above changing the way we communicate and collaborate, developing platforms, digitising the workforce, etc. I believe that I am in a great position to really push the digital agenda and work across and beyond the NHS sector.
As I still have contacts in the games industry, we are also looking at how virtual reality can be deployed in clinical settings (we have great ideas around this and a prototype in use). By developing platforms and also working with cloud vendors, we aim to deliver flexibility and scale to the organisation. I am also showing them what can be done with small amounts of money – for example, developing prototypes at pace (with agile development) but also pushing the ethos of user-led design, which helps with adoption and ownership and ensuring that the UX is optimised.
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
I have covered many of the points in previous answers; one example is around the delivery of value-based healthcare, which is being led by the chief clinical information officer, who I work very closely with. We need to develop our care pathways by protocolising service delivery, thus allowing the programme to deliver value by measuring performance with business intelligence (new platform). To do this, we wish to design the pathways (and use algorithms) to assist with decision-support. This will be supported by the new hosting model for our clinical system, allowing us to innovate and develop processes/pathways on the top, which will be developed by the CTI teams.
We are delivering tech adoption days to help the trust staff to exploit the technology, and will be presenting at the trust conference with Microsoft teams, as well as have stalls set up, and create tech café days across the trust to allow people to drop in for advice on using mobile devices or Office365.
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?
We regularly send out updates via the central communications team. We also distribute a quarterly IT newsletter and publish a balanced scorecard. We speak at the trust conference, post on the intranet and are rolling out Yammer.
How do you use social networks to engage in conversations across the industry about the opportunities and challenges technology is creating?
I don't use social networks per se, but have many social events. I attend many conferences and seminars and not just within the health sector – I will be attending the annual Game Developer Conference in San Francisco in March. I am the SRO for the Health Innovation Network. I recently attended a Westminster Forum on IT within the NHS. I also attend CIO events when I can during some evenings.
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?
Given the number of IT programmes we are running, I have pushed the message that the projects are 'trust projects' rather than IT projects. To support this, I created an IT steering group chaired and attended by the various departments across the trust. I'm not going to tell them which devices or where the priorities are – it is their services that are evolving and they know the priority areas, so they have more control of the improvement initiatives, and we just provide a guiding hand.
Describe how you keep up to date with developments in technology and IT management
I have many contacts/friends in the IT sector and meet with many SMEs, vendors and startups as part of developing an ecosystem. I like to keep abreast of what's going on in industry and expect to meet a few players in San Francisco.
Provide an example of how you have developed the diversity and improved the culture of your team
I improved the culture by breaking it before I started, but mainly by being positive, having an authoritative style and setting out a vision, and then delivering against that vision. I also ensured that we have enough women on the team and have recently brought on a new head of PMO who was a contract project manager. We are converting a few contractors into permanents who want to be on the journey with us. We delivered training around culture to equip managers with knowledge and how to deal with the cultural baggage that exists.
Describe how you collaborate and influence the organisation and its leadership team
Regularly meet on a one-to-one basis with the execs, non-execs and chairman to keep them updated, but also to politically navigate the organisation and beyond. In terms of influence, by delivering what I said we would deliver certainly helps. I also regularly meet with other department heads and bring them into 'my space', which takes them away from their environment and helps to open up the conversations.
Tell us how you have developed your own management, leadership and personal skills
I have always pushed myself to improve and learn, and I believe in life-long learning. While I was at Sony Playstation I delivered an ITIL programme; instead of just asking the teams to go on various levels of service management training, I led by example and sat all the exams to become an ITIL expert V3, which then introduced gamification, and the rest of the IT management team followed suit. I also did Prince2 and MSP as well as COBIT, which again the teams followed. Within a two-year period we had a well-developed IT organisation with various qualifications.
I am also fortunate in that I won a scholarship in 2012 (IBM and Computer Weekly), which allowed me to study and obtain an executive-level master's in information leadership at Cass Business School, which was run by David Chan. This was a fantastic opportunity and we had different CIOs and experts who would give up time at the weekends to come in and teach us. For this I am extremely grateful.
What new technologies are you investigating, tracking or experimenting with?
We have NLP in place and certainly make use of analytics for research. We are also developing the use of wearable tech as this will provide a rich source of data – patient reported data – that will allow us to understand certain medicines and effects, and how interventions can make a difference. The Centre for Translational Informatics is all about this. The aim is to provide an environment for collaboration between industry (big digital, big pharma, SMEs and startups), academia, NHS and third sector.
How do you decide where to apply the best technological approach?
We are looking at all possibilities and determining what our capabilities are. We don't want to run email or collaboration tools, so have signed up with Office365 and have 5,000 staff migrated. We are developing (with a partner) an open source digital observation platform for clinicians in the wards, and an open source personal health record app with internal teams and a spin-out entity that is close to our organisation. Our business intelligence will be in the Azure cloud too, although we will work with MS to configure that. There is no single approach for us – it depends on our strategic objective and where we can add value.
Do you give yourself and your team time each month to assess or learn about technology vendors outside of the established providers?
Absolutely. I and my team meet with many different organisations and SMEs as I believe in building the ecosystem of suppliers. I encourage the teams to talk to other organisations.
Describe your sourcing strategy and your strategic suppliers
Sourcing strategy is to find the best fit and to continually monitor the market for not only the key players, but the disrupters and orgs that bring something new to the table. At the same time, we also work with the big players, but like to think of it more as partnerships and not just being a customer. Our strategic suppliers now see us as pioneering and leading the way, which requires different models.
Describe the technology innovations that you have introduced in the last year and what they have enabled
Cloud services – eg Office365 and collaboration tools – are changing the way the trust communicates and providing a resilient platform. We are testing a new business intelligence platform on Azur that will deliver a single source of truth and 'board to ward' information. We are developing small innovations such as agents within the patient database that will send an alert when keywords are entered around specific drugs, allowing near real-time monitoring. We have delivered a new prototype of a personal health record app, which allowed further charity funding, and the beta will be ready end of March. Not a tech innovation, but pushing data visualisation and infographics across the trust from board level downwards is changing the way information is being presented, and getting away from the typical NHS paper-writing mentality.
What strategic technology deals have been struck and with whom? What uniquely do they bring?
Currently in talks with many people. No one tech deal has been struck at this point, although I expect this to change fairly soon.
Rate how important your sources of innovative technology suppliers are
- Often use: CIO peers, media.
- Occasionally use: analyst houses, consultants, industry body.
Has your organisation detected a cyber intrusion in the last 12 months?
How is cyber security led and discussed by senior management?
We have a very good information governance department which leads on this, and reports are submitted quarterly. We also have external auditors who work with us across the whole.
When did you start your current role?
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?
£8.5m revenue, £2.5m capital.
What is your budget's operational/development split?
How many 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?
Was 60% external, 40% internal, but have now converted a few contract staff and we are nearer 75% internal, which is rising.