NHS England Director of Patients Slams NHS England Director of Information

This whole care.data debacle has led to a number of very helpful and informative blogs, and I certainly do not intend to rerun all the column inches that have been spent discussing the pros and cons of the project.

For me, this tale has highlighted an odd decision to create a senior position in NHS England of Director of Patients and Information.  A job description that was bound to lead the job holder into a predicament where media outlets and patient groups would inevitably question whether he could reflect 'patient voice' with any authority, whilst also advocating an IT project that appeared to them to have listened very poorly to that same voice

Imagine, if you will, a different past, where there were two jobs, not one.  The Director of Information and the Director of Patients.  Now imagine what would have happened in the corridors of Quarry House when the Director of Patients realised that the Director of Information was going to breeze ahead with a junk mail drop about care.data in the face of mounting disquiet in primary care, and without even the overt support of HealthWatch England!  We might make a reasonable guess that the Director of Patients would be requesting urgent meetings with the Director of Information and most likely bending the ear of Sir David Nicholson.  There would, no doubt, be 'robust' exchanges.

Of course, none of this can happen as the two directors are the same person.

What I think should happen during this 6 month hiatus, is that NHS England should consider freeing up Tim Kelsey to focus on his role as Director of Information.  Not as a demotion or on any way as a failure, but to highlight that IT is just too important to have a part-time head.  And Tim remains the charismatic leader that can make real changes in the way the NHS thinks about its IT, and continue the drive for a more open and transparent future.  He can help make patients voices better heard through the delivery of innovative and open solutions.

And the Director of Patients?  Frankly, I think that the role is moot.  For NHS England to imply that this is separate job, implies that the other Directors have less responsibility to patients.  That is obviously a nonsense.  For a Director of Patients to successfully reflect 'patient voice', they need complete independence from the Board.  But if the Board pays their wages, then the public and media are never going to quite buy into it.  My choice would be to take the budget for 'patients' out of NHS England and deliver it to where it should be, in HealthWatch England.  Failing that, then move 'patient voice' as a direct function of the office of the Chief Executive, which would at least reflect the central, core role that patient voice has within the new NHS.

Introduction. Who I am and what I'll be talking about.

Johnny Hoover works in IT for the NHS. I've been doing this for about the last 20 years, and before that spent a further 10 years doing IT for lots of different businesses right across the UK.

So I've seen a lot of changes. And as most people my age would say, there's a lot of different stuff and yet there's also the same old problems to solve.

I've been moved to start a blog, because I have found Twitter to be an excellent place to gather information, but an appallingly bad place to actually discuss any issues with a proper level of rigour.  Twitter's 140 characters leaves posts as bland sound bites turning the important subjects into trivia.

If I've got an overall philosophy, then it is that successful projects in the NHS:

• have a well defined and manageable scope
• are delivered by a reasonably small group of committed and skilled individuals in the core team
• attract the full backing of both national and local management
• must clearly answer Hopkinson's Question, "How does this improve patient care?"

Great advances are never made by visionaries who think they can change everything in [enter time period until next election] years. It just doesn't happen and the structure of the NHS beast means that it cannot happen. 

Anyway, I've got a lot I want to say about NHS IT, so in the coming months I hope people might find some of what I say interesting. And of course, all the comments and opinions written here will in no way reflect an official position of my employer or any stakeholders on my projects.