“In adversity we thrive,” says the motto that has been used by innovation leaders. The age of austerity and in particular its depth in the UK public sector has been used as an innovation trigger by NHS CIO Rachel Dunscombe.
Dunscombe, who leads technology at the Salford Royal Foundation NHS Trust has used the perilous state of funding available to the NHS under the current Conservative government to create an environment where clinicians are highly involved in technology strategy, but also the growing Manchester technology community.
At the centre of the Salford Royal NHS Foundation Trust is the Salford Royal Hospital, one of the UK’s top performing hospitals, which underwent a major redevelopment as part of £130 million PFI contract, which was part of the Salford Health Investment for Tomorrow programme. The trust has been named as the one of the best to work for and has a strong research heritage through its links to the Manchester Medical School.
“I have to stand side by side with the clinicians,” she says of the culture change this has created and the barriers that have fallen.
“We don’t take people full time, as it is not too unusual for clinicians to do some part time managerial work. So some of the clinicians do a week of 12 hour shifts, which is way too much, so two days with us gives them some balance in their weeks.”
“The bit that is really exciting is that we have been working with small and medium sized enterprises (SME) to do hack days with the clinicians as well as look at new ways of doing procurement which mean there are better ways for the trust to be inclusive,” she says of breaking down the monopoly large vendors have on the NHS.
“It is about sharing our knowledge and information and we are building a capability for our patient records,” she says. “For example if I’m training my folk on interoperability then bring the SMEs in to be part of that and make some time for them.”
This strategy has a wider impact than just growing the skills available to Salford Royal Foundation Trust. “The more jobs that we create the better the health of the community will be,” she says. Adding that her Gran taught her to buy local.
“Twenty-five percent of our digital spend should be bought locally. We have so much gifted talent on our door step,”
“Twenty-five percent of our digital spend should be bought locally. We have so much gifted talent on our door step,” she says. The CIO admits working with challenger vendors is hard work and some of them have had negative experience of large organisations. “Some of the startups have been badly burned in the past when it comes to working with the public sector, so some really need help articulating their business model.
“The value set of these people has meant we have been very aligned,” Dunscombe says of how today’s technology startups have an ethos closer to that of the public sector than large international businesses. Dunscombe knows, she’s been a technology entrepreneur in the mobile space herself.
Like all transformational CIOs, Dunscombe knows there is great value available in the major vendors and it is a CIO’s role to discover and unlock that value. The Manchester CIO is working with partners like Hitachi using innovation models to change the culture into her organisation. “The model describes how you have teams that hand-off and support one another without any issues,” Dunscombe says. Asked how challenging it is to introduce an innovation culture into an NHS organisation, she says: “There is a culture of absolute rigour,” she says with pride for the NHS, “at the other end we need UX, prototyping and interventions, so we need to be creative. When you are keeping people alive it can be a monolithic culture of low risk taking, yet that will not solve the issue that we have. This is where strategic partners like Sectra, Hitachi and Allscripts fit in, they are co-located inside Dunscombe’s organisation so that technology business ethos of experimentation rubs off on the clinical world.