Salaries in the NHS may compare unfavourably with other sectors, but it seems that there are compensations. "It may sound a little corny, but people want to work in the NHS because they are making a difference," says Zane O'Driscoll, head of the health division at recruitment firm Elan.
"Everything you are supporting is life-critical, and you are ultimately improving patient care and saving lives. People take salary cuts to work in this sector because there is real job satisfaction."
The NHS also offers excellent opportunities for development and training. "It is a good starting place for a first job," says Ken Rutherford, information security and governance manager at the Tyne and Wear Contractor Services Agency. Rutherford joined the NHS in 1999 in a general support role, after more than 20 years with the British Army.
Jon Reed, director of ICT at the Royal Marsden Hospital, agrees. In 1992, Reed was a recent graduate and had just started at the NHS, working as a developer for the St Helier Hospital. "It was a new trust, and only just thinking about its local IT needs," he says. "It was an opportunity for me to get my hands dirty in lots of different areas."
Reed progressed at St Helier as the IT department grew, moving into management and eventually becoming head of an information department that encompassed medical records and management reporting, as well as IT.
Investment in staff
In 2006, Reed moved to the Royal Marsden Hospital, where he is now one of many NHS ICT department heads who recruit trainees into roles where they can flourish. "Continuous development is a strong theme here, and we will invest in you as much as we can," he says.
Jane Bodley-Scott, a director at training company Premier IT which heads up the company's NHS activities, says this focus on training is partly a result of the highly structured approach to recruitment within the NHS. However, she warns that many NHS organisations will meet the cost of courses, but not the final certification process.
"The NHS needs technical people with the skills to deliver, but they often find that if they put staff through programmes to become certified, those individuals realise their value in the marketplace and move on," Bodley-Scott says.
Nevertheless, Rutherford says the NHS is very supportive when it comes to training. "I had some Microsoft and Novell qualifications from my time in the army, but when I came to work in the NHS, my employer sent me on numerous courses over the next few years related to both specific NHS software and general IT such as networking, databases and various Microsoft back-end technologies."
Rutherford was promoted into his current post of information security and governance manager at the Tyne and Wear Contractor Services Agency in 2005.
"When I moved into the security role, I was able to identify and request the courses I felt I needed to do the job, including the certified information systems security professional (CISSP) qualification," Rutherford says.
"Funding for training can be an issue - some of the courses are very expensive and can wipe out the whole training budget for the IT department - so you have to be flexible. But within those constraints, the NHS is very supportive of training."
Rutherford's role is a mixture of providing technical support for security measures and leading operations for the agency's data protection, freedom of information and data governance obligations.
This combination of traditional IT skills and "informatics" - data analysis and information governance - is typical of NHS IT departments, says O'Driscoll. Project and programme managers are also in demand to deliver the stream of IT-based initiatives flowing from the government, most recently the National Programme for IT.
On the cutting edge
"It is also a sector where there is constant change, with the chance to work on challenging and complex projects," O'Driscoll says.
Many jobs offer the chance to work with cutting-edge technologies on interesting projects. The independence of the trusts that make up the NHS means there is also a great deal of variety in how they tackle IT.
The two hospitals where Reed worked exemplify the two main approaches: St Helier focused on implementing and integrating best-of-breed packages the Royal Marsden, until recently, developed most of its systems in-house.
The Royal Marsden is now planning to introduce some best-of-breed components in areas such as pathology, where sophisticated packages are available. However, the hospital will continue to invest in its own systems for elements of the patient record, using InterSystems' Ensemble package to integrate the two.
According to Reed, the downside of working in the NHS is that it can be difficult to implement change, with regular reorganisations and changing targets. Nevertheless, it seems that once people join the NHS, they are reluctant to leave.
The careers of both Reed and Rutherford are typical of the long service found within NHS IT departments. "Many staff have been with the same organisation for more than 10 years because the NHS is a very people-based organisation, which breeds a culture of loyalty and commitment to the role that is not purely financial," Reed says.
"It is a worthwhile place to work, and you do feel like you are making a tangible difference."
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