Kathleen Hall is correspondent for Computer Weekly. She writes about technology issues in small to medium-sized enterprises, as well as specialising in the retail and services sectors.
Previously Kathleen worked as business reporter for Vitesse Media, covering SMEs and enterprise IT.
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As controversial plans to restructure the NHS push ahead, only one thing appears certain within the Department of Health (DoH): change. Katie Davis (pictured), interim managing director of informatics at the DoH, tells Computer Weekly why her role reflects this process of transformation.
Davis moved from her position as executive director in the Efficiency and Reform Group at the Cabinet Office to become interim managing director of NHS Informatics in July 2011, following the departure of former IT head Christine Connelly. However, according to Davis she is not stepping into Connelly's shoes entirely with the new role.
"I wouldn't describe my position as interim or permanent. It is a transition role and my job is to transition from where we were to the future," says Davis. "What that future will bring is a bit too early to say, but I don't think my role translates that easily into the future. I see it more as making sure we've got the right governance, the right levers and incentives to make the future marketplace work as well as it needs to."
As plans to dismantle Primary Care Trusts steam ahead and the focus moves to a local approach to commissioning, the commissioning board will take a strong role in supporting local procurements, says Davis. "This isn't in place yet, but it will evolve over the next few months."
Tackling the NHS IT programme
The department recently declared its intention to "accelerate the dismantling of the National Programme for IT (NPfIT)". But Davis says the announcement was primarily a reiteration of plans last year to move to a more locally-based commissioning approach. "I'm not sure we followed through as visibly with that intent as we feel we needed to, so an important aspect was to reinforce that intent," she says.
Not all of the programmes under the NPfIT will be wound down. Aspects such as N3 and Spine are genuinely national programmes and deliver a single outcome, so it would only make sense to deliver those systems once, she says. "You wouldn't want multiple networks existing across the NHS. And it certainly wouldn't make sense from a value-for-money perspective. In those situations, no doubt, we will continue to develop national applications. Infrastructure, by definition, falls into that category," Davis says.
Her aim is to get behind the "brand" of the NPfIT and decide which programmes should be wound down and delivered locally, and which should be run nationally. "The new model is about having the right programmes in place with the right ownership," she says.
But the big question for anyone who has followed the troubled NPfIT is, where do the outstanding £4.3bn of troubled contracts for electronic care records with CSC currently stand? "This is a focus of everyone's attention. CSC is our partner - it is providing a lot of services to the NHS today. I can't comment in great detail, except to say we are working with CSC to determine how we can work together in future," she says.
Another area Davis is not in a position to discuss in detail is the healthcare revolution strategy - originally due out this autumn - which now falls under the remit of Giles Wilmore, director of quality framework in the Department of Health.
"The information strategy is not an IT strategy, it is there to support the department of health and how it uses information across the healthcare system to deliver better patient outcomes. Quite rightly that's a departmentally-led initiative, a policy initiative, and I'm thrilled Giles has taken the lead. We are working closely with him," she says.
Future Forums, a group of clinician, patient and voluntary representatives, is also involved in the consultative work around the strategy. They won't be reporting until December at the earliest. Giles and his team will be taking account of what they come back with, says Davis.
However, one focus of the strategy will be in making more information available, in line with recent drive to open up more datasets in the health service. "That's really important because here in the centre we are not as close to the patients as we would like to be. And there are no doubt people better than us at delivering the iPhone apps of the future in a local context. We won't get the level of innovation we want if we try to deliver everything from the centre. We also won't necessarily deliver the best value for money if we try to deliver it all," says Davis.
So how would Davis summarise her current role? "First of all, making sure that we continue to deliver systems that support the NHS today; secondly, understanding how we can do things differently in the future; and thirdly, making the transition from where we are today to that future," she says.
Broadening the NHS supplier catalogue
Davis is currently talking with trade body Intellect to open the healthcare IT market to more suppliers, as the department intends to commission a number of the projects under the NPfIT more locally.
"The relationships with the LSPs [layered service providers] and the big contracts have dominated much of the conversation," she admits. "Certainly a disproportionate amount of public focus has been on that. It's about recognising the reality and spending as much time talking to all the suppliers in the market, not just the big suppliers. Different suppliers will meet the needs of different organisations depending on what they are trying to achieve."
Of course, this isn't the first time government has made noise about the importance of SMEs in public sector procurement. But Davis says the risk of small businesses being overlooked in favour of larger suppliers is lower than in other areas of government because the NHS is more diverse by definition. "The reality of the NHS is that what provides value-for-money and benefits for a small rural hospital is not necessarily the same as that for a large metropolitan hospital. The NHS itself is diverse, which means a variety of suppliers can help to meet those different needs."
Commercial arrangements will be put in place once the NPfIT has been fully reviewed. "I wouldn't want to say today whether that would be framework agreements or local procurements. There are lots of different ways of meeting those needs," she says.
Amid the major shake-ups underway, one of the biggest challenges for Davis has been the impact on her staff of 1,300 people. "Because of the extent of the change, it is not yet possible to make clear to individuals what their future will bring. So that's a challenge. We've got some great committed people who have given a lot over the past few years, and it will be a bit of time before we can tell them precisely what the future will bring. No doubt by the spring we will be able to bring a level of clarity that we don't have now," she says.
Once the strategy is released, Davis hopes to press ahead with her biggest goal: to reach a point where people stop talking about NHS IT. "We don't want IT to dominate the conversation in the way that it has done over the past few years. Having the right information should just be a basic, it should just be something that you have as a patient. I really hope we get to the point where there isn't such a focus specifically on the IT and it is something we just take for granted," she says.
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