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CIO interview: Toby Clarke, interim head of IT, Moorfields Eye Hospital NHS Foundation Trust

Moorfields Eye Hospital’s interim head of IT talks about the complicated world of NHS IT, building foundations and business-led IT transformation

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Toby Clarke, interim head of IT at Moorfields Eye Hospital NHS Foundation Trust, meets Computer Weekly after a day helping to deliver technology-led transformation in the world-renowned healthcare organisation. 

The hotel bar where we meet for coffee is just a short stroll from the hospital. Clarke often pops across for a working break during the day, suggesting the move to a new environment can help create a separation from the operational concerns that can fill an IT leader’s time. 

Clarke, as he makes clear during the interview, is being employed to focus on much bigger concerns. Across standards, infrastructure and skills, he is helping to create the technological foundations for improved patient care. 

As part of his role, Clarke has just helped to recruit a permanent head of IT for the hospital, which means his interim appointment will end soon. Clarke will help the new incumbent bed in, however. He also expects to continue in interim positions when he leaves Moorfields this year. 

His move to the interim side of technology management came two years ago when he left finance specialist Abbey Protection Group after almost 12 years as IT director. Insurance giant Markel bought Abbey in early 2014 and Clarke decided to explore the market and try new opportunities.   

After spending a few months away from work with his children, Clarke analysed his skills and realised he had developed expertise in transformation after helping support Abbey’s ambitious growth plans. He entered the interim market and realised he could use his skills to help organisations change. After a period of consulting for other clients, Clarke joined Moorfields in early 2015. 

“Helping the organisation in its IT-led business transition was what excited me,” he says. “The role has allowed me to try new things in a different sector and a very different type of business. Taking on a role like this helps you to reassess what drives you and you realise the work you do as IT leader can actually make a difference to people’s lives.” 

New challenge 

However, Clarke recognises that he was not expecting change to come easily. He is more than aware of the perception that surrounds public sector organisations. Compared with its nimble private sector counterparts, the NHS is a behemoth with multiple stakeholder interests and a requirement to provide life-saving service to its customers. 

Yet Clarke, despite encountering some challenges, has been pleasantly surprised by the organisation’s appetite for change. “There are a lot of processes in the NHS and the organisation can be risk-averse, which means there is a danger of standing still,” he says. 

“But you really can make a difference and my interim role been hugely enjoyable. I have learnt so much about the public sector and myself as an IT leader. In fact, I’ve enjoyed it so much that I’m now 21 months into my initial six-month contract.” 

Clarke, who reports to trust CIO Elisa Steele, says previous incumbents in Moorfields’ head of IT role delivered what was expected in terms of systems and services, but he was determined to do more. “I didn’t join the trust to simply tick boxes,” he says. 

Right standards

Most crucially, Clarke was keen to establish why certain activities were being undertaken and to place context around decisions that had already been made. “I have questioned some of the things that were occurring and helped move the technology team from a reactive to a proactive organisation,” he says. 

He points, for example, to the use of IT infrastructure library (ITIL) practices. A previous head of technology had introduced ITIL, yet there was no strong understanding of why the service management framework was being used and how it could be applied usefully. 

“I have worked to place some context around ITIL,” says Clarke. “I have used the framework to help demonstrate why we really need strong human expertise in the IT department, rather than simply using automation. I’ve used ITIL to promote the use of lateral thinking within the technology team.” 

The main benefit is that the use of ITIL within the organisation now has meaning, he says. “The IT department has bought into the theory. I guess I’ve been purposefully disruptive, but there’s been no push back. People have been really receptive – they want to do the right thing.” 

Key priorities 

With the right foundations in place, Clarke says the technology team can now act in a more progressive way. For example, IT professionals in the organisation aim for continual improvement, and the careful adoption of ITIL has promoted a particular stance on leadership within the organisation. 

“The whole approach has been about educating the IT team so that they recognise that their work is a fundamental part of the wider business outcomes Moorfields aims to achieve,” he says. “It’s really been a leadership epiphany – everyone knows how to react when issues occur and new challenges arise.” 

“It’s really been a leadership epiphany – everyone knows how to react when issues occur and new challenges arise”

Toby Clarke, Moorfields Eye Hospital NHS Foundation Trust

Clarke says his work on underlying standards has also allowed him to address other core concerns. The team has also built a more efficient IT environment. “We are re-using kit, rather than just buying more hardware,” he says. 

The building of stronger relationships with managed service providers has been a crucial element of his success. Clarke has used this partnership arrangement to assess the hospital’s disaster recovery (DR) processes. The result is the creation of a separate network for the DR site. Clarke has also outsourced the hospital’s local area network, which has helped to reduce costs. 

Internally, the IT team has focused on support concerns, and a new ITIL-based service desk has been launched. The portal-based approach promotes self-service for certain support issues. “It has helped us to up the game,” says Clarke. 

Business challenges 

While Clarke praises the adaptive nature of his team, he also recognises that change creates significant cultural concerns. The people challenge is always the priority issue for any IT leader who looks to push a technology-led transformation agenda, he says. 

“The average length of tenure for an IT professional in our department is about 10 years,” says Clarke. “The way of working in a public sector organisation is very different from most private sector businesses. As someone coming from the outside, it took me a while to accept that difference.” 

The key to success is to get people intrigued and interested, says Clarke. “Our IT team buys into the change process. They want to be more involved in the work the business undertakes and they want to develop their skills base.” 

Clarke has introduced a mentoring scheme to push development. He provides continual feedback to team members and encourages strong collaboration across the different project areas of the IT department. 

“I like seeing people enjoy what they do,” he says. “There’s a lesson for me, too – IT leaders need to understand that everyone in the organisation has experience, but also carries baggage. As a technology executive, you have to learn to adapt your management style to the people you inherit.” 

Lessons learnt 

Looking back on his time at Moorfields, Clarke suggests strong progress has been made. Standards have been set and workers in the IT department are now engaged with the rest of the organisation on a range of key initiatives. The foundations have been laid for new projects through 2017 and beyond. 

Important projects are likely to focus on storage management and data retention, says Clarke. He also expects the hospital to start paying more attention to the cloud. As regards his own development, Clarke says the interim post has provided great experiences. 

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“I’ve learnt that I’m an adaptable executive,” he says. “The leadership skills you gain in one sector really are transferable. In many ways, the technology and processes you encounter as a CIO are always the same. To be successful, you must learn how to apply your knowledge in different ways in specific business contexts.

“I’ve really enjoyed being an interim IT leader. Yes, you can find more frustrations that you might in a permanent position. However, the opportunity to help drive changes makes you commit to the cause.” 

Future of the CIO role 

Clarke reflects on the nature of the IT leadership position and suggests there will continue to be big differences between technology decision making in the public and private sectors. Access to project funding is one key distinction. 

“Money is tight in the public sector and you need to have a sound reason behind every decision you make,” he says. “However, that also provides a good learning curve – it forces you to re-evaluate projects on a cost and value basis.” 

Clarke says great IT leaders in the digital age will need to act like brokers who bring together disparate stakeholders and partners. Technology executives must understand a broad church of business factors and show how IT can make a significant difference. 

“The CIO continues to be an evolving role,” he says. “There are a lot of frustrations associated with working in IT in the public sector. However, I believe the public sector needs more executives with private sector experience in order to be disruptive and make a difference. 

“There is a lot of talk about innovation in various guises. I think the great IT leaders harness that creativity and find ways to use it to help their organisations transform. In the public sector, that is often going to be about re-using what you’ve already got in a better and more productive way.”

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