Seeing a beautiful day – Working in the NHS

Are you an IT professional that wants to make a difference to peoples  lives? I mean a real difference, not just making them more efficient,  cooler or anything like that, but safer, helping them live longer,  better and more fulfilled lives? Not everyone gets to see a beautiful day in the same way that you may.

I just read the excellent post by Chris Casey on why would anyone want to work in healthcare, particularly in the IT profession; I couldn’t agree more on what a great time it is to work in healthcare IT.

Over the past 14 years of working in this profession I can say I have  seen many things,  I have worked in most settings – Acute, Primary  Care, Urgent and Emergency. Here is my summary of thoughts:

Staff

The staff in the NHS work so hard it is unbelievable, the hours  people work are insane, often unpaid overtime and they do it because  they believe and actually do make a difference to the lives of other  individuals.

The IT staff are the same, they tend to be more risk averse than in the private sectors (check out The Facebook Release Process),  but that is what we all expect, they can’t simple A/B test a new  process or technology and chose the one that kills the least people.  Everything must be scrutinised and checked before release and  deployment. There is a reason NASA take years to send a manned shuttle  up and beyond the earths atmosphere carrying 4 people, we expect the  same caution and so we should, to those 4 people, it really matters.

In terms of technical skills, I have worked with some great people, I  have also had the privilege of working with some truly awesome and  outstanding people, who have that deep technical knowledge, a real  understanding of making things work across many settings and domains and  the impact it has. These people are usually the ones who are  comfortable with heterogeneous environments and it doesn’t phase them  one bit, they bring process, discipline, continuous integration and  continuous personal development to the mix, they really understand the  problem, they never stand still, they never stop learning, these people  are inspirational to me, I try my hardest to be one of those people.

Patients

The people that really matter, we can make such a difference to these  people, they are our family, our friends, and if not ours then they are  someones. I know that from the work I have done this past few years,  that when people ring NHS 111 and need an ambulance they get one faster  than they ever have done before with the exception of calling 999, I am  privileged to say the work I have done has saved lives, I am proud of  the many other talented and hard working people who have been part of  the team I have led in this space. See you really can save lives with  IT, it is not fiction.

Technology

Has a reputation for being old,  slow,  getting in the way and  costing too much. This may all be true, the NHS is still reliant on  Windows XP in many areas, bound to IE 7 and has integration issues  across organisational boundaries. It sounds grim, but I assure you it  isn’t, it is exciting times ahead, watch this talk if you don’t believe me.

The NHS has to maintain a level of stability, technology can’t be  introduced for the sake of introducing it, it must offer actual  measurable benefits. Now though, with many of the technologies coming to  the end of their supported shelf life we are in a position of change at  a time when the NHS and government as a whole is looking at  alternatives to the de-facto Microsoft stack and embracing open source.  For example Spine 2 is built on the Basho Riak DB, an amazing piece of cutting edge technology. Fancy a play with it? Spin up a cluster on your own machine and learn by doing. Here is a screenshot of my converged lab that took minutes to setup:

Personally

Over the last couple of years I have led the development of  integrating NHS 111 with other services across the country, in true any  to any connect all ways that makes it a develop once and deploy many  environment. It’s an urgent care infrastructure that is semantic in  nature, secure, robust and reduces the cost of change substantially.

I have used git/bitbucket to manage and collaborate with software vendors in a true open source culture, something HSCIC have now adopted for many other things.

I co-built QDOS for the Department of Health in my own time, an innovation using  software that automated a costly manual processes of assuring a  populated clinical directory of services or usage with NHS Pathways.   It saved so much time and money and drove quality up it was  unbelievable and led to HSCIC building an in house version, it makes me insanely proud.

So 14 years later in healthcare IT, I  can say I more excited, more motivated, more capable and working with  more opportunity to make a difference than ever before. If you look for  the negatives you will undoubtably find bad things, these may just be  the things you could improve?