A to-do list for the next NHS Director of Transformation

The news broke last week that Tim Ferris, Director of Transformation at NHSE is leaving. I was quite surprised about how relatively quiet the Twitterverse seemed about it, but change fatigue is a forgivable response. The news reminded me of Joe McDonald’s excellent lava lamp analogy to describe the NHS’ constant pattern of reorganisation.

The plans and timeline for appointing Tim’s replacement haven’t been made public yet. Assuming there will be a like-for-like role to step into, the new appointee will have a full in-tray.

Here are six suggestions for what I’d put on the top of their to-do list.

  1. Exemplify the NHS England ambition to adopt a collaborative, servant-leadership posture, and establish what the system will solve at the centre, what it will not, and why. Contrary to what you might hear from some quarters, the NHS doesn't need fewer managers. It needs a different leadership approach, one that strengthens the feedback loop between the system and national teams.
  2. Publish and keep updated a single roadmap for national products and services that describe the relevant team’s future approach, the rationale for any major product decisions (e.g. why particular features have been prioritised above others), and how they relate to each other. That roadmap needs to give systems and suppliers confidence in what’s coming, and what they can rely on.
  3. Stop the Federated Data Platform procurement until there’s a good answer to the questions posed in the very sensible UKFCI paper. Start working in the open so that people can be brought on the journey and be confident about what’s going to happen with their data.
  4. Step into shaping the software market for health. Make this an explicit mission of the transformation directorate, and take a 10-year view. Quietly ditch the EPR convergence mandate, make space for interoperability approaches, and remove the barriers to entry faced by challenger suppliers that are taking iterative, design-led, open standards based approaches.
  5. Do less, better. System digital leaders are bombarded with pots of cash, priority requests, exacerbated by end-of-financial year “spend it or lose it” moments. No cash for “innovation” until organisations have put an end to 10 minute login times. Work with wider NHSE and ministers to agree a smaller set of key priorities, and stop doing other things.
  6. Give the next administration a plan to allow the long term funding of teams, not projects. Prepare this so it’s in the in-tray of the new administration on Day One.

What would you do?

I'd love to hear your ideas.

And for those in the trenches trying to get the work done - keep going.

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