Weeknotes s01e04

Posted by: Chris Witham - Posted on:

TL:DR; Making connections and meaning, heartbreak and hope.

[week ending: 29/01/2021]

The good

This week has been a week of building connections. In practice, this has meant a lot of video calls and converastions, and times of feeling like I’m not ‘busy doing things’. However, as we move forward with the aspirations of The Longterm Plan, there is more need than ever for our people, systems and services to be interconnected and interoperable.

Vaccinations really do seem to be bringing the very best out of the NHS. I’m proud Gloucestershire are not only leading the way with the percentage of target groups vaccinated, but the way organisations are collaborating and supporting one another.

I’ve had a number of conversations this week about how we bring together two national Covid response projects and exchange data in a secure way. Important work but challenging timescales. I’ve met a lot of new people and everyone is really keen to be supportive and helpful. Throughout this work, I’m onboarding more of our teams with our text message and information update service that I’ve developed on top of the GOV.UK Notify common component. This is an excellent tool and really worth looking at if you’re building services that need to contact people. We’re seeing around a 60% response rate within the first hour of sending out a text message which is giving our teams some excellent data to plan with and action quickly.

Another service that (I think) makes excellent use of Notify is NHS Digital’s new Find Your NHS Number service. So simple and useful on the surface, so incredibly complicated behind the scenes I’m sure. Another example of doing the hard work to make things simple. Tony Yates has also written a great article on why this is even better than it first appears.

As Lead Governor, I joined my first ICS* NED and Lay Member Network (*Integrated Care System, Non Executive Director) meeting this week. It is certainly an exciting time for the development of ICSs and whilst we rightfully spent time focussing on policy and how we want to see ICSs developed in future, we had good discussions about how we move towards the right impact and outcomes for our citizens. I’m really looking forward to doing more work developing principles and standards for how our organisations will work together. First on the agenda for me is developing a shared understanding of what we mean by IT and Digital, how they are different and why both are important.

At Gloucestershire Health and Care Trust, we had our first Governor Engagment Committee this week. The pandemic has halted many of the usual ways governors would engage with communities and and services. So we’re thinking creatively about how we can create more opportunities and connections. I’m particularly keen that we make it easier for people to understand the structure of the NHS, how the different bits fit together and how people can be more engaged in their health and care provision. This will be key as we start to explain the benefits of the work we’re doing as an ICS.

I’ve been thinking more about inclusive recruitment this week too. After over 25 years of loyal service, our Town Clerk is retiring so I’ve been updating the job description and thinking about how we’re going to expand our (Cinderford Town Council) workforce over the coming year. Whilst there are qualifications for Town Clerks, in a rural community like ours, I think there is a good opportunity to create a training opportunity for someone with the right attitude and desire to develop.

I finished switching our network and devices over to NextDNS this week and in doing so freed up a Raspberry Pi that previously ran PiHole. I’ve enjoyed having a bit of a play with the Pi and remembering how to use Docker. I’m now rocking a pretty cool dashboard from TeslaMate which is pulling data from my car via the Tesla API, albeit a little bit redundant at the moment as I’ve only driven three times so far this year! I was also keen to try out WikiJS after a recommendation from Marcus on the Health CIO Network. I don’t particularly have a need for a new Wiki tool currently, but I’m always keen to see what new Open Source software is developing and what technologies people are using. A few teething problems on the Pi to work through, but I got it running in Docker for Mac and it looks pretty neat. If we’re going to have interoperable, highly connected teams working across organisational boundaries, tools like this could be really helpful. It’s ok thinking the whole of the NHS is now on Office365 (albeit that still presents challenges), but we need to think about CARE and the wider system.

Sun rise over the River Severn with a snow covered field in the foreground.
Views that are worth getting out of bed for. 18 miles walked this week.

The bad

This week, here in the UK, we passed the tragic milestone of 100,000 Covid deaths. 100,000 families missing someone. Millions of people greiving. Words fail me, so I’ll link to this Thought for the Day from Justin Welby.

We’ve also been sorting out a headstone for Nigel who died one year ago on Sunday. More sadness and heartache trying to find the right words to have engraved and publicly displayed for centuries to come. On a positive note, this sparked a really healthy family discussion about death, funerals and arrangements. Who wants to be burried, cremated, donated to science? What will funeral services look and sound like. Conversations that you can’t have when you need to, better to have them now. If you don’t feel you can talk about it now, maybe consider leaving some notes in your will. Nigel left details in his will of the songs and a poem he wanted at his funeral, and we found a note about how he despised dead flowers as we sorted through his things. It certainly made the choice of a vase or not on the headstone a lot easier! If you want to help other people talk about death, the Church of England have some great resources, Grave Talk.

The ugly

Cannot order medication until 13 Mar 21. A message in the NHS app.
Message in the NHS app.

I got myself in a bit of a panic this week. I overthought a situation and didn’t take time to read messages carefully. I tried to order my repeat prescription through the NHS App (so convenient) but got a message to say “Cannot order medication until 13 Mar 21”. I saw this and knowing I’d run out, frantically tried to sort it out. I told the pharmacy about the message and they said I’d need to speak to my GP about a different drug. The GP receptionist said I needed to try a different pharmacy first. That pharacy said they had it in stock, but needed me to call the first pharmacy and ask them to release my prescription back on to Spine so they could then pull it down and issue it. When I rang the first pharmacy again and asked about Spine, they checked and had actually already prepared my prescription and it was ready for collection.

With my techy head on, I clearly thought that this all singing all dancing system would definitely be linked to my pharmacy and have pulled the message back from them to say they were unable to order it. A dangerous Google of the drug name suggested that there was also a global shortage due to Covid and further confirmed my fears.

Thankfully, a very helpful user researcher in NHS Digital was keen to listen to my feedback and explained that there isn’t currently a direct connection from pharmacies to the NHS app (another interoperability puzzle!). Knowing this, I then more calmly re-read the message and understood that it is really telling me several things:

  • How many there are and when to take them
  • When I last had the prescription issued, not when I made the request as I assumed
  • That I now can’t order it again until mid March, because I have just ordered it, not because it is out of stock
  • That the status of this order is issued, it has been sent to the pharmacy and they will be sorting it – I totally didn’t read this the first time.

I love reflecting and thinking through puzzles like this. Especially when I can so obviously see the user’s point of view. I’m very grateful for the NHS App team listening to my feedback. Hopefully sharing this story illustrates the importance of testing our systems with real data, with real people, in real situations.

Notable conversations

A week of notable conversations, many I’ve already talked about but here’s a few more:

  • I talked to a GHC colleague about digital training. How the trust has moved induction online, what works well for managing learning and how we need to support people who don’t sit at a computer all day and aren’t used to using technology.
  • I’ve had more brilliant conversations with one of our regional teams. I’ve learnt a lot about local regional passports and how these are helping with the vaccination workforce. Some good learning to share in our own ICS. We also had conversations about our Open Source NHS WordPress theme and how they could use it locally.

Things I’m reading and watching

  • MIB International – never caught it at the cinema, fun predictable, entertaining.
  • Dr Gurkaran Singh Samra’s ‘My Digital Unacademy‘ – a brilliantly thought out and well researched treasure trove of resources for anyone wanting to develop into a senior digital role within health and care.
  • Emotional Agility – Slow going this week but thinking through comfort vs challenge and how I can be whelmed. I think prior to the pandemic, I was getting rather comfortable and moving into a consciously competent state. The last year has brought a whole raft of new challenges and I want to think more about how I create the right balance of comfort and challenge so I keep developing.

I’ve really valued all the conversations I’ve had this week and the things people have taught me or signposted me towards or helped me think. If you’ve got any thoughts or feedback on any of my week, please leave a comment below or reach out on Twitter. Also, it’s worth reading Andy Callow’s demonstration on the importance and benefit of conversations.

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