UCLH CIO James Thomas on negotiating regulatory scrutiny

See also: UCLH CIO James Thomas on unified communications UCLH CIO James Thomas on supplier management

The University College London Hospital (UCLH) is one of the most complex healthcare organisations in the city and is continuously called upon to bear the brunt of emergencies.

It’s CIO James Thomas’s job to ensure the systems that support the hospital are up to the job. Like the rest of the NHS, the hospital is highly regulated and scrutinised in terms of quality of care and expenditure.

One part of Thomas’s initiatives to fulfill those requirements has been to develop a ground-breaking unified communications network that links the hospitals many buildings.

With seven separate sites including the historic Georgian buildings facing the trust’s busy Maple House office, providing a seamless technology experience is a challenge for Thomas, his team and suppliers.

“Some buildings are less than four years old, others are over 120 years old, but the standard of care has to be the same. The challenge for me is to put the infrastructure in and deliver it to the same standard. For example surgeons are using our networks to provide them withX-rays, CT and MRI scans. A&E has 100,000 people go through its doors every year and it has to achieve the government target of a maximum wait of four hours.”

All this places great pressure on Thomas­ to ensure resources are injected into the right areas of the IT operations.

Two years ago he moved the UCLH datacentre out of a 120-year-old building, but before securing the capital, he had to carry out an analy­sis to prove the investment was necessary.

“We calculated that a seven-day datacentre failure would cost around £12m. Some of the equipment in the old data­centre was so old too.”

He now uses a ­datacentre in Docklands. “You really have to balance up the case of damaging ­patient care compared to damage from not doing enough. And we [the NHS] live in a world of a lot of people making sure we are compliant and on target.”

This has made Thomas reflect on his IT leadership experience and he sees the role of the CIO in a different light. “CIOs are not necessarily aware of the pain it causes the organisation. Clinical risk is something really powerful to consider,” he says.

“My role is trust-wide, the scope of it is all IT services; clinical and non-clinical; also telecommunications and patient entertainment. I am also responsible for all the paper medical records. I picked up the pain of the paper world as it will promote me to move it to electronic,” Thomas says of his role.

Creating value Thomas is keen to use technology to create value for the NHS. UCLH has been using business process management tools to analyse the difference between ­patients who make a single use of the hospital and those who return for regular treatment.

UCLH hopes that the tools will enable them to “optimise the journeys through the hospital care these patients have”.

With a shift to managed services and by providing analytical support to the trust, the IT department has changed.

“We provide technical assurance and a programme office for the transformational agenda at UCLH. The operational world is commodity stuff, so let the experts manage that.”

Thomas has an IT budget of between £12m and £14m to cover IT, records management, telecommunications, governance, security and transformation.

NHS IT is keenly watched, so Thomas and the trust’s information governance team have written a five-year vision of what UCLH wants to do with IT.

“It is based on a set of scenarios for ­patients and nurses. We got sign-off for it and then we went away and worked out what that means as a roadmap for technology,” he says.

Thomas and UCLH certainly like to do things in their own fashion. As a result the hospital never became a wholesale part of the National Programme for IT founded by then NHS CIO Richard Granger.

“When I saw the National Programme I thought it was ill-conceived from the start,” says Thomas. “It asked people who had been in the NHS for 10 to 15 years what the future would be, and to create a system for the entire nation. You’d never do that in any other organisation.”

He does back some parts of the project. “At a national level the spine is a great concept and mental health has done well, they were the poor relative and at least they can now share resources,” he says.

Making a difference Thomas entered the NHS after a personal encounter involving the health of one of his children – their pictures adorn his office alongside his pair of classic Mini Coopers. His son is fine now, but the regular contact with the NHS made Thomas realise it was an organisation that could really extract the benefits the IT offers organisations.

“I had been with Oracle and in IT leadership with utilities and oil firms as customer, supplier and back to customer. My world was about bonuses and all that and I wanted to do something to contribute.”

Although his six-year stint at UCLH has seen him implement major changes and strike deals that have reshaped perceptions of how the NHS can work with vendors, Thomas shows no sign of losing his public service ethos. One of his greatest pleasures is the high perception of UCLH among staff and patients alike.

“A lot of junior doctors come here for training and experience. When they leave, in the exit survey we as a hospital always get positive feedback,” he says.