From private sector board member to NHS CIO

Making the transition from private to public sector has so far been a fascinating experience. I have been in position as CIO of the Yorkshire and Humber Commissioning Support Unit (YHCSU) for 12 weeks. My motives for considering and accepting this role were initially, and primarily, based on sentiment, after two of my children were saved by Sheffield Children's Hospital many years ago, with a self-made promise that at some time in my career I would like to take a role to "make a difference and give something back".

Years later, my career having progressed in to CIO leadership, I was headhunted in November 2013 to consider this new position. The letters "NHS" were the one thing that would catch my attention and consider a move away from a role that was very rewarding while leading technology transformation in an aggressively growing company like Plusnet. I started at the YHCSU in April 2014.

The Yorkshire and Humber Commissioning Support Unit (YHCSU) covers 16,000 square KMs in geography and has responsibility for a population of circa six million supporting 23 Clinical Commissioning Groups (CCGs). NHS England is undergoing massive transformation as an organisation. Simon Stevens has recently been appointed as the new CEO. In a difficult global economy, and austerity within the UK economy, a national health public service has its challenges with an annual budget of circa £120 billion which has remained flat in real terms while simultaneously having to absorb and accommodate an increase in demand; in short treating a greater number of patients in a growing population (birth rates and immigration) where people live longer and suffer from many different types of physical and mental illnesses.

As the NHS implements its reform commercialisation is high on the agenda; increase the quality of services whilst lowering prices through competition. Primary Care Trusts were previously responsible for both commissioning and providing services across all NHS entities. PCTs were consolidated and replaced by CCGs to commission and CSUs to provision. In April 2013 when CCGs and CSUs were formally created to replace PCTs there were around 100 CSUs attempting to formalise.

Some 25 were created as entities in April 2013 and since then there has been further consolidation through merger or alliance down to nine CSUs. CSU consolidation is representative of competition as CSU organisations look to strategically place themselves in positions of strength to provide services as demanded and needed by CCGs. Equally a CSU is not limited to providing services solely to its natural geographic region. The marketplace for a CSU is nationwide; a CSU can compete against other CSUs and tender for the provision of services anywhere outside of its natural habitat. A CSU has the freedom to specialise in particular service lines, or broadly provide all services. CCGs have the freedom to commission service lines for all of the entities that they are regionally responsible for (GP surgeries, hospitals, day and community centres, mental health etc) from any CSU, or indeed any private sector service provider, based on best value for money, or strategic relationships.

For a CSU to survive and flourish, the result is clear demand on leadership experienced in both the NHS with critical injections of commercial acumen from the private sector. The same is true for the demand on CIO leadership within a CSU. Incidentally understanding of a modern CIO role – disruptive, innovative technology leadership experienced with commercial acumen and business growth - within the NHS is limited. There are exceptions however. My own transition in to the CSU from the board of Plusnet is testament to the leadership of the CSU who sought headhunter assistance to recruit such a CIO.

I plan to share elements of my journey as I "make that difference" through technology leadership with commercial expertise, digitisation, transformation with Big Data in the field of BI, and innovation across technology, all of which will ultimately improve patient care, and assist the government's agenda.

I also aim to provide insight in to my experience with a view to in many ways break down any barriers that restrict talent flow from private to public sector and indeed in reverse. For now I will share with you some of the more salient observations.

During transition I have been struck by the commitment of leadership and workforce within the CSU and within the CCGs. Motivation theory is a fascinating topic and it is one I enjoyed studying within organisational behaviour as I completed an executive MBA. On the whole those who I have met are genuinely motivated to make a difference and go above and beyond for that reason. There are no financial incentives such as bonuses. As I reflect on my own motives for moving I can understand. For the time that I am within the NHS my desire is to be positively disruptive with my own leadership across technology innovation and business growth to ultimately improve patient care.

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