Katie Davis will be the last person to single-handedly lead NHS IT at the Department of Health when she leaves Richmond House at the end of August.
Although it has gone through many name changes, her role can be traced back to Richard Granger, the director general of NHS IT appointed to lead the National Programme for IT in the NHS back in 2002.
But once Davis leaves, responsibility for NHS IT will be split between the DH, the NHS Commissioning Board and the Health and Social Care Information Centre.
Unlike some of her predecessors, Davis is quietly spoken and projects calm competence. It’s difficult to imagine her giving senior staff members a public dressing down or threatening to get medieval with a supplier.
Her lasting legacy may be to help make NHS information infrastructure boringly reliable; which will be no mean feat.
It needs to provide the underpinning foundations on which the more eye-catching, patient-first initiatives expected from the new NHS information leaders can be built.
In an exclusive interview with eHealth Insider, Davis says that her proudest achievements have been to maintain the essential NHS information infrastructure and ensure its continued availability, in a period of intense change and reform.
“We’ve just had the Olympics and we managed the huge extra demands placed on the NHS network,” she says. “The way we planned for that and ensured the network coped with the extra demand is something to be proud about.”
Davis also takes pride in tackling the “malaise” that had hung over NHS IT, to the point where NHS leaders are excited by the possibilities of information initiatives and want to be part of them again.
Wiping the slate clean
Davis arrived at the Department of Health from the Cabinet Office in July last year, following the departure of Christine Connelly.
Connelly succeeded Granger and a number of short-term appointees, and set about tackling some of the problems of the national programme; focusing on clinical 5 functionality to engage clinicians and a ‘connect all’ approach to building clinical systems.
Despite this, Davis – who has styled herself managing director of NHS Informatics – inherited a good deal of unfinished programme business; not least the endlessly protracted negotiations with CSC over a new local service provider deal for the North, Midlands and East.
She also found herself engaged with a coalition government determined to both reform the NHS and give it a quite different kind of information strategy.
‘The Power of Information’, which emerged this spring, is focused on delivering information to researchers, managers, clinicians and patients; but not so much on the detail of the funding, organisations or systems needed to do that.
“There have clearly been problems on delivery and leadership in the past and one of the things I wanted to achieve was to clean the slate,” Davis says now.
A big part of cleaning the slate, she adds, was to “get NHS Connecting for Health out of the silo approach it had developed.”
Increasingly, interoperability matters because health is crossing traditional boundaries of care. “In the new health and social care system, we needed an integrated approach to information.”
She adds that the concept of interoperability runs throughout the information strategy, and is beginning to be seen on the ground. “We’re starting to see trusts and suppliers working together to join things up.”
Creating a vibrant market
The revival of a vibrant market – one that supports innovation – is another key development that Davis has sought to foster, championing market transparency initiatives with Intellect and EHI.
“I’ve seen more innovation and enthusiasm for innovation in the past 12 months than I have done in several years,” says Davis, who has been chair of the judging panel for the EHI Awards for the past two years.
The aim must be to create a truly open marketplace, one that actively encourages smaller players and start-ups.
“For real innovation, and to create a vibrant healthcare marketplace, you don’t just need big organisations; you absolutely must have the smaller organisations, too,” she says.
“I hope what we have demonstrated is that there is a great opportunity and that we won’t do top down anymore except where it’s really needed.”
Davis stresses: “The focus on value for money helps shift the focus to innovation, because small suppliers are the key to innovation.”
National infrastructure needs to be designed to support this new environment. For example, Davis says Spine 2 enables smaller suppliers to use spine services – most likely through intermediaries.
And the NHS needs to do more to spread knowledge about implementations and evidence relating to clinical and business benefits.
“We should be making sure that every NHS programme is publishing costs and benefits information on an open basis,” Davis argues, adding that the NHS CB is certain to have a “strong focus on value for money” as it looks beyond the ‘Nicholson challenge’ to further funding constraints ahead.
She expects the Leeds-based organisation to have some pretty strong views about open source and open data, as well. “They will both be an important part of the agenda moving forward.”
Three way split
The three way split between the DH, NHS CB, and ‘new’ HSCIC has raised eyebrows and concerns. In theory, the DH will do IT and information policy, the NHS CB will focus on strategy and on commissioning infrastructure, standards and information, while the ‘new’ HSCIC will deliver and monitor them.
Veteran EHI readers may at this point feel a tingle of déjà vu, with the split evoking memories of the old Information Strategy Unit and NHS Information Authority. This time will, of course, be different.
Davis is certainly happy for others to take over. “I’ve done the things I wanted to achieve, I have to let the new leaders lead,” she says, adding that knowing she is going, to spend more time with her family, has proved liberating.
She also argues that the new organisations and their leadership teams have been very carefully set up to give the new NHS information strategy the best possible chance of success.
For instance, she describes the decision to separate information strategy and information and products service delivery as a key split that will make sure the NHS CB can have a very clear focus on patients.
And she describes the ‘new’ HSCIC as “a best of breed delivery organisation”, focused on delivery of CfH products, services and – of course – information.
Davis says the new leadership at the three bodies understands that the patient-centred NHS being willed into existence will not be possible without national information infrastructure and services.
“I’m pleased that Tim Kelsey [the NHS CB’s head of patient engagement and information] is the first to recognise that without infrastructure you couldn’t share information. Its vital role is absolutely recognised by the new leadership team.”
Davis says the important future leaders are now in place: Charlie Massey at the DH: Tim Kelsey at the NHS CB: Tim Straughan at the HSCIC: and, until April 2013, Tim Donohoe running the rump of CfH.
“The only problem with the new set-up is that there are too many Tims,” she jokes.
One big item on her desk that may not be resolved by the end of August is the perennial contract renegotiation with CSC, even though the latest ‘standstill’ agreement between the DH and the company runs out on 31 August.
Davis declines to offer any comment on whether a new design will be signed before her leaving party. “You know I can’t say anything”, she says, echoing a line that she has delivered consistently throughout her year in post.
Davis signs off without regret. She is looking forward to putting a lot more time into being a mum. Asked for a final word she praises the hard work of her “magnificent team”, working in the DH Informatics Directorate and CfH.