Perhaps unsurprisingly for a man tasked with managing millions of pieces of data, Andy Williams has a strong head for numbers.
The chief executive of the Health and Social Care Information Centre has a master’s degree in mathematics from Cambridge University, which he says was driven by a childhood affinity for the subject.
While his memory of specific formulas is somewhat foggy, Williams says the broader lessons he learned from his degree are still very much relevant to his everyday work.
“One of the nice things about mathematics is that it teaches you to think about things analytically. You try to find elegant solutions to difficult problems rather than just bumbling in, which can be invaluable in this role.”
Tracking the internet in banking and comms
After finishing his studies, Williams moved into the IT sector, where he has worked for more than 30 years.
“I’ve been in IT, and worked for IT, ever since I graduated, but until I arrived [at the HSCIC] I’d never worked in the public sector – I’d always been in private sector firms.”
Williams first started work at IBM, where he eventually became responsible for the company’s internet banking and insurance industry contracts in Europe.
He describes the experience as an eye-opener, working alongside colleagues who were “wrestling” with the creation of the Internet and what it would mean for them as a company.
After 25 years at IBM, he moved to global telecommunications company Alcatel-Lucent, where he set up a managed services organisation that grew into a €2 billion business in three years by winning mobile network contracts for providers such as BT and Telecom New Zealand.
In 2010, he moved to CSC where he held a number of titles, including president of Northern Europe business operations.
Williams says a driving principle behind his work on the delivery of “huge, complex” IT programmes, particularly working with the public sector, has been a focus on the financial benefits of improving the use of technology.
“An important thing to say is that I’m not into technology for technology’s sake – I’m more interested in how technology can bring a business benefit and help you do something that you couldn’t do before.”
Moving into government
When the HSCIC came calling in early 2014, Williams was somewhat ambivalent about moving into the public realm. “My first thought was that I’d never worked in government, so why on earth would I start now? But there were also a big set of positives that came with the offer.”
Chief among those, he says, was the opportunity to make “the next step change” in the use of technology and information in healthcare.
“I saw it as an opportunity to make use of all the things I’ve learned over the last 30 years of my professional life: implementing large-scale IT change, governance and how you make the programmes better.”
Williams says the healthcare industry is “probably the least penetrated by modern data and information”, contrasting the difficulty in arranging a medical appointment with the ease of purchasing a flight from an airline.
“It’s as if you tried to make a booking on an EasyJet flight to Barcelona, but instead of being able to get on your PC or your smartphone you had to ring them up and have them send you a letter one week later, saying they’d booked you on a 3.30pm flight without knowing whether you can make it.
“They’d probably send you to Warsaw by mistake as well.” All in all, Williams describes the current use of information technology for patients as “not what I would call 21st century”.
However, he offers some surprising support for the often-maligned National Programme for IT, praising its set of “laudable aims” and suggesting it may have received a raw deal in some quarters.
“It’s got some bad press, and I think it’s got a worse press than it deserves, because it’s laid some building blocks for us that are very relevant. We’re not starting from scratch – we just need to develop the next generation starting from those building blocks.”
Finding a role
The HSCIC was established in April 2013 under the Health and Social Care Act as a merger of several organisations, most importantly the NHS Information Centre and NHS Connecting for Health, which was responsible for delivering NPfIT.
Williams describes the HSCIC’s role as four-fold. The first is collecting, analysing and disseminating information about health and social care; the second is operating the existing national health and social care systems; the third is developing the next-generation versions of those systems; and the fourth is setting the standards for the use of IT and data.
He acknowledges that some of the finer details in the relationship between the HSCIC and NHS England are still being worked out, with some “misunderstandings” amongst public about the division of responsibilities between the two organisations.
“This system has only been in operation for 18 months or so, and you still get some overlaps and confusion, but we are working those through. The governance arrangements that exist are starting to work and are now a key part of that and we are certainly in the right direction.”
While the HSCIC has been tasked with most of the implementation and operations capabilities for major informatics projects, Williams says it always works in tandem with the organisations affected by its work.
“If it’s a project for NHS England, then the oversight role is with them. If it’s for someone else, it’s with that someone else. And if it’s something across organisations like the Spine, then it would be either the HSCIC or the Department of Health.”
In addition, he says the organisation is not intending to replace the informatics knowhow that other health and care providers already possess.
“There are 2,300 people that sit in HSCIC, but there are a lot of informatics professionals in all sorts of organisations around the system, not least hospital trusts and social care organisations, and it’s not our job to replace all of them.
“Our job is to build and operate national systems, and design and implement standards so organisations can build systems that conform to those standards for interoperability. But it’s not our job to build systems for hospital trusts.”
Clarity about strategy
Williams says the impending release of the National Information Board’s informatics strategy will clear up a number of questions regarding the HSCIC’s role, as well as the direction of healthcare informatics in general.
The National Information Board is comprised of representatives from a number of health organisations including the Department of Health, NHS England and the HSCIC.
He says the first draft of the strategy will be published “very shortly”, setting out a high-level agenda for the system, of which the HSCIC will then implement a significant amount.
Williams says the release of the final strategy will “undoubtedly mean some changes” to the structure of the HSCIC, but he is reluctant to elaborate further while the strategy is still in draft form.
He says the strategy will also “say a lot” about access to personal health records, including what systems must be put in place for them to be successful.
“I think over time, some of that will be done through national systems, some of it will be done locally, and our job is to make sure the national systems are developed, and that the local systems are enabled.
“If you think about how to make the health and social care system more accessible to patients digitally, a lot of it is about how do I make appointments, how do I know where I am, do I have access to a personal health record, and how do I find out the information that’s relevant to my care.
“The NIB strategy is about how do we bring that information together and make the most of it.”
Sorting out care.data
The controversial care.data programme is another issue on Williams’ plate. The project to expand the Hospital Episode Statistics, link them to new datasets, and then release the information to researchers and others was paused in the spring, after an outcry over who would get the data and the opt-out arrangements.
Despite this, Williams says work on the programme is “progressing well”, with new pathfinder CCGs due to be named in late October, and their work to start in November.
“We’ve got our house in order much more around care.data and it is progressing well. I think we’ve answered a lot of the concerns that have been expressed, particularly around consent, and the purpose of the pathfinders phase is to confirm whether or not that’s the case.”
However, Williams is conscious that there is much more work to be done to gain the trust of patients to ensure that their data can be put to the best use possible.
“It is undoubtedly true that we can manage the health and social care system much better by using the data that care.data can provide, we can deliver much better personalised care and health outcomes, but we can only do that if we have the trust of the patients.
“Although where care.data is concerned, we’re much clearer about the consent model, there is a broader question about consent for all of those types of data. We recognise how important that is, and I am confident that we are on a path to resolving it.”
Andy Williams will be one of the keynote speakers at EHI Live 2014, where other keynote speakers include Tim Kelsey, the director of patients and information at NHS England, and Dr Ranj, the popular presenter of ‘Get Well Soon’ and a fan of social media in health.
A full list of the keynote speakers, co-located conferences, feature areas and exhibitors at this year’s EHI Live is available on its website. Registration is free for all and open now.