Seeing a beautiful day – Working in the NHS

Coast Line in Anglsey

Coast Line in Anglsey

Are you an IT professional that wants to make a difference to peoples lives? I mean a real difference, not just making them more efficient, cooler or anything like that, but safer, helping them live longer, better and more fulfilled lives? Not everyone gets to see a beautiful day in the same way that you may.

I just read the excellent post by Chris Casey on why would anyone want to work in healthcare, particularly in the IT profession; I couldn’t agree more on what a great time it is to work in healthcare IT.

Over the past 14 years of working in this profession I can say I have seen many things,  I have worked in most settings – Acute, Primary Care, Urgent and Emergency. Here is my summary of thoughts:


The staff in the NHS work so hard it is unbelievable, the hours people work are insane, often unpaid overtime and they do it because they believe and actually do make a difference to the lives of other individuals.

The IT staff are the same, they tend to be more risk averse than in the private sectors (check out The Facebook Release Process), but that is what we all expect, they can’t simple A/B test a new process or technology and chose the one that kills the least people. Everything must be scrutinised and checked before release and deployment. There is a reason NASA take years to send a manned shuttle up and beyond the earths atmosphere carrying 4 people, we expect the same caution and so we should, to those 4 people, it really matters.

In terms of technical skills, I have worked with some great people, I have also had the privilege of working with some truly awesome and outstanding people, who have that deep technical knowledge, a real understanding of making things work across many settings and domains and the impact it has. These people are usually the ones who are comfortable with heterogeneous environments and it doesn’t phase them one bit, they bring process, discipline, continuous integration and continuous personal development to the mix, they really understand the problem, they never stand still, they never stop learning, these people are inspirational to me, I try my hardest to be one of those people.


The people that really matter, we can make such a difference to these people, they are our family, our friends, and if not ours then they are someones. I know that from the work I have done this past few years, that when people ring NHS 111 and need an ambulance they get one faster than they ever have done before with the exception of calling 999, I am privileged to say the work I have done has saved lives, I am proud of the many other talented and hard working people who have been part of the team I have led in this space. See you really can save lives with IT, it is not fiction.


Has a reputation for being old,  slow,  getting in the way and costing too much. This may all be true, the NHS is still reliant on Windows XP in many areas, bound to IE 7 and has integration issues across organisational boundaries. It sounds grim, but I assure you it isn’t, it is exciting times ahead, watch this talk if you don’t believe me.

The NHS has to maintain a level of stability, technology can’t be introduced for the sake of introducing it, it must offer actual measurable benefits. Now though, with many of the technologies coming to the end of their supported shelf life we are in a position of change at a time when the NHS and government as a whole is looking at alternatives to the de-facto Microsoft stack and embracing open source. For example Spine 2 is built on the Basho Riak DB, an amazing piece of cutting edge technology. Fancy a play with it? Spin up a cluster on your own machine and learn by doing. Here is a screenshot of my converged lab that took minutes to setup:

Screen Shot 2014-01-09 at 11.15.58


Over the last couple of years I have led the development of integrating NHS 111 with other services across the country, in true any to any connect all ways that makes it a develop once and deploy many environment. It’s an urgent care infrastructure that is semantic in nature, secure, robust and reduces the cost of change substantially.

I have used git/bitbucket to manage and collaborate with software vendors in a true open source culture, something HSCIC have now adopted for many other things.

I co-built QDOS for the Department of Health in my own time, an innovation using software that automated a costly manual processes of assuring a populated clinical directory of services or usage with NHS Pathways.  It saved so much time and money and drove quality up it was unbelievable and led to HSCIC building a more scalable supportable version, it makes me insanely proud.

So 14 years later in healthcare IT, I can say I more excited, more motivated, more capable and working with more opportunity to make a difference than ever before. If you look for the negatives you will undoubtably find bad things, these may just be the things you could improve?

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