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CNWL’s digital infrastructure for a knowledge service


Industry Voice

Central and North West London NHS Trust benefited from its use of a SIAM approach during the pandemic

Doctor manipulating data on screen

Changes in the thinking behind, and organisation of, digital infrastructure over the past year made a major contribution to how Central and North West London (CNWL) NHS Trust was able to respond to the Covid-19 pandemic.

ICT director Owen Powell outlined the developments at UKAuthority’s recent online Powering Digital Public Services conference, referring to the trust’s evolution from an early focus on mental health to the provision of a range of healthcare services – such as for addictions, eating disorders, learning disabilities and sexual health – to other bodies including prisons and community groups.

He highlighted the transition of his team from a ‘technical’ to a ‘knowledge’ service and its use of a service integration and management (SIAM) approach. Supported by its partner Rackspace, this had begun before the pandemic arose.

It involved the ICT department transforming into a digital services team, with strategic outsourcing of hosting, infrastructure, network services and the service desk, while keeping in-house partners for digital skills, systems development, projects, cyber security and commercial activities.

Underpinning all this has been an in-house integration layer for a range of digital services, including the provision of wide and local area networks, printing, cloud hosting, unified communications and support for mobile phones and other user devices. The appropriate licensing and security is built into all elements of the solution.

This has provided a coherence to the way different elements are deployed that has been crucial to the overall success of the model.

Different components

“Often ICT is seen as a single function, whereas we know there are different components and you have to treat them in different ways,” Powell told the conference.

“There is a commercial aspect to where we outsource or retain in-house when we think there is a strategic value. The integration is key, so our management team is very focused on how we pull all this together to create an integrated service for the organisation.”

In response to a question, he added that the SIAM element has proved to be critical in the organisation’s response to the pandemic. It has provided a senior coordinator to pull together all the internal and external IT services, ensuring everything was fully aligned, and to do so horizontally and vertically.

“We have the in-house knowledge of business processes and external providers who can respond quickly with new bits of technology to help us provide healthcare in a complex environment,” Powell said.

Home working surge

Among the steps it has taken for dealing with the pandemic lockdown is the facilitation of a big increase in the use of Teams and Zoom, supporting 5,000 staff in working remotely – although it has the technical capacity to increase this to 8,000 – and making its Skype telephony fully portable. This was accompanied by increasing the number of concurrent remote access slots from 2,000 to 5,000 in just 48 hours, with the average being used climbing from 200 in January to 2,000 during the pandemic.

Another step has been big reconfiguration of the trust’s information systems to capture data on the number of people with Covid-19 symptoms or who need shielding, and to support the rapid deployment – inside three weeks – of a testing facility for staff.

In addition, in a move to support the welfare of patients it has upgraded the guest Wi-Fi to support video contact in wards.

“We’ve got the providers, the capacity and the ability to create new bits of technology for healthcare in this complex environment,” Powell said.

Looking forward, he identified the next steps as retaining the best of what has been achieved during the pandemic, developing a team skills profile, and adopting a partner rather than a supplier model, internally and externally.

CNWL is also looking at rebranding its ICT department as a digital service.

ICT to digital

“We’re thinking more about modelling jobs for people working from home,” Powell said. “And I’m trying to retire 'ICT' as a term. There’s something powerful in the language of the user and digital, and for a while people have used ICT and digital interchangeably. But we want to focus as a leadership and knowledge team to support business change.

“We have a very strong team that is up to the challenge.”

Catch up with Owen's recent presentation at UKAuthority Powering Digital Public Services here

You can read more about 'best of breed' and smart sourcing by downloading UKAuthority's report with Rackspace, Smart sourcing insight' below:


Image from iStock, thomasandreas

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