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‘Use government as a platform in health and social care’



Incoming BCS president Jos Creese talks about service integration, a local GDS, creative skills and the evolution of senior management in IT

Lead roles at Hampshire, Southampton, Socitm and in the Local CIO Council have given Jos Creese a high profile in local government IT. With a recent move to independent consultancy and appointment as president of BCS, The Chartered Institute of IT for the coming year, his position has changed but he maintains a focus on the public sector digital arena and how it can cope with the intensifying pressures on services.

Talking to UKAuthority days after the general election, he shares the consensus view that there will be continued demands on authorities to do more with less, and expects some radical changes in which digital technology and the exploitation of data will play a big part. And the area in which expects the most intense pressure change is in the integration of health and social care.

"It's apparent to anybody that there is no hard boundary between health and social care provision," he says. "They need to be able to permeate in the interests of an individual simply and flexibly. To do that you need joined up budgets and technology, commonality around the mechanisms for data interchange, security, federated identity management, accreditation of organisations working in that space.

"The technology and probably a lot of the resource we need exists. The challenge is how do we take the existing resources and technology to restructure how health and social care can work together around individuals, patient groups and communities without upsetting the apple cart?"

Misalignment and fragmentation

It is a big ask. Creese says the information governance priorities of the two sides are not close to being sufficiently aligned, records management varies widely, there is a lot of fragmentation between healthcare IT groups, and the cultural differences that always emerge when organisations try to work together.

He sees the potential for some early lessons from the Greater Manchester initiative, under which the city has a £6 billion pot to coordinate health and social care. But he also suggests the need for a national initiative with a common budget for the two sides to make it work, and that it would have to be administered with flexibility.

"There is a proviso that pulling everything into a massive national, central budget does not have a great track record for delivery," he says. "I would like to see a more subtle model whereby you allow local innovation, prioritisation for what matters for your geography, but it's built on some common platforms that include standards, tools and infrastructure that can be shared.

"The principle of government as a platform now needs to be played out in health and social care."

Local government needs

Flexibility is also a big element of his perspective on the future of local government IT. Creese is not convinced that creating a local GDS would be a good move, concerned that it could be too prescriptive and fail to match up to the diversity of local public services.

But he thinks the existing body could play a role if it does not exert as much influence as it has over central government, just providing some common features as a basis others to develop their own solutions.

"A lot about this will be determined by the style of GDS. It needs to be collaborative, consultative in the way it goes about developing common platforms, policies and infrastructure, and identify the things that need to be done that way and the other things that are better left to the innovators and entrepreneurs in local public services."

He adds that there are going to plenty of other demands.

"We've got much more around the corner to contend with - new service models, new supply chain models, partnerships, big data and analytics, customer insight. We haven't done much of that yet - and that's before the internet of things, which will create a huge disruption. And at the same time we are still in the middle of a lot of process re-engineering."

Management evolution

The evolution of senior IT management is also prominent in his thinking. There is a debate in the boardrooms of public and private sectors about the role of chief information officers (CIOs), chief digital officers (CDOs) and even chief data officers.

Creese believes there is no clear space in an organisation for both a CIO and CDO, as if the roles are defined correctly they are bound to overlap. Instead, he sees the way forward in a CDO working closely with an operational head of IT and an organisation's business leaders to use technology in transforming services.

"If you get that right there's a symbiotic relationship that helps IT to perform better so the business is more mature in its adoption of technology, and helps the organisation by providing someone who can manage the change and risk associated with new ways of working."

Alternatively, the role of the CIO can be redefined to take on a broader business transformation remit than it has in some organisations. Otherwise there is a potential for serious problems.

"If you get it wrong you either create a CDO who doesn't understand the technology, which leads you into some dark places, or you create an avoidable professional conflict."

Boardroom voice

This is related to an issue that has been on agenda for several years without having a big effect on many organisations - giving the IT chiefs a louder voice in the boardroom. Creese says that Socitm has made progress in its own arena, but the traditional perception of IT as a realm for the geeks has restrained its leaders' influence, and prevented some CIOs from fulfilling their potential.

One of his priorities as BCS president is to make a contribution to breaking down that perception. It could come partly through encouraging people who want to get to involved in the more creative digital disciplines, in areas such as business analysis, project and relationship management, and mapping out the architecture around cloud models.

"These are different skills and require a different set of experiences to make them successful," he says. "A successful CIO has to have a whole range of skills around advocacy, financial acumen, political nous."

The BCS has responsibilities to its members who come from the more traditionally techy backgrounds, but it has had past success in boosting the role of women in IT, and Creese says it can break down the "nerdy perception" to increase its members influence and show that people from different backgrounds can find rewarding roles in IT.

In turn, this could affect the relationship between technology and business managers in government, and help to influence the transformation that is becoming a necessity for public authorities.

"I'd like government to encourage the link between digital and technology management," Creese says. "And I'd like to see the language we use to describe IT professionalism not being purely the language of technologists, but the creative industry as well."


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