We sat down with Hamish Laing, Medical Director, and Chief Information Officer, ABM University Health Board, to discuss all things digital and the NHS. We wanted to understand where Hamish has come from through his journey in the NHS, what inspires him and what he hopes to see in the future of the NHS.
Last read book: ‘Being Mortal’ by Atul Gawande
Most memorable place visited:Iceland
Last film seen: ‘Sweet Bean’ directed by Naomi Kawase
“Leadership only works when you've got followers. You need followers. You need people who will join with you in a common purpose and I think as a clinician and being in senior management, you can help to build those coalitions with clinicians.”
Last read book:I always have two on the go, a fiction and a nonfiction. So ‘Stranger in a Strange Land’ by Robert A. Heinlein, about a boy brought up by Martians, and ‘The Undoing Project’, by Michael Lewis, about Danny Kaufman and Amos Tversky
Most memorable place visited:Israel
Last film seen:The Post
“Often, innovations happen because somebody's brave enough to make a decision, they just need someone to step up and take it.”
Tom:Hamish, how and why did you get into medicine?
Hamish:I think it is always difficult to answer that. My father was a surgeon, so I guess, I grew up immersed in the surgical life. I spent every Christmas day from the age of about 1 to the age of 18 with my family carving turkey in the ward in a hospital! I kind of fell in love with medicine, which you could say is the reason. My father spent a lot of time trying to persuade me that I probably shouldn't be a doctor because it wouldn’t be the same for me as it was for him and he is right about that.
I always enjoyed sciences, I liked doing practical things, so surgery seemed like an attractive career. As it happened, my father was a burns and plastic surgeon and I’ve ended up being one, but it probably wasn’t quite as linear as that, it's just the way it worked out really. I loved the work that I did while still practicing. It was great.
Tom:How do we support clinicians in creating innovation and is it through a coalition, is it through leadership, is it through supporting them to make those brave decisions?
Hamish:Leadership only works when you've got followers. You need followers. You need people who will join with you in a common purpose and I think as a clinician and being in senior management, you can help to build those coalitions with clinicians. I think the first thing is not preventing them [innovators]. There is a tendency sometimes to squash innovation if it's not the innovation you are expecting to see. Trying to create an environment where people come forward with innovation so they come forward early.
You can avoid wasted effort by engaging with people - by saying, “actually, there are elements in what you are doing there that are really interesting, and there are elements that probably aren’t because we have an application that does that already. But there are gaps in what that ours does, and you are addressing some of those. Let’s work on that bit and not so much on the other bit.”
Tom:So, of all of these kinds of digital interventions you've seen locally, which one do you think has the greatest impact on your health board?
Hamish:I think free public Wi-Fi has made a huge difference. A while ago we were the first health board in Wales to offer free public Wi-Fi. It was driven by a conversation with a patient on the renal dialysis unit. I was walking around talking to patients, seeing how they were. He was a young chap, running a small business. He spends four hours three times a week in the basement in our hospital and he said, “You know, I can’t even get a phone signal here. I can't get on the internet and I’ve got to run my business. For about half of every week, I cannot work.” That's what life can be for someone who has renal failure. “Could you get me a phone a signal? That would make a difference!” I said, “how about if we got you Wi-Fi instead?” He replied, “Brilliant.”
The initial response from colleagues in IT was, “No we can't do that!” due to the issues of security. “What if they downloaded inappropriate material? We could be liable for that.”
But I knew that when you stay in a hotel, they've got two networks: one for running the business and one for the customers. Once a partition was established then we created our own connections to the internet rather than using the NHS network. It has been the most brilliant thing. We can have 12,000 concurrent users at times. It's allowed patients to stay connected to their businesses and their families and friends. It also allowed us to completely transform our model of mobile working for the staff in our sites too: using our free WiFi and secure middleware which we give them. It has also released bandwidth on our NHS network: lots of “wins” for a small investment!
Tom:Do you think there is evidence that if you give people the infrastructure and tools they need to innovate, will innovate themselves?
Hamish:I think patients will innovate themselves if we let them, but we don't make it easy for them, and we are resistant for many reasons. I think we need to respond to them in a different way: the conversation should be “come and talk to us and let's work out how we fix your challenges because if it works for you, it probably works for a whole lot of other people.” We should be encouraging our patients and citizens to tell us how they think we could work with them better.
Tom:What do you think the NHS needs to change and can gain from digitalisation? Do you think these new digital features, which we do or believe we will get to at some point, do you think that is going to be powered by the patient and the customer as much as it is from within our organisations?
Hamish:I think in some areas it will be both. I think patients are already pretty intolerant when they can't find when their appointments are or change them easily online, unless they have been lucky enough to use DrDoctor of course! It's just crazy, isn't it? We have an enormous amount of failure demand because patients can’t remember when to come, or them ringing us to say they can’t find their appointment letter.
At last these patient-facing applications are beginning to become prevalent. I think there is a tipping point where it will go from “I'm lucky that the NHS has given me that” to actually, “I want it and it would make a big difference to me.”
- Ends-
It’s not often you get the opportunity to sit down with the Chief Information Officer of ABM University Health Board, although the time we spent talking with Hamish was brief, it was incredibly insightful to hear about his past, his visions for the future and his thoughts on digitalisation of the NHS.
We would like to extend a huge ‘thank you’ to Hamish, and everyone working at the ABM University Health Board.