I’m sure I only wrote one of these a few days ago - but apparently we’re almost in April.

Somewhat unintentionally, this one is very focussed on my health / NHS based work rather than digital / tech.

Work

Work continues to be very busy. Some of the work we kicked off in January is starting to get to the crunchy parts of the engagements.

Earlier this month we got most of the team working in our part of Public Digital together in-person for a bit of a review and planning session. So far this year we’ve been supporting 12 different pieces of work across 6 countries and 15 different locations. Lots of spinning plates!

15 places so far this year

We’ve been doing a review of a legacy tech replacement project that has been delayed and gone over budget in a part of Canada. Nothing unusual there, but after many interviews and research with the people involved, our recommendation has been to stop, reset the team and start again. Anything else would just be succumbing to the sunk cost fallacy and will lead to further failure.

That’s not an easy message to give, but the team have done a fantastic job landing it with the people responsible. The report is clear, unambiguous and holds no punches.

In January, we also started a digital maturity assessment of a public sector organisation in Ontario. Last week we delivered our draft report, with great feedback from the client. This week we’re kicking off the next phase - helping them develop a roadmap for how to improve. Again, the team have done a great job here building confidence and trust for this report to land properly.

Aside from all that, I’ve been continuing to support our work for the Registry of Motor Vehicles in Nova Scotia and the City of Kyiv. We’ve been planning a visit out to Nova Scotia in April, and getting ready to welcome our first member of staff based in Canada who starts on Tuesday.


Board

In my health world, this month has been dominated by the annual planning cycle. The latest plan, covering 2024-2027, was published at our public board meeting this week.

It’s been a difficult year, and the next isn’t going to be much different. There’s a huge amount to do - including bringing down waiting lists, dealing with the oldest parts of our estate, developing a plan for how we deal with RAAC at Nevill Hall (one of the main hospitals), and bringing costs down so the budget is balanced. The Execs have a huge job ahead of them.

These planning documents are always huge and complex - and some of that is a reflection of the large number of moving parts in an organisation of this size. I’m never a fan of big documents like this - but I know that this year team has put a huge amount of effort into describing the rationale behind each area of work, developing clear milestones and making it measurable. It’s a big improvement on previous plans.

Now the immediate plan is approved, the team’s focus will shift towards the longer 10 year strategy, which I’ll be chairing and working on with them over the next few months.

There was lots of other board activity this month - including some annual reports and a Finance and Performance Committee. I’m covering a few of these lower down in this notes - so keep reading!


Non-work

This month has been dominated by work which hasn’t left much space for other things.

Last month I said that we’ve been pushing to get our architect, builder and quantity surveyor into a room together to work through the costs of our house work. That finally happened 2 weeks ago, and as I’m writing this we’ve received an updated set of figures to go through over easter. Fingers crossed we can finally get moving.

As previously previewed, this month my dad and brother-in-law spent a full week in our stream working to stabilise the banks and protect it from erosion. They’ve been installing Willow Spiling. The finished product looks absolutely beautiful, and seems to be working already. We took photos of progress along the way, and will write up something more detailed about the process soon.

There’s a little bit more to do to finish it off - but some of that is reliant on the house building work beginning, as we’ll be using some of the waste material from the link foundations to backfill the spiling in places.

Willow spiling at The Forge

What I’m reading

Front cover of report

This is a bit of a continuation of the Health section above - but I wanted to share it.

This week the Director for Public Health - Tracy Daszkiewicz - published her statutory annual report for Gwent. The report focusses on children and families across the area.

Tracy and her team talked to around 200 children in primary school, and 150 in high school and youth centres.

The report is a collection of stories and artwork from them which tells their experiences of life through covid (and after).

It’s a good - if sobering read.

It’s about using our children as our educators, learning from them to understand their needs and how we make Gwent a better place for them to flourish

Aneurin Bevan UHB has also recently published the Gwent Joint Strategic Assessment - loads of analysis and data about the health and well-being of the people in Gwent. Another interesting thing to click through.


I’ve been thinking about

Weeknotes

Weeknotes have had a huge resurgence in the digital community over the last few months. Many people have picked up the mantle again - and Giles has written a fantastic guide to them.

I’m particularly proud that Chris - my health board’s Deputy Director of Strategy, Planning and Partnership - has started writing his own. It’s great to see this being done in the open.

I’m quietly hoping I can convince a couple of other people at Aneurin Bevan to start doing the same over the next few months.


Protecting reputation vs Duty of Candour

Many organisations and businesses talk about the need to protect their reputation. The risk of repetitional damage is often included in risk registers, employment contracts etc. Building a good reputation is important for all sorts of organisations, as is protecting it from malicious actions.

However, there’s a very thin line between protecting your reputation and actively hiding things that might damage it.

I’m from the train of thought that being open and transparent about mistakes and failures is important. It helps you learn. And can build trust. It’s why I love organisations which publish incident reports, or admit when things go wrong.

In the NHS (in NHS England, NHS Wales and NHS Scotland), there’s the Duty of Candour. It requires the organisation to be open and transparent when things go wrong. I know my health board’s executives take this very seriously. Being transparent is part of building trust.

Where organisations fail admit mistakes (or actively try to hide them) under the excuse of protecting their reputation, it inevitably comes back to bite them harder.


Horizon

That neatly brings me onto Horizon. In January I wrote about some of the repeating and systemic issues arising from the ongoing Horizon scandal.

In that, I said:

If the Post Office staff managing the Fujitsu relationship had a better understanding of how the system worked, it would have been obvious that the system was poorly built. If the Post Office investigators had a better understanding of the system, they’d know what faults were likely to occur. If the Post Office leadership had better understanding of the system, they’d have known they were on risky ground from day 1. If the officials in government had technology understanding, they’d have seen this issue coming.

In recent days, various news sources have obtained documents and recordings of meetings where it has become clear that Post Office staff knew exactly what faults there were:


What I’m cooking

Ann was away for a couple of days this month, so I had control of the kitchen for a bit.

This is Chicken & black pudding in a sherry and cream sauce - from Diana Henry’s A Bird in the Hand cookbook. Very tasty. Incredibly easy to cook.

Brown some chicken thighs and some slices of black pudding. Pop them in an ovenproof dish with some chopped onion and lots of sherry. Toast up some pine nuts. Once the chicken is cooked, stir some double cream into the juices, scatter with the pine nuts and coriander.

Chicken and black pudding

Photo of the month

Taken from one of our early evening walks with the dog (yes, we can do evening walks now!). Looking down over our valley

Our valley in Monmouthshire