Joining NHS England

After nearly 20 years of working in startups in October I joined NHS England, the non-departmental part of the Department of Health and Social Care that is responsible for the planning and operation of the NHS in England.

It is an enormous change. I’ve never worked in an organisation with over 200 staff. NHS England, by comparison, employs over 30,000 people and is part of a wider NHS that is the largest employer in Europe, and the fifth largest employer in the world.

As well as day-to-day delivery, NHS England is responsible for a suite of digital products and services that support NHS staff and patients. As you’d expect, it’s within this part of the organisation that I find myself, specifically as Head of Product for Digital Screening.

I am going to write something longer about why I got excited by the opportunities in screening, but better to address the more obvious question first: isn’t one of the world’s largest bureaucracies going to drive you mad?

Yes, but… as someone who has spent most of their career with the kind of autonomy that only a founder of a small organisation has, it is likely that anywhere would. And, somewhat perversely, I think I’d be likely to get more frustrated in an organisation that I could see repeating the kinds of mistakes I’d seen in the past, than one where the problems they face are unlike any I have ever faced in my career.

The folks I met during the interview process - and since joining - have filled me with confidence too. As well as smart people with a deep well of experience from their time working in the NHS, there were people from larger private sector organisations, people from startups, from scientific backgrounds and from high performing areas of government like the Government Digital Service (GDS). It is the kind of diverse bench that you’d hope to find when taking on some really big problems.

I also picked up on a changing mood. Yes, because of the new government with a large majority which will hopefully return a bit of stability to the organisation. But also because of the genuine successes that have been delivered over the last few years. Successes like the NHS app, the vaccination service roll out and the changes being delivered in GP settings.

I am going to be realistic. Change will, and often should be, slower than what I am used to. And the desire for governments to plan in a way that is anathema to people with a product mindset will be frustrating. But, with the year drawing to a close, this feels like an appropriate moment to lay down a marker. I need to be able to look back in two years from now and see some significant changes that I am proud of. The optimism and excitement I feel right now is a good start, but I am in this to make a difference and the only way I know how to do that, is by building.