At the end of 2024, and after only recently joining NHS England, I gave myself two years to see if I can make the kind of impact I would hope to see in a Head of Product role.

A year has now passed since I published that post, and so, with the challenge I set myself in mind, and as my teammates from across Digital Prevention have been doing in the past few weeks, its time for some reflections.

Profession lead

My post from a year ago was filled with lots of optimism. I found myself alongside some talented people, doing important work, with ambitious goals. All of this remains true today – more on that later – but this enthusiasm for my new job was short-lived as I found that the position I occupied was caught in an awkward middle layer. Too senior to be part of a specific team, and not part of leadership.

I was regarded as a “profession lead”, someone who’s responsibility was to set standards in product management and to coach / mentor when problems arise. I am a big believer in the power of peer groups and their ability to raise overall standards within an organisation, but this should be secondary to the strategic and directive work that a “Head of” does. It shouldn’t be their only job.

What’s more, professional silos risk undermining overall goals. Your duty is to your team and the people they serve, not to your profession. Putting too much emphasis on professions risks people asking the wrong questions, and creating teams that ask the right questions is one of the most important jobs of leadership. If you’ll allow me to butcher JFK for a moment:

Ask not what work you can do for your profession – ask what work you can do for your team.

Part of a team

If 2025 was a game of two halves, during the first I felt completely out of position. I saw quite a bit of change that needed to be made, and yet despite being in a senior role, I had minimal power to affect it. I hadn’t got to handing in my notice, but I was certainly wondering if I was in the right place.

The second half has been a different story and it began when Rachel Hope (Director of Digital Prevention Services), reorganised the leadership team in Digital Screening and with that asked me to join.

Suddenly I was in a team that felt familiar to me. I had people to ask questions, share idle thoughts, laugh, plan and vent frustration. Most importantly, I was able to work with the other teams in screening in the way I was used to. I still get to say what good looks like as far as product management is concerned, but I also get to contribute to the direction of the work itself.

Duncan Brown put it well in his end of year review. You are lucky if you find your people, and I have absolutely found my people within Digital Screening and the wider Digital Prevention team. If I look back at my career the best work I have done as been a byproduct of smart and motivated people coming together at the right time to do interesting work. Part of it is luck, part of it is by design, and for the latter we have Rachel Hope to thank.

Celebrating different wins

I am in this to make a difference and the only way I know how to do that is by building.

Reflecting on this, the final sentence from my post a year ago, it now feels somewhat naive. To build in my mind (like to ship or deliver) is to get code into the hands of end users. And while I still think building is the high watermark, I have learned to reset my expectations somewhat.

Part of the reason for this is obvious, the NHS is the largest of large organisations, it’s not going to move as fast as I am used to. But the other part is more frustrating. It is a deeply risk averse place to work, one where just writing failure on a slide causes people bristle. It’s also one where you have to spend more time than is productive explaining how you are doing something, rather than just getting on with it. Then there is the politics, the re-orgs, and the obviously detrimental focus on in-year benefits.

During my interview process Lauren Latham did a smart thing: she tried to make sure I knew what I was getting myself into. I recall her saying that I would need to “celebrate different wins” and it’s only now that I understand what she was getting at. You will make progress here, but it won’t be in the way you have experienced it before and the way to stop yourself from going mad is recognise those differences and celebrate them.

That was good advice because, while there has been some genuine progress in 2025, notably on digital communications in Bowel and Cervical screening, we have not built at the speed I, or indeed any of us, would like.

We can and must build faster in 2026, but I also need to celebrate different wins. Wins such as a green service assessment rating for our work on HPV Self-Testing; the development of the Lung Cancer Risk Check prototype; a clearer articulation of (and the work towards) replacing NBSS, the 30+ year old software stack that underpins breast cancer screening; and, not least, changing the entire operating model of Digital Screening to one in which the leaderships gets closer to teams, and we focus on building services that solve problems for users, rather building a “platform” from which those problems were solved.

2026

There remains a lot to of work to do. And while 2025 had its ups and downs, my enthusiasm for the digital prevention, population screening and the NHS remains as strong as ever.

I agree with Sarah Fisher, that the work to build a new breast cancer screening service is the probably the most interesting and difficult work happening anywhere in government right now. And alongside that we will, launch HPV Self-Testing, so non-responders to cervical screening can test at a location they choose rather than having to get a GP appointment; we will pilot the Lung Cancer Risk Check, as part to the 10 Year Plan commitment to rollout lung cancer screening nationally; and play a central role in the advancement of prostate cancer screening. All of this while iteratively improving the digital services that screen over 10 million people each year.

2026 is going to be an exciting one.