Why Did NHS England Appoint Professor Keith McNeil as Chief Clinical Information Officer?

McNeil oversaw a £200m IT disaster as CEO of Cambridge's Addenbrooke Hospital, so why has he been appointed NHS CCIO?


It came as a surprise when the NHS hired professor Keith McNeil, former CEO of Addenbrooke's Hospital, a part of Cambridge University Hospitals NHS Foundation Trust, as chief clinical information officer (CCIO).

Government IT projects don't exactly enjoy the best reputation for delivering on budget, on time or even at all in some cases. And arguably the most notorious example of government IT project failure was the disastrous National Programme for IT in the NHS.

So it came as a surprise when the NHS hired professor Keith McNeil, former CEO of Addenbrooke's Hospital, a part of Cambridge University Hospitals NHS Foundation Trust, as chief clinical information officer (CCIO).

McNeil resigned from his post as CEO of the trust in September 2015, just before the publication of a damning report by the Care Quality Commission (CQC). The trust was put onto 'special measures' by health regulator Monitor after overspending by an average of £1.2m a week, in part due to a new £200m online patient record system by US supplier Epic which was fraught with problems.

McNeil's resignation, as well as that of chief finance officer Paul James, indicated that they bore much of the responsibility for many of the trust's problems, although neither the trust nor McNeil gave any reason for his stepping down. It did, however, come just before the CQC report, suggesting that McNeil knew what was coming in the report and felt that it was best to step down before it was published.

McNeil and James are unlikely to be the only people responsible for the patient records disaster and overspending at the trust, but it is an incredible vote of confidence to hire someone associated with the waste of £200m on an IT project disaster.

The Epic system caused confusion among staff, and it made it harder for the trust to find locum cover. More seriously, it produced inaccurate discharge information, leading to a risk that patients did not receive appropriate follow-up care, and there were problems with timely access to data for patients and healthcare professionals.

The botched Epic implementation meant that the trust saw a serious decline in its 18-week referral-to-treatment performance, and it had a detrimental effect on staff. Three employees told CQC that they "felt bullied after raising concerns about patient safety following the implementation of Epic".

Granted, not all these problems with the technology can be blamed on McNeil. But the implementation of the technology can be, at least partly, and he, along with new CIO Will Smart, will have to act on behalf of the whole NHS to provide strategic leadership.

At the same time, McNeil will chair the National Information Board and act as a commissioning 'client' for the relevant programmes being delivered by NHS Digital. He will also be accountable to NHS Improvement with responsibility for its technology work with NHS providers.

These are huge tasks, and the way the NHS releases job ads for senior roles suggests that it is looking for the very best in the industry. Is McNeil really the best CCIO it could get?

The NHS has taken its time to make all senior appointments, and it must be assumed that due diligence has been carried out. Perhaps it found that McNeil wasn't to blame for Addenbrooke Hospital's shortcomings or that what he learned from it means he has a lot to offer the NHS. Either way, the NHS did not respond to questions from V3on the matter. 

In fact, it is ironic that McNeil will be part of a team that replaces Tim Kelsey, who held the role of national information director and chairman of the National Information Board in health and care. Kelsey had managed several failures at the NHS, such as NHS Choices, the Health Apps Library and the care.data project that was scrapped last week.

The NHS' intention was to replace Kelsey with former Department of Health CIO Matthew Swindell, who would take up the role of national director of operations and information, as well as hiring a chief information and technology officer (CITO) to report to him.

But after releasing a job ad for a CITO in January, the NHS struggled to find the right candidate.

NHS England told V3 last month that the exact remit for the CITO role will be decided when a successful candidate is in place, which is a bizarre recruitment strategy.

But the NHS said about last week's announcement of McNeil's appointment that rather than appointing a single CITO, it would appoint a "senior medical leader" to work alongside, and support, the new CCIO.

Effectively, the NHS has taken seven months to hire three people to take over Kelsey's duties. And it has done so after continually changing the remit of the role, creating an additional role, and suggesting that it would accommodate a candidate's skills and form the role around that, rather than sticking to its guns and ensuring the right person for a specific role. 

To top it all, the NHS hired the former CEO of a hospital that was dogged with problems, and who eventually resigned rather than resolve them.

The NHS has failed in its recruitment strategy and appears to be rewarding failure too.


Source: V3



Why Did NHS England Appoint Professor Keith McNeil as Chief Clinical Information Officer?

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