All good fairy tales start with the phrase “Once upon a time”. There’s a challenge, often a seemingly insurmountable one, which gets resolved through struggle from the hero (and fighting monsters along the way). I’m led to reflect that a big organisational restructure is the same, minus the dragons.

In January 2025, after the last ICB restructure, I took ownership of two teams (one new, one expanded). Suddenly it’s the end of June 2025: the sun is out, the flowers are sprouting, and BOB ICB is about to enter another restructure. It’s a good opportunity to step back and look at what we’ve done and what I’ve learnt as a leader from this.

In the public sector digital world - that means writing a blog. We didn’t have a blog. So we’ve made one. So there!

The challenge

We formed as a Transformation team with the challenge of using user-centred design principles and digital and data tools/skills/knowledge to help colleagues across the NHS in Buckinghamshire, Oxfordshire and Berkshire West transform and improve the way we deliver care.

This challenge came with several limitations:

  1. For our ICS team, our ICS Digital and Data Strategy was starting to look a little long in the tooth. In particular, the roadmap of “things to do” no longer reflected the reality of the priorities of work to do. We’d have to define the work to do before we did it.
  2. No more money to spend on shiny new tools or tech. We’d have to make better use of what we’ve got, or what we can replace with the same (or less) money.
  3. We were starting as new teams with new identities in the organisation. We’d have to get good at answering the questions: who are we? what are we here to do? how do we do things around here?

What we’ve done

  • We’ve done a huge amount since January! Future blog posts will show off the full spectrum of work we do but for now here’s a summary:
  • We came together as a team. We met as a new-look transformation team for the first time at the Oxford office in January
  • We decided what we’re aiming to do this financial year (FY25/26) and documented this in two roadmaps
  • We improved information sharing between professionals with our shared care record
    • We added more details from GP consultation notes
    • We made headway on improving the number of GP practices sharing into the record
    • We started work on sharing out of hours GP data in Buckinghamshire and hospital data from Oxford University Hospitals
  • We launched a targeted data-led initiative, working with GPs to prevent Cardiovascular Disease (CVD)
  • We started trialling new technology to improve detection of falls in care homes. This uses sensor-based technology in a few care homes in Oxfordshire and Buckinghamshire
  • We designed new initiatives to help digitise neighbourhood health. This is via a new academy for digital transformation leaders. We also issued guidance on how to improve administrative processes within neighbourhood working
  • We started work to understand how we can safely use AI to improve care across BOB
  • We helped our providers look at their digital contracts.
  • We got the approval to start digitising ReSPECT forms. This will lead to improved sharing of advanced care planning information across BOB
  • We helped people access digital health services through our Digital Cafe initiatives. We got short-listed for an HSJ digital award for this!

9 things I’ve learnt

Forming two new teams has taught me a lot about leadership and how to make good digital teams tick. Given I now have a blog to pollute with my takes, I’m going to try and give three things in each area of learning and hope my team agree with me.

Things I got right first time

  1. I learnt to delegate things early on without seeking to micromanage how they’re done. It took some time to get perfect - but broadly I’ve managed to do it and it leads to a team where we trust each other to get on with things and just check in to see how each other are doing.
  2. I realised the value of a truly multi-disciplinary team early on. Start with a focus on forming good relationships with lots of different people. Form teams with lots of different specialisms to work on a problem together. And bam: if you bring the right people together - magic happens!
  3. I continued to spend time learning more about what others do and being interested in the details. One of the most valuable things I’ve done this year is shadow an Ambulance crew. Now I know enough about what a “day in the life” looks like to form an accurate mental model.

Things I got right after trial/error

  1. I’ve not always valued having a written strategy, preferring instead to knuckle down and get on with things. This works when you are working mostly independently and have goals to reach, but not when you have a team you want to share that vision and drive. I spent too long waiting for others to set this strategy for me, before realising that as a leader it’s actually my job!!!
  2. I read plenty of books about what makes a team successful. I latched onto some ideas straight away and some later than I should have. For example, the importance of a face-to-face start to a team’s work is incredibly important, especially in an organisation that mostly works remotely. Ongoing face-to-face team meetings in a hybrid organisation are also really important… I didn’t start these until May!
  3. We don’t have proper project/portfolio management software. So tracking what’s going on - both what you’re on the hook for, and what you’ve asked others to do for you - is a nightmare! I didn’t crack this straight away but have found a good way to use Trello to keep track of everything at a macro level and our project workbook templates to keep track of project-level bits and pieces.

Things I’m still learning

  1. I love (and I mean LOVE) the GDS-style way of working which is outlined in the NHS Service Standard. I haven’t yet found a good way to work out to ensure the spirit of this is applied well given the range of projects we do. To give one example, I’m sure we could be doing much more user research, especially with patients, than we do at the moment. I’m going to try and do some mock service standard assessments with the team (if they humour me) to work this out.
  2. I’m still working out the best way to check in with colleagues on a regular basis if I’m not in the project team. This is difficult where task management is not always the same as line management, and where we don’t all attend the same office.
  3. I want more of our projects to be managed with Agile Scrum but haven’t worked out my role in making this happen. I’d love to be attending sprint planning meetings, daily stand-ups and sprint reviews/retrospectives. I set up and ran one project like this and really enjoyed it but haven’t got any others yet.

What comes next…

Despite the new restructure we’re focusing on our roadmaps. If we get everything right, we’ll see the real benefits for patients and staff that will occur .

We’re continuing with a lot of the things we started and starting exciting new projects. One of these will look into how we can improve Optometry referrals to secondary care.

Now we have a blog - watch this space for the team to tell you about what they’re up to and what they’re learning. We aim to work in the open after all.