Few good things came out of the 2001 foot-and-mouth outbreak in the UK, but one positive by-product of the year-long crisis that decimated livestock and is estimated to have cost the economy £8 billion, is that it led Anthony Brewer taking the IT director's role at Kingston Hospital NHS Trust.
Brewer was a strategy development manager at rural affairs department Defra when the first cases of the disease were reported early in 2001, and he recalls how the transformation from doing banal departmental work to leading a fire-fighting project, in which strategies changed by the hour and the response had to be immediate, inspired him.
"I was leading a project to establish testing facilities across the UK, involving everything from having valid tests, recruiting staff, putting up buildings and adding computer networks and computer systems," Brewer recalls.
"It was really exciting times because you had to get stuff operational fast, turning strategy into reality over a week. The army took over a floor of our building - we were fighting a war against the disease. I said once we couldn't do something and I was threatened with having to report to [Cabinet emergency committee] Cobra.
"All that made me think I needed a job where I could turn strategy into reality."
Brewer arrived at the hospital in the London-Surrey border town later the same year, and while the pace of change at the trust is somewhat less dramatic than that required by the foot-and-mouth crisis, as a proven change manager he has spent the last 12 years successfully using technology to improve patient care and, in the process, saving money for the trust.
Like all public services in this age of austerity, healthcare is in the grip of an efficiency drive, with the NHS working to meet the 'Nicholson challenge' laid down by its chief executive Sir David Nicholson to save £20 billion by 2015. For the trusts themselves that means annual efficiency savings of 5%, a target Brewer is helping to meet with what he calls an "IT-enabled productivity programme" which includes the digitisation of everything from patient records and X-Rays to staff rostering and procurement.
Outsourcing has been seen as a silver bullet when it comes to cost-cutting, and within the public sector, local authorities are also starting to identify overlapping areas where they can procuring and manage shared services. As part of a cost and performance benchmarking study conducted by ImprovIT, Brewer and his counterpart at St George's Hospital in Tooting, John-Jo Campbell, asked the business technology specialists to explore the feasibility of the two trusts sharing services and to investigate whether or not it would be cost-efficient for either to outsource some or all IT services. Brewer says the findings around outsourcing confirmed his suspicions, but the investigations into shared services - for which ImprovIT modelled the services of the trusts' IT teams as if they were a single body - threw up surprising conclusions.
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