New Year, new job, new blog

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New Year, new job, new blog

A New Year, a new job and a New year’s resolution to share some important aspects of my life. You can find the blog at nicholas.oughtibridge.com. I’ve primed it with some earlier articles and will add more as I remember them.

So, after 19 years with the same employer I’ve moved from what’s now NHS Digital to NHSx just as that organisation joins it’s parent, NHS England. Following Laura Wade Gery’s review, NHS Digital is also moving to be much closer to NHSx and NHS England and Improvement. It feels as though I am changing employer only to be shortly followed by my (former) colleagues.

I’m sure I’m not the first to say “leaving the people is the hardest part of changing employer”. I, at least, have the comfort of knowing I will still be working with many of them going forward. Thank you all!

I’ve written elsewhere about my reflections in the healthcare industry over the last 25 years and reflected on my contribution, so I won’t repeat that, but a few highlights from the last few years won’t go amiss, along with the continuing work I leave behind for my colleagues.

  • The introduction of the NHS Digital Terminology Servers is a standout success. Providing reference data and complex algorithms on reference data as a service using industry standard APIs is a game-changer for anyone trying to develop and implement clinical or analytical systems. All the complexity of handling vocabularies and ontologies is taken away from the developer and provides as a service.
    • The choice to take the Terminology Server forward as a “framework contract” enables any public sector body in the UK and Republic of Ireland to call-off the same technology.
    • Added to that each server can, if desired, syndicate with other servers forming a mesh of connected Terminology Servers.
    • Thanks go to the NHS Digital project team who took this forward and the contracts team who made it all possible. Doing the right thing isn’t always the quickest or easiest.
  • Transforming the NHS Data Model and Dictionary publication to be a fully web-accessible product that performs well on mobile devices and screen readers has made a significant difference to its utility. You can read more about how the Data Dictionary is published on its website.
    • Usage increased by 250%, from 20,000 users a month to 50,000.
    • The data dictionary is at the heart of describing NHS data flows.
  • The visible change to the Data Dictionary was only one step on a multipart journey. The next steps are nearing completion but will complete after I have left. My former team are now:
    • Transferring authoring onto the Mauro Data Mapper (open source) model catalogue
    • Documenting the embedded relationships within the Data Model, including separating the data sets into separate models. Thanks go especially to the team at the University of Oxford Big Data Institute for their help in this.
    • Integrating the assurance of data collections with the data dictionary so that assurance becomes a part of documenting the collection specification rather than a bureaucratic add-on.
    • Making all 4,000 or so code lists available through the Terminology Server
    • Making the whole Data Model and Dictionary available through APIs including as a SPARQL endpoint
    • Joining all the metadata about UK SNOMED CT release “reference sets” into the Data Dictionary to replace the now out-dated Data Dictionary for Care.
  • The Organisational Data Service are in the midst of handling the largest changes to the NHS structure since 2013 with the replacement of clinical commissioning groups with Integrated Care Systems governed by Integrated Care Boards. They reliably and efficiently manage the master data for the 40,000 NHS and social care organisations and distribute a range of other administrative master data about people working in the NHS and about the geographies of the UK. Their work is used by any citizen whose been involved in the NHS COVID vaccination programme (and most of the remaining people in England too). I leave a team I remain in awe of.
  • The National Clinical Content Repository (Copyright Licensing Service) is one of those unsung bits of infrastructure that you would only notice if it was missing. Much of health care depends on having access to peer-reviewed forms, assessment scales and outcome measures. These often have intellectual property rights associated with them. The Copyright Licencing Service provides a vehicle for national licences. Without it, the cost to the NHS of licences would be significantly increased.
  • I am proud to have supported the development of a few International Standards over the last few years and remain committed to the British Standards Committee for Health Informatics.
  • Finally, but by no means the least, is the work I have been doing to steer the development of Mauro Daa Mapper to be an ecosystem for semantic data models to coexist with their interrelationships mapped out. Some of the stand-out features include:
    • Git-style version control with forking, branching and merging of data models and families of interrelated data models.
    • Bi-directional integration with the terminology servers using the industry standard FHIR APIs, enabling Mauro to be the golden source of vocabularies or a consumer from other sources.
    • Automated registration of Digital Object Identifiers with live-cycle management so that academics can cite the data assets they used in their research.
    • Federation, so that a catalogue can subscribe to another catalogue and reuse or alter data models governed elsewhere.

So what does the future offer? To some extent it is an undiscovered country but I’m expecting to work in the areas of semantic health care models, leading the revision of the ISO 13940 standard – A system of Concepts for the Continuity of Care and driving the architecture for standards and interoperability in the NHS in England. I doubt I will be deserting my past but bringing my learning into the NHSx strategy. At the heart of my work will be enabling people to live healthier for longer.

A Mac Classic

And what have I found most difficult about the change so far – its silly, but the transition from Windows to a Mac and from Office to G Suite. Who thougod idea to put the @ symbol in different places, and what happened to all my keyboard short-cuts.

Its 33 years since I last used a Mac (they’re called a Mac Classic now). The move away from a 9 inch black and white screen is an improvement, as it the additional of a hard disk. The removal of the pretty rainbow on the logo is one of a number of things I am not happy with, but perhaps that list is for another day.