Ed Garcez and BT's Tom Baker plot London ICT framework success
Garcez and Baker hope to see health organisations using a new £200m ICT framework and everyone sharing the learning from it
The three London boroughs of Hammersmith & Fulham, Kensington and Chelsea and Westminster City Council recently announced that BT has been chosen as the sole supplier to provide a range of ICT services and products under a pan-London public sector procurement framework agreement worth up to £200m.
It is the latest of four frameworks set up by the three London boroughs, which operate shared service arrangements.The deal will see two of public sector ICT's highly regarded local government chief information officer (CIO) specialists working together to make the framework fly, and they hope to see take-up, particularly, from healthcare organisations.
Ed Garcez, the three boroughs' CIO and Tom Baker, Business Development Director, Smart and Healthier Cities at BT, and the former CIO at Norfolk and Sunderland, both took part in a recent event that showcased the agreement to several potential London public sector customers, including a number of NHS trusts.
So what are their thoughts on the framework and what does its potential usage say about the public sector?
For Garcez, the sharing is about learning from one another, benefiting from scale, but without compromising sovereignty.
"For us, the frameworks provide a perfect mechanism to create a catalogue of stuff: service, device, hardware, you name it, that we can procure in entirety, or in part to cater to and meet the local service needs. That's one really crucial layer of the discussion. The next is to provide better IT that's more cost effective and more enabling to users within the organisation. I believe most local authorities have been doing that, delivering excellent services and value, for a number of years. I don't think IT in local authorities is worse than anywhere else, I often think it's better quality and very often at a more competitive price per user when compared with benchmarksin other sectors.
"What we're only starting to tackle is the issue of how we integrate with other sectors. How we work with health. The recent-ish inclusion of public health within the responsibilities of the local authority is a good example. As that process started, the barrier to sharing was technology. It's great to be in a place where the barrier to sharing is not technology, it's process, or procedure or mindset. And that's where we are increasingly finding ourselves. These frameworks allow us to extend that reach even wider into the public sector and to facilitate the opportunity to work together and share across organisations.
"It would be absolutely fantastic if a health body signed up through the framework because it would allow us to really start demonstrating how this can be more than simply doing stuff within an organisation but actually about doing stuff across organisations and sectors. And that's the second layer, if you like, where it becomes genuinely transformative. It stops being about Hammersmith, or Kensington, or Westminster, or this or that health trust and starts being about the recipient of the services that those organisations deliver."
Had Garcez not decided to go down the framework route, what would he have done procurement-wise?
"If we just step back, we could have called off G-Cloud, for example. The ability to synchronise across the three boroughs was key and G-Cloud makes that quite complex because of the length of those frameworks. The fact that there is a mini-competition also means that there is a risk that you might go out to buy that exact same thing but not land up with the same solution provider, which would make some of that integration more complex again. So while I am a strong supporter of G-Cloud it had some complexity that we needed to be mindful of for the three boroughs.
"We also had the opportunity to run individual procurements in each of the three boroughs, but each one of these large procurements is a really, really expensive exercise. It costs a huge amount of our money, the suppliers' money, and ultimately impacts on the public purse. It also involves a huge amount of emotional energy and effort.
"That's one of the other key drivers. If we can get to a place where we start to run these procurements together, then we can start to optimise our costs. Rather than running procurements multiple times, we can run them once with enough flexibility to allow for local needs and nuance. In other words, in Councillor language, we can protect sovereignty while delivering choice and best value. I think that takes us all forward. It allows authorities to buy better stuff, at lower cost and it also allows suppliers to sell better stuff at lower cost. Best of all, we end up with the unexpected benefit of an ecosystem of people who are working together on common solutions and sharing learning.
"If you'd asked me three years ago what I thought the biggest benefit of procuring in this way would be, it would be that we're buying once, not three times. We're saving ourselves two big procurement exercises. If you ask me today, it's the fact that we're able to share learning much more effectively than we were three years ago and with a much wider range of partners in the eco-system."
BT's Tom Baker has seen the same issues first hand as a former CIO of Norfolk. And he admits the challenges are significant.
"There are huge, huge challenges out there. We've been talking about salami slicing that's gone on. Local government is generally quite good from an IT perspective in terms of the price per user challenge. But if you think about what's facing us in the public sector -austerity and demand for services, this is a simply huge challenge that's in front of us. We have to look at what's going to facilitate the delivery of sustainable public services into the future and one of those key enablers is going to be technology.
"There is a huge role for CIOs in the NHS to really start to take a lead on some of these agendas. From a personal perspective, having been in Norfolk, getting teams of social workers to work in a particular hospital ward to discharge whatever they needed to do or bring an integrated team together in a particular locality based around a GP surgery is hugely time consuming and hugely frustrating. If you're talking to practitioners it's one of those really basic things, just being able to access a particular record on a particular system that might be hosted in somebody else's network. Whilst on the face of it these things are simple, in practice they are not. Having a common approach to information governance and shared infrastructure could make all the difference. Practitioners increasingly want to see these sorts of capabilities. And the sort of framework that Ed's done out and procured, it's fantastic in many ways, not least because it allows the system to buy and integrate as one where it needs to go.
"First of all, because of the breadth of those services. Then because of the catalogue that's contained within, you've got ultimate flexibility for multiple agencies to buy from. I think as we progress over the next 12-24 months there is going to be a profound shift in something that we've talked about for years and years in terms of integrated public sector working.
"If you look at the sustainability programmes that CCGs are working on. If you look at the NHS forward view, if you look at increased demand for local government services, how do you articulate the value of the service or intervention that you're delivering? How do you articulate the need to be delivering that service and to continue to do that and potentially to invest more in it?
"Increasingly we're going to have to take a holistic, whole system view and if we're intelligent, if we're integrated, if we're linking information and data in a way such that we can make those decisions. Cities are looking at having to save hundreds of millions of pounds simply to cope with rising demand for services. Now unless we can think about integrating services, delivering in a different way and intervening, which is the role of local government, then we're not going to make those changes to people's behaviours and their general well-being."
Baker explained that he recently heard the issues starkly outlined first hand.
"I went to an event at the King's Fund a few months ago and Simon Stevens stood up and he was talking about change in the NHS. There was an opportunity to ask questions from the floor and a doctor at one of the London hospitals stood up and said, "Do you know what? I do my best every single day of the week but the things that will make the biggest impact, and the biggest change to my patients, I have zero control over. It's education, it's housing and worklessness. And we need to take a system view. So even at that base infrastructure level it's fundamentally important that we have the integrated care record and networks and trust models.
Local government, local IT needs to be putting those things in place now and the framework provides a lot of that, and to be able to dip in and call off services from that, as a CIO, that would be fantastic."
So what are their hopes for the framework? For Garcez, it's about supply and demand.
"Building on what Tom has said, if you look at local authorities, there's been a huge focus on what we call demand management. How we can better manage demand. Change the front door and all those kind of analogies. In essence, my take, my step-back would be that the frameworks are an attempt at supply management. And there's a really interesting and neat notion of demand and supply equilibrium. It's control, it's the market that makes equilibrium happen. And actually, I think this is an example of whole system thinking, where, yes, there will be initiatives that look around demand management and how we optimise that. This is really about saying, 'How do we structure our supply?' 'How do we manage our supply?' Simple things like the utility based costing model allow us to have the right supply at any given point. It enables us to optimise supply, to scale supply, and to meet and establish equilibrium with demand.
"In essence, you are describing a partnership, not simply between the three boroughs and BT but actually among all the parties that we hope will engage through the framework. It has to be possible to see the wins for everyone. And very often, those wins will be predicated around achieving scale.
"And so for me, achieving the scale, that will create one increasingly virtuous shared learning, cost reduction, volume increase. All those good things would be great. And I guess, at the most strategic level, working together is the biggest benefit I can see. On a much more personal level I would most love to see a non-local government entity using the framework, particularly health. I think if we could demonstrate of our own volition, that local government and health can work together, and share a framework to deliver better outcomes, by design, that would be fantastic. I think that would be a turning point."
Garcez says the three boroughs have learned from previous experiences.
"If you look at Service Tower1 and 3, also through BT, they were less explicit on the inclusion of health. And we learned from that. So a lot of the health procurement managers were a little bit nervous about the extent to which they can use those service towers. To address that we're taking legal advice on the extent to which those service towers can be used by the health sector and more fundamentally we have been much, much more explicit on the inclusion of other sectors for this service tower."
Baker concurs. "How I see it for us is very similar. It's an absolute given that BT wants scale. But we also appreciate that scale will only come if we're successful. People aren't going to buy into these frameworks if we're not able to demonstrate credibility with the existing customer base that we've got. That is really important for us. I think in terms of going beyond that, there is almost a public sector supply chain type concept where you've got multiple agencies working together to satisfy demand of the market, the citizen. And actually when you're ill or when you need a particular service, in many instances you don't really care where that service comes from as long as it arrives with you in a way that it is easily digested, which is straightforward, that is joined up.
"If we can enable that supply chain. If we can enable that transformative pathway or process, and if we can enable something really good to come out of it, in terms of actual quantifiable benefit to citizens, then that will be our panacea and something that we actively want to contribute towards. And that's a difficult ask because also what we're talking about here is the fundamental enabling services at the infrastructure level, and there are so many other things that you need to think about: business process, applications, etc.
"But if I think we've got that opportunity to work together and to bring in partners, especially from the NHS, then it really is quite exciting. There is far more to be engendered around place, or city as a platform than government as a platform. There is a huge opportunity amongst all this for cities to innovate and lead on some of this and to actually drive tangible outputs and benefits. We're really keen to support that from a BT perspective and we're equally keen to think about that in the wider context of what we deliver as well. It's a fascinating time. If we stand together on this stuff, and we support each other, then we've got every opportunity over the coming months."