After the best part of 40 years in public service, holding senior positions in local government, health, and the public sector, what has Dylan Roberts learned about using technology to deliver change and the best way to achieve progress?
Dylan Roberts has spent almost 40 years in public service, holding senior positions in IT in local government and healthcare. So, what got him into computing in the first place?
“It’s the usual, geeky story,” he said. “When I was a young teenager in the 1980s, I had a ZX Spectrum, and that got me really interested in it. When I was 16, I left school and went onto the YTS (Youth Training Scheme). I was earning £28.50 a week and learning programming.”
Leading Leeds
It’s a story to inspire the current government, with its renewed interest in vocational education. But Dylan says he soon realised that “I wasn’t a brilliant coder, after all.” Instead, he went into network engineering, which led him into a job and then leadership positions at Denbighshire County Council.
From there, he went to Leeds, a post-industrial but rapidly changing city, with one of the biggest and most ambitious local authorities in the UK. “We had a massive piece of work to get IT infrastructure in,” he says. “Then, we got into the e-government agenda in the early 2000s.
“Instead of being part of the back-office, IT was suddenly about making things work for people, thinking about them as citizens, moving services online, and putting in self-service options.”
It didn’t last. The financial crisis triggered by the collapse of the sub-prime mortgage market, and the Cameron/Osborne government’s decision to respond with “austerity” measures, hit local authorities hard.
Leeds City Council’s IT funding dropped cumulatively by 60% across two spending reviews; something that gives Dylan an interesting perspective on the NHS’ current demand and funding gap. “The NHS doesn’t really realise how lucky it is,” he argues.
“In comparison with local authorities, it is awash with money, so it’s never had to really think about how to do things differently. When austerity hit Leeds, we had to do that. We had to change the model of service delivery.”
Partnerships at all levels
Then as now, the council’s biggest cost was social care, demand for which was starting to rise, just as the economy stagnated and austerity was starting to drive inequality. Dylan found himself working on a city partnership tasked with improving health and welfare outcomes, alongside local GP (and Highland advisory board member) Jason Broch.
One of its initiatives was the Leeds Care Record, one of the first shared care records in the country, which set out to integrate information from the many systems in use across health and care.
The aim was to give clinicians more information about their patients, and to generate data to address problems from damp housing to poor air quality; often working with the grass-roots organisations that know the people most affected by them. “That led to other initiatives, like Smart Cities,” Dylan says.
“We set some ambitious targets: we decided that we wanted 100% of people in Leeds to be digitally included and fibre to 100% of premises as key enablers to underpin better lives. We reached people through intermediaries, such as Neighbourhood Networks, different in each community. If you want to engage and work with homeless people, you work with organisations like St George’s Crypt.”
The view from Wales
In 2020, everything changed again. Covid-19 arrived, and Dylan found himself in Leeds, doing an extreme version of his day job: enabling 8,500 staff to move out of their offices and get up to speed working from home in two weeks.
After the pandemic, he took on new challenges as chief digital and information officer at York and Scarborough NHS Foundation Trust and then Betsi Cadwaladr University Health Board, a combined acute, mental health and community provider in North Wales.
The health board has long-standing problems. Dylan worked with the senior leadership team on a project to apply design principles to workflows and all decisions, to reduce variation and improve safety. But one of the challenges was a lack of IT infrastructure to support them.
When the National Programme for IT collapsed, England and Wales took different approaches to health tech. Wales chose to develop its own IT infrastructure and core systems or, when this wasn’t possible, to run national procurements.
While admired at the time, this has left the country with a lot of legacy IT and systems that don’t always integrate or support effective clinical communication.
Dylan worked with consultant Andy Kinnear (another Highland advisory board member) to argue that Wales should procure a modern electronic patient record and “change the picture” on safety and outcomes by using it to embed more efficient, best practice workflows. But for the moment, at least, the politics don’t work.
The postcode lottery and devolution
Dylan now works as an independent advisor and fractional CDIO. He supports the South Yorkshire Mayoral Combined Authority, undertakes strategic task-and-finish assignments across public services, and mentors IT leaders.
He also contributes to Socitm, takes an interest in the development of the digital, data and technology profession as a member of BCS, The Chartered Institute for IT, and holds non-executive director appointments at a housing and a football association.
With all this experience, where does he think the country, its IT, and its public services are now? “It’s a bit of a postcode lottery,” he says. Some areas, like Leeds, parts of London and others are in a position to do well. They’ve recovered a lot of the ground they lost during austerity, have great universities, and lots of young entrepreneurs.
Other areas, like North Wales, may be beautiful, but they are still struggling, and their young people leave for better educational and job opportunities elsewhere.
Do ‘with’ not ‘to’
Still, the message he takes from this is not that more central initiatives are needed. The importance of devolving decision making, and working with communities, that he developed to such good effect in Leeds, still holds. “I’m a great believer in devolution and in working with people instead of doing things to people,” Dylan says.
“In the end, that’s the only way to get real change, particularly if you don’t have that much money to spend.” Having good leaders, with good professional skills, and the space to focus on a handful of priorities, instead of running after an ever-expanding list of objectives are also important.
As is a quid pro quo that isn’t always easy for politicians or very centralised organisations like the NHS to accept. “If we are going to progress, we need to accept that people are at different levels, and work with that,” he says,“ and we also need to accept that will mean differences in approach.”
