Sharing the Dark Arts

I’m Joe Selfridge, Information Manager within the Costing Team at Leeds.
I was asked to reflect on the impact that my ‘data’ skills have brought to the NHS ‘finance table’. So, I decided to commit my thoughts to this blog post in the hope it may inspire others to realise that broadening your ‘knowledge horizons’ can open up a world of possibilities in what you can achieve, and how you see your role.

Our team generate PLICS (Patient Level Information & Costing) information. When I started working in this strange world of finance almost 9 years ago, this was really its sole purpose. Like many other Costing Teams, there wasn’t a great deal of interest, engagement or imagination in what PLICS could do. Five years ago, things really started to change and now, producing this information on a monthly basis consumes only a fraction of our time. We’ve come a long way since and today our mantra of ‘Improve PLICS, Promote PLICS, Use PLICS!’ embodies everything we do and makes for a far more fulfilling day at the office.

Our successes are a result of the quality of information we have as well as the dynamic and flexible manner we work as a team to interact with data and our clinical and service colleagues. A key component to reaching this point came from sharing what once was a unique tool set of Informatics skills known only to me, to the rest of my team.
I was brought into the team to provided dedicated informatics skills and support, which became both a blessing and a curse. I was able to do a host of things that to the eyes of my finance colleagues seemed mysterious, out of reach or impossible. As the volume of clinical datasets available to us ballooned, so did the levels of interest in what we could do from tapping into these along with increasing feedback from clinical services on how to adapt and improve our costing model.

The benefits from all this were substantial but I became a bottle neck, and all the things I was able to do which made me ‘special’ and mysterious were creating a risk. It was clear that I would have to share my Dark Arts with the rest of the team, in particular, my SQL skills. SQL is a database management language which is fundamental to the running of our PLICS model and being able to interrogate the tens of millions of lines of information contained within the multitude of clinical data sets we have available to us.

Over the course of 4 years we were privileged to have 4 fantastic students who each joined the team for a year out from university. They proved to be a great test bed in showing what could be achieved by equipping others with SQL knowledge and it very quickly became apparent how this increased our teams capacity to add value, become more responsive to the needs of our ‘customers’ and relieve the pressure on me as being the sole expert that everyone would come to. Gradually this led to a greater appetite from other members of the team to learn as they could see the benefits it provided.

Being more self-sufficient and empowered with the gold mine of information we have available has cultivated the dynamic, responsive, free thinking team we have today, helping us to engage in more confident and in-depth conversations with clinical and service colleagues. This means the bar is constantly being raised in terms of the art of the possible and continually pushes the boundaries for me. It has led to challenges and inventive solutions derived collaboratively with my colleagues whom I have also learned from, so much more so, than had I been the only keeper of this knowledge.

This wider appreciation of SQL has provided the foundations for our team to work innovatively with data, and dream up and create ‘Opportunity Seeking’ tools that are supporting our clinical teams to explore and identify where improvements can be made. From helping our A&E to analyse cross-city variations in how we treat emergency patients, or highlighting differences in consumables used for the same operation to surgical teams, to evidencing the benefits of treating anaemia pre-operatively. None of this would have been possible without SQL, and I am humbled by how my team has evolved from their willingness to learn this alien language from me.

Realising the impact that it has had within our own Trust, and in the spirit of wider collaboration we decided to throw open our doors and offer bespoke SQL training for NHS Costing Teams throughout the region. We wanted to provide a workshop that including specific examples and “inspirational” content showing what can be achieved if SQL is embraced within Costing Teams throughout the country. So, in November’19 and ably supported by former-student but now a permanent fixture of our team, Tom, I ran an event which was attended by 20 NHS colleagues, from 11 trusts, stretching from Birmingham to Northumbria!

The feedback was tremendous and there has been a steady stream of communications between the trusts since. There was a collective feeling that more was possible with increased SQL skills and less reliance on Informatics and they now feel empowered to drive the benefits of PLICS throughout their trusts in a manner which was never conceivable before.

Sharing the dark arts of SQL has lifted the curtain on what is possible with data. It has brought a belief to many Costing colleagues that such skills are vital but attainable and a realisation that the sky is the limit with PLICS.