Healthcare informatics

Howard's story - Part 2

Dr Howard Leicester is featured in Spark the Difference's Humans of Healthcare art exhibition and is interviewed here by Sam Meikle, founder of Spark the Difference.

Howard's interview is published in two parts. You can listen Part 1 of Howard's interview here. The recording and transcript of Part 2 is below. You'll also find links to Howard's two interview warm-ups: (1) Getting to know Howard in 10 questions and (2) Howard's drawing challenge.

Please note: In this part of the interview, Howard also shares how his sense of humour sometimes gets him into trouble. This might almost be a 'PG' rating, so best to listen with headphones if you have kids around, or are listening at work. 

Sam: Thinking about when you or a family member have used health or social care services has there been a time when it went really well?

Howard: When I had an experience about 20 years ago, which was complete, it was game changing in my treatment for my hearing loss.

I had been staying in Scotland with my brother and he has a dog that has been trained not go up the stairs or chew things but he did go up the stairs, he found my hearing aids and ate them. So I was 700 miles away from any form of hearing or anything else, I managed to get a replacement set of hearing aids sent up a couple of days later.

Also Kent Hospital dealing with my hearing aids were informed about the problem, so they were getting things ready. So when I did get home, they had a brand new set of hearing aids ready for me waiting at home so I can carry on with my work and everything. So I sent them a picture, it was actually coming up to Christmas time, a picture of the offending hound called Trinity which said,

Dear Kent Hospital, I am very sorry for eating Howard’s hearing aids. I should do better next time.’

And I sent this and a letter from me saying thank you them and I sent it off. The next time, about couple of months later, I went in for a regular check-up make sure the hearing aids were working fine. I wasn’t sitting in the waiting room and being told that ‘Dr Leicester, we’ll see you in another couple of minutes, be with you in a few minutes’ they said, ‘Hello Howard, how are you mate, how you getting on?’

So besides that the dog ate my hearing aids and they responded brilliantly at the hospital and I thank them with that letter and it all added up with that chemistry that change the relationship between me as the patient and them as the professionals caring for me all to the better and its ongoing, its brilliant.

Sam: What made you decide to start working in healthcare?

Howard: When I was at university my sight and hearing were deteriorating anyway but became obvious and I thought well I needed to get back into the areas I want to be. I want to be medical-based research and I tried to do that coming back through information technology computing. So I did an MSc in effectively computing and the combination of computing and my background in the medical side of health led me into health informatics. And the opportunities to do research posts and a PhD at city University which directed me straight into health informatics in healthcare.

Sam: What has working in health and social care taught you about people?

Howard: Organisations don’t make the difference. It’s the individuals who make the difference that I have found in my personal experience. I see that so in organisations I’ve visited, worked with in health and social care, it’s just the few of the people I have met who share my views and are prepared to do things and fight to get the Accessible Information Standard on the agenda on the ball of that hospital.

Sam: If you feel comfortable to do so can you please tell me about the darkest, scariest, or most challenging moment in your career.

Howard: Well, away from the darkest moments of emotional thing like a loss of a close friend or family member - the scariest moment in my whole life was doing an abseil. Kent Association for the Blind had called, had sent around to various pubs sponsorship forms to do an abseil for their charity.

My local pub decided to put me down as the person they were going to sponsor to do this abseil event. And I thought, ‘OK, no one would bother with that.’

So many people signed that sponsorship form, I was up for sponsorship of over £1,000. I couldn’t cop out in the end. I turned up in Maidstone and a six-story, multi-storey car park and somehow had to go up there and abseil down, when I have great fear of heights.

I also had been trained for navigating on a long cane: just standing on the stall or stepping up two or three flights of steps and trying to come back down gave me vertigo. This experience I had to do it ‘cause so many people had sponsored me. It was the scariest moment. Everyone gave an enormous round of applause when I actually finished. And it was the first time I've ever gone into the pub to help me stop shaking, rather than leaving with the shakes – it was such a nervous moment.

Sam: How did you get through it at the time? What were you think when you were at the top of that building?

Howard: Well, I have a rude version of this.

Sam: Folks, put your kids to bed right now.

Howard: The truth was I knew I had to do it because so many people had sponsored me. I just couldn’t face anyone unless I did do it. I didn’t know how I was going to do it. But also the very next weekend I was a best man at a very dear friend’s wedding and he said he was very pleased that I was with everyone because only the week before I was on a very difficult abseiling event. And I thought I couldn’t say this in public, because there were grannies and aunties there –

But, I was thinking, ‘what’s the similarity between abseiling and sex?’

... in both cases you put absolute faith in somebody else's equipment!

Which is true. Well, I’m godfather to his first born daughter, so I was right not to use that.

Sam: You were telling me, only on the phone the other day that sometimes your cheekiness does get the better of you. I can’t imagine what you mean…

Howard: My brother thinks that I am - he calls it, ‘inappropriate humour’. If he's here we have a laugh and we have a good banter. If he hears about the sort of things I've said at conferences and things like that he just can’t believe it.

To an extent it is a defence mechanism, because I do - I often fill in between the jokes with solid facts and figures and logical argument. But if it was all that, no one would listen. But back to the defence mechanism - it feels nicer and more as if people are responding to you, if you do hear a titter of laughter, you know something’s happening. You know that the audience is still there, if nothing else. It’s helpful.

I sit and listen to people reading effectively their PowerPoint presentations at conferences all over the globe and I'm never convinced by anything.

It has to be an exceptional presentation to grab my attention. And I’m not saying that I’m the greatest presenter in the world, but I try to use different ways of doing things to get my message across to an extent that I am happy with. And if I can hear a bit of laughter out there, then I may have got the message outside and people are more likely to remember that they had a good laugh then if they are sitting there bored stiff.

Sam: Looking back across your career to date, what do you hope the people you’ve worked with remember you for?

Howard: The humbug joke.

Sam: Oh go on, what’s the humbug joke?

Howard: It was my dad’s favourite joke in the last few months of his life. So I told it actually at his funeral, which worked. It’s about 95 - 90% true, with a bit of poetic license.

The Methodist minister comes up over to me and says, ‘Howard, I hear you been measuring the quality and quantity of my sermons by how many polo mints you can chew.’

‘That is true minister, but don’t worry - based on the content of your sermon last weekend, I had switched the Humbugs.’

I got away with it.

Sam: If you could thank one person for helping you get where you are today, who would it be?

Howard: There was one person who, when I have been in most difficult circumstances have stepped in, often with his wife and friends - and that’s my brother. My sister has also been extremely important but I’ve removed.

But, I’d remove the restriction on one person. I am overwhelmed, that’s not the right word, I have an incredible range of good friends and people who wouldn’t stop at anything to give me support, friendship anything. So I am blessed with people who have been an inspirational and helpful to me, on many occasions.

Sam: And what would you say to them all?

Howard: I would say – you deserve the humbug joke as well.

Sam: We’ll make sure that everyone gets a copy of the Humbug joke.

Howard thank you so much for your time, I’ve enjoyed our conversation and getting to know you a little bit better. I thank you for being very open and very honest about your journey. So, thank you very much for having me here, and thank you to all of our listeners for listening.

Howard: Thank you Sam, thank you very much. Pleasure, as they say. Enjoyed it too.

Howard's story - Part 1

Dr Howard Leicester is featured in Spark the Difference's Humans of Healthcare art exhibition and is interviewed here by Sam Meikle, founder of Spark the Difference.

Howard's interview will be published in two parts. The recording and transcript of Part 1 is below. 

You'll also find links to Howard's two interview warm-ups: (1) Getting to know Howard in 10 questions and (2) Howard's drawing challenge.

Sam: Howard, thanks very much for joining us.

Howard: Pleasure to be here.

Sam: I am really delighted to be interviewing Howard. We’re down in your family home in Otford and you described yourself to me once as a blind visionary, a deaf listener and a patient champion. Can you tell us why use these labels on yourself?

Howard: Patient, very patient, champion. Yes, because these are messages that everyone should be aware of. We are all in our own way blind; unable to see what is obvious to others, that we can’t see. We rarely listen to others. We, we hear, but we don't listen – and to join up patient champion when everything is going so slowly, just to put in patient twice, makes the point – patient, very patient, it's taken longer than we anticipated, champion.

It all fits together and its message quietly making the point and putting a smile on people's faces. And if those people with smiles on their faces really understood what the messages were – they wouldn’t have such a big smile on their face.

Sam: (Laughs) I’m a bit worried ‘cause I always have a very big smile on my face when we spend time together.

And what are you a doctor in?

Howard: I'm a doctor in health informatics and trying to push in particular, patient centered health informatics. And it’s a new discipline that is part of the information and communications technology but it’s trying to be specifically in the health and social care arena and to spread it into other sectors. If everyone starts to realise that health and social care is so important and it’s the basis for everything else in society.

Sam: Where’s your accent from?

Howard: The accent of Kent. I’ve lived in and around basically south London but Kent side of it for virtually all my life. My parents were Londoners, but it’s south east England – well, you call it an accent, I say you’re the one with an accent and I just speak good Queen's English.

Sam: What do you do for work now?

Howard: I work with NHS England and various royal medical colleges, trying to support and champion their projects going on, like the patient online programme, which is about patients having access to their own records.

It’s about the big issue at the moment - the Accessible Information Standard - which is so that everyone who needs it, should have documents in alternative formats best suited for them, or support with face to face communications like sign language, or touch alphabet, or whatever if you have special needs that are direct communication that should be made of as well.

And I work with the College of Physicians and a professional record standards body to try and make sure that the right standards for recording information are coming in to health and social care records over the next few years.

Sam: How long have you been doing that for?

Howard: I've been involved in health informatics for a good 20, 25 years. I’ve just had the opportunity to recently to make accessibility, in other words making things easier for many people as possible, a bit of a mainstay of my work because NHS England and others appreciate that it needs to be there, so they call on me and others to push things along.

Sam: Thank you. What has made you stay working in healthcare?

Howard: Two simple reasons: one is, health and social care should be exemplary. And should set the standard. No other sector, despite what they all say - banking systems, booking travel, all those sort of things - they’re good, but they aren’t accessible for the broadest range of people that people say they are.

But number two, if you don't have reasonable health or support, all other sectors of society are irrelevant. You can’t do them. So everything is predicated, founded upon health – health and social care. Everything else fails. And until we get that right, all this mucking about in other sectors of society is pretty irrelevant. Get healthcare right, and if you are - you’re making a benefit to all the other sectors of society.

Sam: What keeps you going?

Howard: I’m not really sure what keeps me going, except the fact that if I can be up there and help other people and fly the flag which most people aren’t doing, then it’s my responsibility to do that.

I was at a conference - a workshop - on housing provision, here in Sevenoaks, Otford being close by. And there was the local government Minister for Housing, who is also the local government Minister [with] responsibility for adult social care.

So said to him, ‘do you know about the Accessible Information Standard?’

He said, ‘the what?’

And now he does. And that was me getting the plug in and pressure in at ministerial level, just by being there. Nothing to do with being an academic of City or Edinburgh, or anyone else. It was being out the fighting, to certain extent, as a local activist.

When I was a sort of academic I was invited to a conference at the 2020 organisation, which are very good. But they invited me to be on the same platform as somebody very senior from Microsoft and the then shadow Secretary of State for Health, Andy Burnham and a senior person from British Computer Society health division.

And I just said, ‘my normal opening to a presentation like this, is the point that I am deaf and blind, so I have more in common with politicians and senior managers in healthcare than I do the patients I represent. I never believed I’d be on the platform with exactly those people that I was aiming that joke at in the first place.’

It was truly remarkable. But that's why I stay in health and in particular the IT field, because you get out there you can lobby, you are more than just an academic - you are a champion, you are a blind visionary, a deaf listener and a patient, patient champion and a strong activist. And you can get your messages through.

Sam: What one piece of advice would you give a young professional who’s starting out on their career, about how to retain their values, or how to stay human, in an increasingly stressed work environment?

Howard: Believe in yourself. Listen to others. Do not be overwhelmed by all the negative stuff that is going out. But have faith in yourself and follow - follow your goals and your beliefs - don't be chaperoned along routes that you don’t agree with.

Keep your head up. Keep smiling and also, you may be on the way up and doing well – but do not offend anyone at whatever level, because sooner or later you will be coming back down again and you will be meeting the same people, so you better be nice to them!

Sam: Very sound advice. Knowing what you know now, if you could, what one piece of advice would you give yourself, if you were starting out on your career again?

Howard: I would have taken more effort into trying to get on top of the technology that I have - learnt to programme it better, to use it better.

I would have tried to develop a stronger sense of self-confidence. Not being blasé, over-the-top arrogant, but being at least being happy in my own skin rather feeling negative or minimal compared to the rest of society. And I just say, stop worrying quite as much as I do. Things become far more difficult if you worry too much. I worry a lot, which means I stop doing the work that I need to do because I am too busy worrying instead of getting on with it.

And more often than not on the other side everything worked out fine and I didn't realise why I worried in the first place, but if I could stop worrying in the beginning, I could get there much more quickly and I wouldn't have suffered heart problems and everything else as a result of being stupid.

Sam: Perhaps you’re little bit hard on yourself?

Howard: Yeah, well, I’ve got to do it because I don't want anyone else having the credit.

Sam: What have you had to work hardest at, to be a success at your job?

Howard: Timekeeping. It’s actually I think a good answer, because this is the problem with people doing PhDs or writing novels, or doing anything that you take passionately, you want it to be perfect, so you put far more time and effort into it than you need to. Whatever that might be, it might just be a simple report, but things like PhD or presentation at some big gathering you want it to be perfect so you put an inordinate amount of time and effort into it. Often for no real additional benefit. So timekeeping and sort of, don’t try to do everything. Be a bit more sensible and it will probably be fine.

Sam: How difficult has that been for you?

Howard: Very difficult – it’s a flippant answer and it’s a sensible answer.

It means that you try too hard where as you’re wasting some time in trying to make something perfect, it doesn’t need to be anyway and probably couldn’t be, when you can put that effort into something else.

The flippant answer was when I was working at UCL and come out at the end of my research fellow contract, I was invited to go on any personal development course I wanted to get me ready for my next job – fine. I applied for a time management course. I got an email or phone call back saying ‘sorry, you can’t go on that course, its fully booked, you’re too late.’

‘That is ridiculous. That proves that I should be on the course in the first place. Throw a few people out and get me on this course’.

They wouldn’t bend in the rules for me, even though I had a cast iron argument!

Sam: And what’s helped you?

Howard: Well, in the end you realise that it’s not going to be quite as difficult as you think. And what you’ve done is probably – it’s good enough.

But you also, whether you’re giving a presentation or you’re attending an interview or doing anything - there comes a point where you know, well there’s not much more I can do, I’ll just have to rely on a wing and a prayer or the fact that I’ve done enough preparation that I can now.

It’s the lap of the gods. And I take it from there instead of trying to do everything all day, every day, to be – to try and reach perfection.