Health

📅 Daily Note: September 30, 2025

Ouch: Europe’s largest city council delays fix to disastrous Oracle system once more:

Elected representatives of Birmingham City Council’s audit committee vented their frustration this week after hearing that the rollout of the IMS – designed to replace the council’s banking reconciliation system (BRS), which went so badly wrong after the April 2022 go-live of Oracle Fusion – is to be postponed again.

The council’s financial management has been unable to file auditable accounts since it replaced an aging – but functioning – SAP system with new cloud-based software from Oracle. Although the council had expected to implement the system out-of-the-box, it made customized modifications including the introduction of the BRS, which failed to function as planned. The council was declared effectively bankrupt in September 2023, because of the ERP disaster and outstanding equal pay claims. It is now working to reimplement Oracle from scratch and go live in April next year.

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A podcast episode featuring Dave Winer on “Decentralisation, WordPress and Open Publishing”:

Today we’re talking about the vision, history, and future of the open web. Dave reminisces about the origins of today’s internet, the early days when idealism and collaboration were at the web’s core. He shares stories from his career, the rise and fall of early software startups, and how the initial spirit of community slowly gave way to the “walled gardens” of big tech giants like Facebook, Google, and Twitter.

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Now this looks interesting! Telex Turns Everyone into a WordPress Block Developer:

Telex is an experimental tool from the Automattic AI team that turns natural-language prompts into working WordPress blocks. You simply describe what you want, and Telex generates the block.

Telex is free to try out.

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Harry Metcalfe writes All policy constrains good action, as well as bad:

Like Shadow IT, pulling what’s currently done in the shadows into the light would teach us a lot about how teams work, what they need, and how we as organisations and leaders can enable them better.

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Lloyd Davis:

And I imagine that there are people who are still working like this, blogging regularly, having creative conversations in the fediverse and using all of that learning and knowledge-sharing to create new things, have new thoughts and find people to collaborate IRL.

But many of the people around me have walked away from writing in public – I have too, it’s hard to write this post without second guessing the responses. But to not write in public feels like a really sad resignation and failure. It feels like letting the bad guys win, and since a lot of bad guys seem to be winning quite often these days, I’m still tempted to believe that there’s a responsibility to put away the closed platforms and only do things that are on the web and controlled by me and to help the people in my communities to do the same.

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Richard Pope writes What the NHS Single Patient Record can learn from India’s Ayushman Bharat Digital Mission:

Part of India’s National Health Authority, the Ayushman Bharat Digital Mission was founded in 2021 to design, build, operate and scale digital public infrastructure for India’s health system. Among the products and platforms it is responsible for are the Unified Health Interface, which provides open protocols for linking medical records, making bookings and managing consent; and the ABHA App which lets patients maintain a copy of their health records, access services and manage consent.

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📅 Daily Note: September 18, 2025

Giles Turnbull: The strategy is enquiry

What I’m suggesting is a new approach for the times when there’s a perceived need for a document called a “strategy”. It shouldn’t be a document full of “we will”; it should be a website full of “what we’re learning”.

Use it to demonstrate your institutional capability to test and learn, to enquire and be curious.

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Key learnings from GOV.UK One Login discovery research for local government:

Key themes emerging from the research include:

  • cost savings are essential – councils told us this would be critical to secure leadership buy-in
  • identity verification is a USP – councils value secure verification and the potential to share credentials across local and central government
  • suppliers are open to integration – many are already using, or moving towards, OpenID Connect (OIDC) compatibility
  • forward thinking but stretched – councils want to future-proof systems, but limited resources, capability, and competing priorities are barriers
  • user adoption risks – concerns about digital exclusion, resident trust, and the transitioning of users to a new system

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Dave Winer, It’s really simple:

FeedLand is the perfect back-end for a twitter-like system, for the feeds part. And for the words, the perfect back-end is WordPress. I only discovered that about 1.5 years ago. And I had to see what it looks like. No more tiny little text boxes, it’s a real editor that supports all the features of the web. How do I know? Because it saves its data in Markdown. That has come to be the defining format for the text-based web. One which has been totally ignored by the twitter-like systems. How could they miss that? Markdown is like MP3. If you’re mixing sound into feeds you use MP3 of course. It’s there for you to use. As was Markdown. If you’re mixing text you’re mixing Markdown.

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Really Simple Licensing – “The open content licensing standard for the AI-first Internet”.

RSL is an open standard that lets publishers define machine-readable licensing terms for their content, including attribution, pay per crawl, and pay per inference compensation.

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Avoiding the hidden costs of leadership debt – Oli Lovell, Public Digital:

Technical debt is well recognised. But the same logic of ever-shifting organisational needs – and therefore the debt accrued by standing still – applies to leadership too. As a leader, your skills, models and culture operate as a system of their own, determining how well your organisation is able to adapt and respond to change.

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Decision making at the right level with Hats, Haircuts and Tattoos by Emily Webber:

What I like about these definitions is that they provide a framework for considering a decision, while also allowing for the differences and nuances of the situation and the experience of the people making them.

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This is a fair challenge:

i know its a lot easier to book the same recurring slot every fortnight / month

but its quite depressing seeing group after group you never get to attend, because they always meet on your non working day 😔

I did the lazy thing with Localise Live! but probably should have mixed it up a bit more. I will be making recordings available to people who sign up, so maybe I need to make it clearer that people should sign up even if they can’t make the meetings, so they get that access…

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David Gerrard – UK government productivity not enhanced by Copilot AI

The main uses were “transcribing or summarising a meeting”, “writing an email”, and “summarising written communications”.

The bot didn’t do so well on anything more complicated. Users could churn out PowerPoint slides faster, but worse. Excel data analysis was slower, and worse.

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How Tim Cook sold out Steve Jobs by Anil Dash:

There’s a tech industry habit of second-guessing “what would Steve Jobs have done” ever since he passed away, and most of the things people attribute to him seem like guesses about a guy who was very hard to predict and often inconsistent. But recently, we have one of those very rare cases where we know exactly what Steve Jobs would not have done. Tim Cook and Apple’s leadership team have sold out the very American opportunity that made Steve Jobs’ life and accomplishments possible, while betraying his famously contemptuous attitude towards bullshit institutions.

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James Plunkett writes What does digital-era healthcare really mean?

When the UK government published its 10 Year Plan for Health two months ago, there was general support for its direction of travel: shifting from analogue to digital, from hospitals to communities, and from treatment to prevention.

The question people asked is whether the healthcare system has the capability to deliver these shifts. Or, put more bluntly, ‘we’ve heard this all before, so why is this time different?’

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📅 Daily Note: September 9, 2025

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The hidden fundamentals of digital transformation in healthcare: how to roll out nationally in a local system – by Jane Maber on the dxw blog:

There’s no question that the technical challenge is real. Designing digital services that work for a national screening programme in a local environment isn’t easy.  You have to integrate with diverse existing systems, handle local variation and consider patient safety.  Not to mention managing, and often decommissioning, legacy systems alongside.

But what’s become increasingly clear is that technology alone doesn’t drive transformation. As more decision-making power is devolved to Integrated Care Boards (ICBs), national teams can’t assume one-size-fits-all delivery. Success is really all about the people impacted by the new product – the admin and clinical staff who use it, and the screening participants who experience it.

Change doesn’t land just because it’s technically sound. Or even operationally sound for that matter.  It lands because people trust it, understand it, and feel part of it.  So development needs to be done in partnership, and the quality of the relationship with those partners is critical.

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I stopped sending out my email newsletter this year – it lost its place on my todo list in the madness of moving house and so on.

However, am minded to kick it off again, but wanted to move away from Substack for a variety of reasons including nazi-friendliness and increasingly user hostile behaviour.

So, taking some advice Steph gave me a while ago, I’ve moved to Email Octopus, who seem very friendly and the system is easy enough to use. I’ve also changed it to be Localise branded – I’m terrible about marketing my company so thought this might be an easy way of reminding people how I earn a living.

If you’re curious, you can sign up on the landing page.

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Have updated my about page which was very long in the tooth!

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📅 Daily Note: December 18, 2024

Ed Zitron:

The people running the majority of internet services have used a combination of monopolies and a cartel-like commitment to growth-at-all-costs thinking to make war with the user, turning the customer into something between a lab rat and an unpaid intern, with the goal to juice as much value from the interaction as possible. To be clear, tech has always had an avaricious streak, and it would be naive to suggest otherwise, but this moment feels different. I’m stunned by the extremes tech companies are going to extract value from customers, but also by the insidious way they’ve gradually degraded their products.

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The English Devolution White Paper.

That is why I am wasting no time in finally giving local leaders and communities the tools they need to deliver growth for their area and raise living standards in every part of the country.

Need to read it through properly.

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Denise Wilton writes One for all and all for none:

You can look for available GP appointments using the NHS app. Pretty cool. Unless your local surgery has opted to use a different system. If that’s the case, you need to make sure you don’t click the ‘Check for available GP appointments’ button in the app because it will just say ‘No appointments available’. And when you phone the surgery, you’ll get a recorded message which says to use the app. So you’ll try again of course and get the same result: No appointments available. Perhaps you’ll feel bad for being a burden – because it’s flu season and the surgery must be flat out. Perhaps you’ll wait another day and when you try again you’ll find there are still no appointments available.

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Rachel Coldicutt, Words Matter:

Digital technologies require a strange combination of seemingly unconnected things, including (but not limited to) big material things like data centres, small things like phones and computers, even smaller things like chips and processors, and a bunch of invisible processes and protocols that conjure tools and services and apps and web pages and all the rest into being. What we see at the end tends to look quite neat and tidy, but many decisions and things are hidden behind those icons and dashboards and shiny cases, so they need great big stories to talk them up and make them feel exciting.

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📅 Daily note for 24 October 2024

Patient records and the NHS App⏈ – or why this stuff is really, really hard. #

Southwark Council⏈ have made some interesting design decisions on their new LocalGovDrupal website.

A week note from Catherine Howe⏈ should always be celebrated. #

A gobbet from a piece I’m drafting for a project:

Consolidation, harmonisation, standardisation… call it what you will. The opportunities however are boundless, but to take them we have to all agree on the central premise: councils have too much to do, and everyone will be better off if they can focus on what really matters to local people.

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4 ideas for the digital centre of government⏈ from dxw. #

The role of Transactive Memory Systems in great teams⏈ by Emily Webber.

Daniel Wegner introduced the term ” transactive memory System” in 1985 as a counter to more negative perceptions of group behaviours.

Transactive memory is like an index of where to find things rather than knowing them yourself.

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