Designing an Algorithmically Enhanced NHS: Acknowledgements

Forever standing on the shoulders of giants

Below are the acknowledgements to my PhD Thesis “Designing an Algorithmically Enhanced NHS” and so also the acknowledgements that accompany the video version of it.

What you are holding in your hands, or reading on your screen, is my magnus optum. It is, by far, the most significant piece of solo work I have ever produced. Yet, because it is a product of me it, would not exist without the people who shaped me into the person I am, developed my ability to think, or gave me material to think about. I owe all those responsible for this shaping, developing, and giving, a debt greater than I could ever repay in a few sentences on a page. It is, however, at least, a place to start.

First, I must thank my never-endingly patient (and probably slightly exasperated) family. When I first embarked on the adventure that is an Oxford higher education as an undergrad in 2009, I plunged my parents (Sue and Michael Morley) head-first into a world of which they had no knowledge or experience. Despite this, I still expected them to be able to understand and calm every single one of the many (many many many) worries and ‘what ifs’ that abounded in my mind as soon as I entered the uncertain world of academia. Whilst my exact worries and ‘what ifs’ changed as I moved from BA, to MSc, and finally to PhD, my expectation of my parents did not. Over the course of eight (non-consecutive) years, they have answered the phone to me (at all times of the day and night), walked around the park with me, and rescued me from Oxford more times than I could possibly count, never once complaining or ceasing to be encouraging. This is of course after years of helping with homework, coming with me to debate competitions, turning up to watch me play hockey (extremely badly, although with an excellent pink stick), telling teachers where to go when my lack of interest in speaking made them underestimate how loud it was inside my head, and so much more. Without the safety net this unwavering support provided me with, I would be – but this thesis would not be - finished. Any qualifications or accolade that may come from this thesis is as much theirs as it is mine.

My grandparents and my brothers must also share some of the credit. It is to my grandad (Redvers Brandling), author of numerous children’s books and assembly books for schools, I owe my love of writing stories – after all, what is a thesis except a very long story? I also owe him my ability to wink, do the thumbs up, and play the piano, but these are rather irrelevant facts. It will forever sadden me that he died six months before I completed this thesis, but his final words of encouragement “don’t forget to enjoy yourself, pet” have been a great motivator in finishing. On the other hand, it is to my gran (Thelma Brandling) I owe my understanding of the power of ‘going for a walk’, of the need to keep looking for a swan when all you see are coots, and of the importance of sequins in an outfit. Finally, it is to my brothers (Elliott and Jamie Morley) I owe my sense of humour, my ability to laugh at myself, and a sense of never being alone in the world – of never being without at least two people who really know and understand me.

Next, I must thank a very large number of friends who, despite my distinct lack of social skills, have kept me company over the last few years and, in doing so, kept up my morale: Miranda Marvin, Eleonora Harwich, Justyna Ładosz, Alessio Gessa, Katharine and Eric Finton-James, Becky Cazacuic, Francesca Kellaway, Jake and all the Bakers, Maggie and Graham and all the Gatlands, and Dr. Joe Zhang. Particular thanks go to Amir Mehrkar, Darius Meaden, Annalisa Jarvis, Dr. Maxine Mackintosh, and Dr. Alexander Finlayson for helping me to find the light switch in the darkest of times. Likewise, particular thanks go to my ‘grad school’ friends, Marta Ziosi, Dr. Jakob Mökander, Andreas Tsamodos, Prathm Juneja, Huw Roberts, and most especially Dr. Josh Cowls for listening to me wax lyrical about health data for hours, proofreading my work, challenging my thinking, and joining me on innumerable co-authored papers.

Now to the exceptional colleagues I have had over the years, both in academia and in the civil service without whom I would have – at best – a surface level understanding of the complexities of NHS data and information infrastructure and so, without whom, this thesis would not have been possible. First, thanks to Iain O’Neil, Dr. Indra Joshi, and all those in the digital team at the Department of Health and Social Care and later in the data and AI team at NHSX for being there at the beginning and exposing me to the weird and wonderful world of policymaking. Next to Professor Ben Goldacre for, amongst many other things, giving me the experience of writing two thesis-length documents within the space of three years. Finally, to Brian MacKenna, Seb Bacon, Dr. Alex Walker, Pete Stokes, Dr. Nicholas DeVito, Dave Evans, George Hickman, Dr. Jon Massey, Dr. Milan Wiedemann, Dr. Linda Nab, Peter Inglesby, Dr. Simon Davy, Tom O’Dwyer, Tom Ward, Dr William Hulme, and all those associated with the Bennett Institute for Applied Data Science, and OpenSAFELY for teaching me more about the technical underpinnings of the NHS than they will ever know.

Crucially, I must thank the many marvellous teachers, mentors, and supervisors I have been fortunate enough to learn from. Starting chronologically with Mr. Graham Yates, my sixth form geography teacher who was the first person to ever suggest I ‘should give Oxford a go.’ At the time, I worried for his sanity, in hindsight I think he was probably right. Mr. Yates’ suggestion led me to meet Dr. Nick Middleton and Professor Peter Bannister, my Oxford undergrad tutors, who taught me to have confidence in my convictions and opinions and, perhaps most importantly in this context, how to write a convincing argument. I shall forever be grateful for every tutorial, every essay crisis, and every stroke of red pen. Of course, coming back to Oxford later, led me to my supervisor Professor Luciano Floridi who, from the first time we met when I was a part-time MSc student, has been endlessly encouraging, supporting me to apply for the PhD and throughout the process of completing it, as well as to write and publish as much as possible. Nobody has had a greater influence on my ability to think, or on my enjoyment of academic life. Professor Floridi has not, however, acted alone, he has been joined by my co-supervisor, and deputy director of the Digital Governance Lab, Professor Mariarosaria Taddeo. If Professor Floridi has taught me to ‘think big,’ then Professor Taddeo has taught me to ‘think deep’, with an unparalleled ability to ask the exact question necessary to sharpen the question recipient’s argument. It is not just for their academic support that I must thank Professors Floridi and Taddeo, but also their friendship, kindness, and frequent reminders to have fun away from my keyboard. Professor Floridi, and the person to whom he is married – Professor Kia Nobre -, also played a very significant role in putting me back together when I was broken, which is something I will never forget.

Finally, I must thank my funders the Wellcome Trust, and my interview participants for so generously giving up their time, and the NHS for giving me something to write about and the UK something to believe in. All these individuals have had a huge and undeniable impact on me as a person and so on the content of this thesis. However, the words within the following pages are mine and mine alone, they do not represent the opinions of any of those named, including my interview participants, and any remaining mistakes remain my sole responsibility.