Harry Evans: Senior Strategy Advisor, NHS

Harry Evans started his career as a research intern for the 50th Anniversary of the Philosophy Department and is now a Senior Strategy Advisor at NHS England. For the 60th Anniversary, Alumni Voices caught up with Harry on how a degree in Philosophy prepared him for a career in healthcare, including the roll out of the COVID vaccine programme. 

“The inevitable question I was faced with having completed a philosophy degree in 2012 was: what have I gained? It was such an existential question for me that it hung over me for some time, even after I entered the job market.

That’s not to say I didn’t enjoy my time at York. It’s a fabulous university. And it’s not to say that I didn’t leave York as very employable. But the nature of the world of work is that humanities students often have to dig deep into their studies to discover the nuggets that make them stand out.

Immediately post-degree, I took up a 3-month paid internship in the Philosophy department at York, researching the history of the department for the university’s 50th anniversary. 

The Philosophy Department at York has been a part of some of the big macro-shifts in policy over the past 60 years. It started small, as one of the university’s first departments, but grew over time to be a very successful and larger department in the ‘70s. However, the department came under threat as cuts to education budgets in the ‘80s affected the humanities disproportionately. The university had to take tough decisions on what to keep and the department was very close to being closed. The department became much smaller as cuts started to bite.

As policy and funding changed, Philosophy at the University of York established itself again, steadily growing to the leading research centre it is today. Researching this was a fascinating experience. I spoke with some of the titans of the department’s 60-year history, including some of those who had been a part of it from close to its inception. Reflecting now, I quickly learned some of the core principles of research, as well as capturing some of the curiosity that would underpin my first career move.

After a Masters in London, I was quickly employed by Ipsos Mori. I’m sure that my internship at York had been pivotal to breaking into this, showing that I had some of that natural curiosity and discipline needed to be a good researcher.

But still I wondered how my degree had prepared me for this world. It troubled me that I had been taught to be a generalist, with an interest in political philosophy. This drew me towards the political side of Ipsos, and kept me from initially fully embracing health and NHS research.

“My attention has now again turned to the philosophical. What is a good decision? How do we define what a good decision looks like? Is there a distinction between a good quality decision and the outcome of a good quality decision?”

Several years after starting in the world of health care, I finally alighted on this as a specialism. Something about this always felt unnatural. A rejection of my generalist roots. The humanities taught me that my skills are universally needed and universally respected. I wasn’t a specialist, was I?

Moving jobs to work at the King’s Fund showed me I was. The King’s Fund is a health sector think tank like no other.  After a period of publishing research, speaking with health leaders, and honing my specialist knowledge. I entered another reflective phase about my Philosophy degree. I remember presenting to colleagues about my degree; about studying Wittgenstein and his approach to paradoxes. I remember trying to find value in being a humanities student in the world of social science.

My career soon led me into healthcare administration. It was nearly a year into working at NHS England – the headquarters of the NHS in England – that the pandemic began. I was initially far away from COVID-related activities. I spent most of the lockdown helping NHS analysts across the country to access one another and share their work. It was only a small contribution to the COVID effort but it was what I could do in the role I was in at the time.

In November of 2021, this changed. I came – somewhat belatedly – into the COVID Vaccination Deployment Programme in NHS England. My first task was to work on the NHS Vaccination Strategy, looking at how we can learn from COVID to improve our approach to vaccine deployment.

Ten days into starting my job in vaccination strategy, the word “omicron” started appearing regularly in my emails. And suddenly the pace changed. I learned a huge amount in those opening weeks on the deployment programme, working with people who could make the impossible possible. I learned from them about how to translate ideas from a powerpoint deck into a mass vaccination programme involving thousands of health professionals and volunteers.

After the omicron period ended, I joined Steve Russell, NHS England’s National Director for Vaccinations and Screening, as his advisor. I see these decisions taken at close range – whether it be how to invest a multi-million pound budget to improve health, or what action we should take to improve inequalities in screening uptake. I help to build the evidence needed for a decision, so that it’s informed by good data and expertise. I then construct the argument for why a decision should be taken, and why sometimes the status quo is not an option.

My proximity to this process means that my attention has now again turned to the philosophical. What is a good decision? How do we define what a good decision looks like? Is there a distinction between a good quality decision and the outcome of a good quality decision? “Decision quality” is the theory behind what a good decision making process looks like. Historically, decision quality is a concept that has come out of behavioural economics and applied to business decisions. But it is just as relevant to healthcare administration and policy. Some of the key themes of decision quality are: good decisions follow logical reasoning; people disproportionately come from a position of preferring the status quo; and that clear and transparent values are key.

“Decisions of real weight come to us later in our careers. That’s why it can take so long to see how relevant and current the humanities are to the world of management and business.”

The COVID vaccination programme was built on an ethos of asking what would need to be true to make something happen, not whether or not a decision was possible. Challenging status quo bias and being clear on core values were principles at the heart of what made the programme a success.

Any student of philosophy will recognise some of the concepts here. Counterfactuals, logical reasoning, and the importance of values. When thinking through a decision to be taken, I develop the chain of reasoning that supports it.

Decisions of real weight come to us later in our careers. That’s why it can take so long to see how relevant and current the humanities are to the world of management and business. Through reflection and study of decisions, and the application of philosophical tools, we can improve the quality of decisions that institutions take. By doing so, we can give those decisions the best chance of surviving first contact with the world.

I am reminded of the anniversary of the University of York Philosophy department and how it had its own existential crisis in the ‘80s. If a different decision had been taken by the leadership, the department could have been shuttered, and York’s philosophy journey ended. But – instead – a positive decision was taken to embrace philosophical inquiry and learning and it has been allowed to develop and flourish and teach many more students like myself.”

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