chore: auto-commit before merge (loop primary)

2026-02-17 02:26:42 +00:00
parent 01a48ce691
commit 9a58b3c312
18 changed files with 1446 additions and 483 deletions
@@ -0,0 +1,400 @@
+# Andy Charlwood -- Comprehensive Career & Portfolio Reference
+
+**MPharm, GPhC Registered Pharmacist**
+Norwich, UK | andy@charlwood.xyz | https://andy.charlwood.xyz/
+
+---
+
+## The Origin Story
+
+Andy is a pharmacist who taught himself to code during quiet night shifts at Tesco Pharmacy. He built a prescription-checking automation before he fully realised that combining clinical knowledge with programming was unusual. That combination has shaped his entire career since, taking him from a community pharmacy in Great Yarmouth to leading population health analytics for an NHS system serving 1.2 million people across Norfolk and Waveney.
+
+The self-teaching wasn't a formal programme or a course. It came from a drive to find root causes in data and build the most efficient solutions to complex problems. Over about a decade, that drive turned into genuine proficiency in Python, SQL, Power BI, and later JavaScript and TypeScript.
+
+---
+
+## Current Position
+
+**Deputy Head, Population Health & Data Analysis**
+NHS Norfolk & Waveney ICB | Jul 2024 -- Present | Norwich, England
+
+Andy drives the data analytics strategy for medicines optimisation across Norfolk & Waveney Integrated Care System. He develops bespoke datasets and analytical frameworks from messy, real-world GP prescribing data to identify efficiency opportunities and address health inequalities.
+
+He reports to the Associate Director of Pharmacy and Medicines Optimisation, with presentation accountability to the Chief Medical Officer and system-level programme boards.
+
+Key responsibilities include managing a £220M prescribing budget with sophisticated forecasting models, leading data infrastructure development, and translating complex clinical, financial, and analytical requirements into clear recommendations for executive stakeholders.
+
+### Previous: Interim Head, Population Health & Data Analysis
+
+**NHS Norfolk & Waveney ICB** | May -- Nov 2025
+
+Andy was appointed Interim Head when his previous manager retired at the end of December 2024. He was effectively performing the role from January 2025 but was only formally appointed and paid at Interim Head rate from May 2025. The role ran for approximately 10 months total (5 months formally). He returned to his substantive Deputy Head position following commencement of an ICB-wide organisational consultation, which paused permanent recruitment due to potential redundancies. This was a structural/organisational change, not performance-related.
+
+During this period he presented strategy, programme progress, and financial position to the Chief Medical Officer on a bimonthly basis.
+
+---
+
+## Key Achievements & Metrics
+
+### The Numbers
+
+- £14.6M efficiency programme identified and prioritised through comprehensive data analysis; achieved over-target performance by October 2025
+- £220M prescribing budget managed with sophisticated forecasting models
+- 14,000 patients identified for intervention through automated switching algorithm
+- £2.8M maximum potential annual savings from switching programme (£200 average per patient); refined to £2.6M in later CV versions with £2M on target for delivery in the financial year
+- 50% reduction in targeted prescribing within the first two months of incentive scheme deployment
+- 70% reduction in required Blueteq prior approval forms through automation
+- 200 hours immediate savings from Blueteq automation, with ongoing 7--8 hours weekly efficiency gains
+- Asthma screening process adopted nationally across ~300 Tesco pharmacy branches, reducing pharmacist time from ~60 hours to 6 hours per store per month, enabling ~£1M in revenue across the network
+- Population served: approximately 600,000 patients across Norfolk & Waveney (the ICB/ICS serves a wider population of 1.2 million, but Andy's direct prescribing data work covers ~600,000)
+
+---
+
+## Major Projects (Detailed)
+
+### 1. PharMetrics -- Automated Switching Algorithm
+
+**The Problem:** The medicines optimisation team ran an annual switching scheme to identify cost-effective medication alternatives. This previously took months of manual work, with a team of people searching tools like OpenPrescribing for opportunities such as new generics, price drops, or better-value alternatives.
+
+**The Insight:** Andy recognised this was highly automatable. With access to patient-level prescribing data through the ICB dataset, he could theoretically identify the most cost-effective switches on a per-patient basis, optimising for the minimum number of patients to switch for the maximum financial saving.
+
+**The Solution:** A Python-based algorithm that ingests real-world GP prescribing data and automatically identifies patients on expensive drugs suitable for cost-effective alternatives. It calculates which switches give the best return on intervention.
+
+**Development Process:** Andy built this independently with a high degree of autonomy. He didn't need formal sign-off to develop it. Once the analysis was complete, he engaged the wider medicines optimisation team for clinical sign-off on the final switch list, which took approximately 3 days versus the previous months of manual work.
+
+**The Novel Payment System:** Andy designed a unique incentive structure for the GP switching scheme. The GP incentive amount varies based on the savings delivered from each switch: higher-value switches earn a higher incentive payment, lower-value switches earn less. This incentivises GPs to prioritise the highest-impact changes first.
+
+**Monitoring:** Andy created dashboards tracking patient-level switching data, monitoring which patients have been switched (or are no longer prescribed the target drug), with quality metrics providing points for each patient intervention (deprescribing, formulary alignment, or other optimisation). He wrote SQL searches to create specific targeted patient cohorts and built dashboards so practices could monitor their own progress.
+
+**Impact:** Transformed months of manual work into a 3-day automated process. Identified 14,000 patients for intervention. £2.8M maximum potential savings. 50% reduction in targeted prescribing within first 2 months. The tool is internal, used by the medicines optimisation team to inform system-wide incentive schemes.
+
+**GP Adoption:** Generally good engagement driven by financial incentive. Some complaints about difficult patients and workload pushback, but the payment structure and targeted approach keep engagement high.
+
+### 2. Patient Pathway Visualisation (Sankey Charts)
+
+**The Problem:** NHS trusts needed to understand how well they were aligned to agreed clinical pathways for high-cost drugs. There was no way to visualise patient journeys through treatment sequences.
+
+**The Solution:** A Python-based tool that ingests years of patient-level prescribing data and creates Sankey charts showing patient journeys through treatments (Drug A to Drug B to Drug C to Drug D). This visualises how well trusts align to written pathways and identifies where patients deviate from expected treatment sequences.
+
+**Impact:** An external-facing tool provided to local trusts. Trusts can understand their own positioning, identify opportunities for improvement, and see which specialists need to be engaged. Enables data-driven discussions about pathway adherence. Used for audit and compliance purposes.
+
+### 3. Controlled Drug Monitoring System
+
+**The Problem:** The team needed to identify high-risk opioid users, track total opioid exposure over time, and identify potential diversion (medications being sold rather than used). This analysis was previously impossible at patient level.
+
+**The Solution:** A Python-based system that takes all opioid prescriptions in the system and calculates oral morphine equivalents for each drug. It tracks patient-level opioid exposure over 6--9 months, identifies patients with dangerously high total exposure, and flags potential diversion risks.
+
+**Impact:** Supports the controlled drug assurance element of the medicines optimisation work. Identifies high-risk patients for intervention. Previously impossible analysis is now routine. Improved patient safety monitoring and better targeting of support services. Enables population-scale patient safety analysis.
+
+### 4. Comprehensive Medicines Data Table
+
+**Developed with:** ICB data engineering team
+
+**What it contains:** All medicines currently available on the dm+d (Dictionary of Medicines and Devices), with standardised drug strength calculations (returning the amount of grams of active ingredient in each product for direct product-to-product comparison), opioid morphine equivalent calculations for all opioid medications, and Anticholinergic Burden (ACB) scoring.
+
+**Why it matters:** Functions as a lookup table where you can find the cheapest formulation with a single minimum value search. Serves as a single source of truth for all medicines analytics across the system. Democratised access to data, enabled more targeted interventions, and created a self-serve model that reduces bottlenecks.
+
+### 5. Blueteq Prior Approval Automation
+
+**The Problem:** High-cost drugs required prior approval through Blueteq forms. The process was bureaucratic and time-consuming for both the ICB and clinical stakeholders.
+
+**The Solution:** Software that automates Blueteq prior approval form creation. Also integrated Blueteq data with secondary care activity databases, resolving critical data-matching limitations.
+
+**Impact:** 70% reduction in required forms. 200 hours immediate savings. Ongoing 7--8 hours weekly efficiency gains. Enabled accurate high-cost drug spend tracking.
+
+### 6. DOAC Switching Programme -- Financial Scenario Modelling
+
+Andy led financial scenario modelling for a system-wide DOAC (Direct Oral Anticoagulant) switching programme, building an interactive dashboard incorporating rebate mechanics, clinician switching capacity, workforce constraints, and patent expiry timelines to quantify risk trade-offs for senior decision-makers.
+
+He also led renegotiation of pharmaceutical rebate terms ahead of patent expiry, securing an improved commercial position for the ICB.
+
+### 7. Tirzepatide Commissioning (NICE TA1026)
+
+Andy supported the commissioning of tirzepatide, including financial projections identifying eligible patient cohorts from real-world data. He authored the initial executive paper advocating a primary care delivery model over a specialist provider on cost-effectiveness and accessibility grounds. This drove the system's shift to a GP-led model following executive sign-off.
+
+### 8. Incentive Scheme Analysis Automation
+
+Andy automated the previously manual incentive scheme analysis, improving accuracy and targeting precision. This enabled the novel GP payment system linking rewards to delivered savings, which achieved the 50% reduction in targeted prescribing within the first two months.
+
+---
+
+## High-Cost Drug Pathways
+
+Andy wrote most of Norfolk & Waveney's high-cost drug pathways, balancing legal requirements to implement NICE Technology Appraisals against financial costs and local clinical preferences. He engaged clinical leads across all sectors of care to agree pathways and secure system-wide adoption.
+
+### Therapeutic Areas Covered
+
+- **Ophthalmology:** Wet AMD (neovascular age-related macular degeneration), DMO (diabetic macular edema), RVO (retinal vein occlusion), central vein occlusion
+- **Rheumatology:** Rheumatoid arthritis and related conditions
+- **Gastroenterology:** IBD (Crohn's disease and ulcerative colitis)
+- **Dermatology**
+- **Neurology**
+- **Migraine:** The most comprehensive and recent pathway, spanning both primary and secondary care, including lasmiditan, rimegepant, and other treatments. Rolled out across all GP practices and all secondary care trusts as a system-wide formulary recommendation.
+
+### Common Barriers & How They Were Overcome
+
+- Getting buy-in from GPs on primary care treatment routes
+- Managing drugs on Pregnancy Prevention Programmes (valproates, topiramates) with specific safety requirements for women of childbearing age
+- Varying levels of engagement from different consultants
+- Competing clinical priorities
+- Cost pressures vs clinical preferences
+- Ensuring equity of access across geographical areas
+
+Overcome through extensive GP engagement, clear safety documentation, specialist collaboration, accessible prescribing guidance, and ensuring pathways were practical and implementable.
+
+### Additional Clinical Work
+
+- Provided primary care prescribing guidance during the ADHD medication shortage in partnership with Norfolk & Suffolk Foundation Trust (NSFT) consultant psychiatrists
+- Led weight management service development as the leading clinical voice, leading the bid for funding
+- Horizon scanning for new NICE technology appraisals, preparing commissioning strategies and financial impact assessments
+
+---
+
+## Career History (Full)
+
+### NHS Norfolk & Waveney ICB -- Timeline
+
+**Interim Head, Population Health & Data Analysis** | May -- Nov 2025
+(Effectively performing the role from Jan 2025; formally appointed May 2025)
+
+**Deputy Head, Population Health & Data Analysis** | Jul 2024 -- Present
+
+**High-Cost Drugs & Interface Pharmacist** | May 2022 -- Jul 2024
+
+### Tesco PLC
+
+**Pharmacy Manager** | Nov 2017 -- May 2022 | Great Yarmouth, Norfolk
+
+Managed all pharmacy operations with full autonomy across a 100-hour contract. Regional KPI delivery lead. Local Pharmaceutical Committee (LPC) representative for Norfolk.
+
+Key achievements:
+- Designed asthma screening process adopted nationally across ~300 Tesco pharmacy branches (60 hours reduced to 6 hours per store per month; ~£1M revenue enabled)
+- Led creation of national induction training plan and eLearning modules for all new pharmacy staff, with enhanced focus on leadership development for non-pharmacist team members
+- Supervised two staff members through NVQ3 qualifications to pharmacy technician registration
+- Full HR responsibilities: recruitment, performance management, grievances, rotas, locum booking
+- Led regional NMS (New Medicine Service) KPI delivery initiatives
+- Initiated multiple PGDs (NRT, EHC, chlamydia)
+- Increased NMS completion from <10% to 50-60% of target through audit-driven process improvements
+- Embedded no-blame culture promoting psychological safety, open communication, and shared accountability
+
+There is also reference to earlier work as a **Duty Pharmacy Manager** at Tesco prior to the full Pharmacy Manager role, and pre-registration/early career work at **Paydens** community pharmacy (including clinical screening for palliative care hospice, wholesale procedures, and regulatory compliance).
+
+---
+
+## Technical Skills
+
+### Programming & Data
+
+- **Python:** Advanced (4/5 self-assessed). Primary language. Production tools built and deployed: PharMetrics, Sankey visualisations, controlled drug monitoring, Blueteq automation, medicines data infrastructure
+- **SQL:** Advanced (4/5). Patient-level data querying, cohort identification, complex analytics, search creation for targeted patient cohorts
+- **Power BI:** Expert (5/5). Dashboard development, real-time prescribing insights, population health metrics, efficiency opportunity tracking
+- **JavaScript/TypeScript:** Working proficiency. Some experience; used alongside Python
+- **Algorithm Design:** Switching algorithms, cost-effectiveness calculations, patient identification logic
+- **Data Pipeline Development:** Building analytical infrastructure from messy real-world data
+
+### Healthcare Systems & Coding
+
+- **SystmOne:** Direct working experience (primary care clinical system). Has not worked directly in EMIS Web but the systems are comparable and the lateral move is straightforward.
+- **SNOMED CT:** Used primarily in analytics work for patient cohort identification and clinical coding
+- **dm+d (Dictionary of Medicines and Devices):** Comprehensive integration in medicines data table
+- **Blueteq:** Prior approval forms, data integration with secondary care databases
+- **OpenPrescribing, Fingertips, Eclipse:** External data tools used for horizon scanning and benchmarking
+- **NHS prescribing databases:** Patient-level and practice-level data
+
+### Self-Assessed Competency Ratings (from conversation)
+
+**Data & Analytics (Core Strengths):**
+- Data Analytics & Visualisation: 5/5
+- Healthcare/Population Health Analytics: 5/5
+- SQL/Database Management: 4/5
+- Python Programming: 4/5
+- Dashboard Development (Power BI): 5/5
+- Statistical Analysis & Forecasting: 5/5
+- Prescribing Data Analysis: 5/5
+
+**NHS & Healthcare Expertise:**
+- NHS System Knowledge & Navigation: 5/5
+- Medicines Optimisation: 5/5
+- Population Health Management: 5/5
+- Clinical Pathway Design: 4/5
+- Health Inequalities Understanding: 4/5
+- Pharmaceutical Policy & Regulation: 5/5
+- NICE Guidance Implementation: 5/5
+
+---
+
+## Leadership & Management Style
+
+### Philosophy
+
+Andy's leadership approach centres on coaching, autonomy, and leading through expertise rather than positional authority. His entire career has been about changing processes and improving efficiency, and every process change requires coaching and change management. His core principle: you have to take people with you.
+
+### Key Examples
+
+**No-Blame Culture (Community Pharmacy):** Embedded a culture where everyone has a valid opinion regardless of hierarchy. Created an environment where people feel free to speak up and challenge authority. Dismantled traditional hierarchical barriers while maintaining necessary governance structures. Recognised that for safety issues, everyone has a valid perspective on human behaviour.
+
+**Autonomy-Based Working (ICB):** High degree of autonomy in how people work. Minimal micromanagement. People given direction on what needs to be done but freedom in how to achieve it. Leading through expertise and guidance rather than authority.
+
+**Leading Without Formal Authority:**
+- Weight management service development: leading clinical voice in pathway development, leading bid for funding, subject matter expert providing direction with no formal authority over the people looking to him for guidance
+- Cross-trust pathway implementation: engaging specialists, GPs, chief pharmacists across multiple organisations to secure adoption of new pathways
+
+**Team Transformation:** Led the change from practice-level EPACT data to patient-level SQL analytics. A long process requiring sustained coaching and support, providing training and framework to enable team growth, pointing team members to relevant training resources, removing barriers and blocks to development.
+
+**Staff Development:** Supervised two staff members through NVQ3 qualifications to pharmacy technician registration. Trained all new pharmacy staff at Tesco (internally recruited from other departments) requiring significant upskilling.
+
+### Formal Leadership Training
+
+**NHS Leadership Academy -- Mary Seacole Programme** | 2018 | 78%
+NHS leadership qualification covering change management, healthcare leadership, and system-level thinking.
+
+---
+
+## Education
+
+**Master of Pharmacy (MPharm), 2:1 Honours** | University of East Anglia | 2011 -- 2015
+- Research project on drug delivery and cocrystals: 75.1% (Distinction)
+- 4th year OSCE (clinical skills assessment): 80%
+
+**University Extracurriculars:**
+- President of UEA Pharmacy Society (May 2014 -- April 2015)
+- Secretary & Vice-President of UEA Ultimate Frisbee (May 2014 -- April 2015)
+- Publicity Officer for UEA Alzheimer's Society (May 2013 -- April 2014)
+
+**A-Levels:** Mathematics (A*), Chemistry (B), Politics (C) | Highworth Grammar School | 2009 -- 2011
+
+**GPhC Registered Pharmacist** | General Pharmaceutical Council | August 2016 -- Present
+
+---
+
+## Stakeholder Engagement
+
+Andy's work requires engagement across a complex web of NHS stakeholders:
+
+- **Executive level:** Bimonthly presentations to Chief Medical Officer; evidence-based recommendations to inform executive decision-making
+- **Associate Director level:** Direct reporting line to Associate Director of Pharmacy and Medicines Optimisation
+- **System-level programme boards:** Presentation accountability
+- **GP practices:** Incentive scheme deployment, targeted cohort identification, dashboard provision, switching scheme implementation
+- **Acute trusts:** Pathway compliance analytics (Sankey charts), high-cost drug pathway agreement, data-driven insights on medicine utilisation
+- **Hospital consultants:** Detailed clinical discussions on niche high-cost drug pathways (ophthalmologists, gastroenterologists, rheumatologists, neurologists)
+- **Chief pharmacists:** Cross-trust pathway adoption, prescribing guidance
+- **Pharmaceutical companies:** Rebate negotiations, commercial terms renegotiation ahead of patent expiry
+- **Other ICBs:** Sharing resources and best practices for medicines optimisation approaches
+- **ICB data engineering team:** Collaborative development of medicines data infrastructure
+
+---
+
+## Career Transition Strategy
+
+### Target Sectors
+
+Andy is actively exploring the transition from NHS to private sector, targeting:
+- Pharmaceutical companies (Medical Affairs, Market Access, HEOR)
+- Health-tech companies (Clinical Implementation, Product Development, Clinical Informatics)
+- Consulting firms (Healthcare consulting, analytics)
+
+### Target Seniority
+
+Senior Manager / Associate Director level positions, leveraging the combination of clinical pharmacy expertise and self-taught technical skills.
+
+### Positioning Strategy
+
+- **Analytical solutions** positioned as digital transformation experience
+- **Pathway implementations** positioned as system-wide scaling capabilities
+- **Budget management** positioned as relevant leadership credentials
+- **NICE TA work and health economics background** aligned with pharmaceutical sector needs
+
+### Dual-CV Approach
+
+Andy employs two CV variants sharing core content but differing in emphasis:
+1. **Strategic CV:** Optimised for senior roles highlighting Advanced Pharmacy Framework pillars, integrated care systems terminology, data analytics, and system-level transformation
+2. **Traditional Pharmacy CV:** Prioritises patient-facing clinical keywords, community pharmacy competencies, and GPhC-related terminology for roles where clinical credentials matter most
+
+### Applications Explored
+
+- **Optum/UnitedHealth Group** -- Clinical Implementation Specialist: Strong skills match but potentially beneath current seniority. Considered as a "foot in the door" to health-tech. Reached out to recruiter on LinkedIn.
+- **Hippo Labs** -- Clinical Engineer: Strong match for background. Overqualified but well-suited for flexible/part-time role. Prepared video application strategy.
+- **Luscii** -- Digital health role: Led to comprehensive career Q&A documentation.
+
+### Identified Gaps
+
+- No direct digital health technology implementation experience (remote patient monitoring, care-at-home technologies)
+- No experience working directly with external software vendors or technology companies
+- Limited external visibility: analytical work has been picked up nationally but no formal conference presentations or publications
+- No direct experience scaling solutions beyond Norfolk & Waveney system boundaries
+
+---
+
+## Strategic Priority Setting
+
+Andy's prioritisation framework balances three key factors:
+
+1. **Value/Savings Potential:** Financial impact, scale of savings possible, return on investment of effort
+2. **Quality Improvement:** Patient safety implications, clinical outcome improvements, health inequalities impact
+3. **Data Need & Urgency:** How much the data is needed to directly impact high-risk or high-value cohorts
+
+High-risk cohorts and high-value cohorts receive highest priority.
+
+---
+
+## Portfolio Website
+
+**URL:** https://andy.charlwood.xyz/
+
+The website has been through multiple iterations. Key feedback and direction from our work together:
+
+### Strengths Identified
+- Compelling narrative arc from community pharmacist to NHS analytics leader
+- Tangible proof of work through projects section (PharMetrics, Sankey diagrams, Blueteq automation)
+- Clear value proposition at the intersection of clinical pharmacy and technical skills
+
+### Areas for Development
+- Quantify impact more prominently (hard metrics above the fold)
+- Tailor positioning for private sector audiences (health economics, NICE TA work, commercial awareness)
+- Sharpen project descriptions to lead with the problem solved
+- Include downloadable PDF CV for recruiters
+- Consider adding key skills section, notable achievements section, and publications/presentations if applicable
+
+---
+
+## Key Figures -- Quick Reference
+
+| Metric | Value |
+|---|---|
+| Prescribing budget managed | £220M |
+| Efficiency programme identified | £14.6M+ |
+| Patients identified (switching algorithm) | 14,000 |
+| Maximum potential switching savings | £2.8M (refined to £2.6M) |
+| Average saving per switched patient | ~£200/year |
+| Switching savings on target for delivery | £2M |
+| Prescribing reduction (first 2 months) | 50% |
+| Blueteq form reduction | 70% |
+| Blueteq immediate time savings | 200 hours |
+| Blueteq ongoing weekly savings | 7--8 hours |
+| Tesco asthma process time reduction | 60 hours to 6 hours/store/month |
+| Tesco network revenue enabled | ~£1M |
+| Population served (prescribing data) | ~600,000 |
+| ICS population | 1.2 million |
+| Manual analysis compressed to | 3 days |
+
+---
+
+## Tools & Systems Used
+
+- **Programming:** Python (primary), SQL, JavaScript, TypeScript
+- **Analytics & Visualisation:** Power BI, Sankey charts, custom dashboards
+- **NHS Systems:** SystmOne, Blueteq, dm+d, SNOMED CT
+- **External Data:** OpenPrescribing, Fingertips, Eclipse
+- **Data Infrastructure:** Patient-level prescribing databases, NHS data platforms, ICB SQL servers
+
+---
+
+## Professional Registration & CPD
+
+- **GPhC Registered Pharmacist** -- August 2016 to present
+- Active CPD portfolio demonstrating continued development in clinical practice, data analytics, and healthcare leadership
+- Regular participation in professional pharmacy networks and medicines optimisation forums
+
+---
+
+*This document was compiled from Andy's CV (v4), attached PDF CV, and comprehensive information gathered across multiple conversations covering career history, project details, leadership philosophy, technical skills, career transition strategy, and portfolio development.*
@@ -0,0 +1,428 @@
+# Andy Charlwood — Complete Career, Skills & Portfolio Knowledge Base
+
+**Contact:** andy@charlwood.xyz | https://andy.charlwood.xyz/ | LinkedIn  
+**Location:** Norfolk, England  
+**Age:** 32 (as of 2025)  
+**Registration:** GPhC Registered Pharmacist (August 2016 – Present)
+
+---
+
+## Personal Summary
+
+GPhC-registered pharmacist and self-taught data analyst/developer who combines deep clinical pharmacy expertise with advanced technical capabilities in Python, SQL, and Power BI. Currently Deputy Head of Population Health and Data Analytics at NHS Norfolk & Waveney ICB, managing analytical strategy for a £220M prescribing budget serving 1.2 million people. Has delivered £14.6M+ in documented efficiency savings through data-driven interventions.
+
+Core value proposition: "Pharmacist who builds health tech solutions that transform care delivery at scale" — bridging two traditionally separate worlds by bringing clinical understanding of medicines and practice together with advanced analytics and automation.
+
+Self-describes with characteristic honesty as a "bootleg data scientist" or "Temu data scientist" — no formal data qualifications, entirely self-taught during night shifts at Tesco pharmacy between 2017–2022, progressing from Excel macros to sophisticated Python applications, machine learning, and population-scale health analytics. Comfortable with "YouTube University graduate" as a title.
+
+---
+
+## Career Timeline
+
+### McDonald's Corporation — Floor Manager, Crew Trainer & Crew Member
+**September 2009 – June 2014 | Ashford, Kent**
+
+Progressed from Crew Member to Floor Manager while completing A-levels and undergraduate pharmacy degree. Developed leadership, customer service, and operational management skills in high-pressure environment. Trained and evaluated staff performance, oversaw cash and inventory management, health and safety compliance, and operational efficiency during peak trading periods.
+
+---
+
+### University of East Anglia — MPharm (2:1 Honours)
+**2011 – 2015**
+
+- Failed pharmacy exams in years 1, 2, and 3 before completing the degree — a fact Andy is open about and uses as a powerful narrative about resilience
+- Independent research project on drug delivery and cocrystals: 75.1% (Distinction level)
+- 4th year OSCE (clinical skills assessment): 80%
+- President, UEA Pharmacy Society (May 2014 – April 2015)
+- Secretary & Vice-President, UEA Ultimate Frisbee (May 2014 – April 2015)
+- Publicity Officer, UEA Alzheimer's Society (May 2013 – April 2014)
+
+**A-Levels (Highworth Grammar School, 2009–2011):** Mathematics (A*), Chemistry (B), Politics (C)
+
+---
+
+### Paydens Pharmacy — Pre-Registration Pharmacist
+**July 2015 – July 2016 | Tunbridge Wells & Ashford, Kent**
+
+Completed professional training in challenging, service-rich environment, taking on advanced responsibilities beyond typical pre-registration scope.
+
+- Led initiation of Patient Group Directions (PGDs) including NRT, emergency hormonal contraception, and chlamydia screening/treatment services
+- Conducted comprehensive NMS audit, increasing completion rates from under 10% to 50–60% of target through process improvement
+- Provided clinical screening services for palliative care hospice — complex patient care and end-of-life medication management experience
+- Developed understanding of wholesale procedures, regulatory compliance, and pharmacy business operations
+
+---
+
+### Tesco PLC — Duty Pharmacy Manager → Pharmacy Manager
+**August 2016 – May 2022 | Great Yarmouth, Norfolk**
+
+**Duty Pharmacy Manager (August 2016 – October 2017):** Progressed from newly qualified pharmacist to Acting Pharmacy Manager within two months. Co-led regional initiatives for NMS and asthma referrals, developing resources supporting service provision across the region.
+
+**Pharmacy Manager (November 2017 – May 2022):** Managed all pharmacy operations with full autonomy. Served as Local Pharmaceutical Committee (LPC) representative supporting Norfolk's community pharmacy sector.
+
+Key achievements:
+
+- **National asthma screening solution:** Designed quality payments solution for asthma patient screening implemented nationally across Tesco's entire pharmacy estate — saving 30–60 minutes daily per pharmacy and generating approximately £1M potential revenue
+- **National training:** Created induction training plan and eLearning modules for all new Tesco pharmacy staff nationally, with enhanced focus on culture and leadership development for non-pharmacist team members
+- **Regional NMS leadership:** Led KPI delivery initiatives including New Medication Service (NMS), achieving target performance and developing implementation resources adopted across 39 pharmacies in the region
+- **System integration:** Established collaborative working relationships with local PCN and ICS partners, creating agreed protocols for managing medicine supply issues affecting patient care
+- **Staff development:** Supervised two staff members through NVQ3 qualifications to pharmacy technician registration
+- **Operational management:** Maintained 100-hour contractual requirements through effective locum management. Managed full employee lifecycle including rotas, recruitment, performance management, disciplinaries, and grievances
+
+**This is where coding was learned.** During night shifts and quiet periods at Tesco (2017–2022), Andy taught himself to code:
+1. Started with Excel macros to automate repetitive pharmacy tasks
+2. Progressed to VBA for more complex automation
+3. Moved to Python through online tutorials and real-world pharmacy problems
+4. Built projects including financial modelling (Black-Scholes options pricing, gamma mapping from options open interest)
+5. Learned SQL once he gained access to NHS databases
+6. Daily practice of 30–60 minutes most evenings for approximately 5 years
+7. Resources: Stack Overflow, Python documentation, YouTube — entirely self-directed
+
+**NHS Leadership Academy — Mary Seacole Programme (78%) | April – October 2018:** Formal NHS leadership qualification providing theoretical grounding in healthcare leadership approaches, change management, and system-level thinking.
+
+---
+
+### NHS Norfolk & Waveney ICB — Medicines Optimisation Pharmacist (High Cost Drugs)
+**May 2022 – July 2024 | Norwich, Norfolk**
+
+Hired for clinical skills, not data — but quickly demonstrated what data analysis could do for the team. This role was the bridge between community pharmacy and data leadership.
+
+Key achievements:
+
+- **Blueteq automation:** Developed software automating Blueteq prior approval form creation, achieving 70% reduction in required forms whilst saving 30 hours monthly (200 hours immediate savings, 7–8 hours ongoing weekly efficiency gains)
+- **Blueteq data integration:** Integrated Blueteq data with secondary care databases, enabling accurate high-cost drug spend tracking and pathway compliance monitoring for the first time across the system
+- **Clinical pathway development:** Created evidence-based clinical pathways for multiple therapeutic areas:
+  - Rheumatology
+  - Ophthalmology (wet AMD, DMO, RVO)
+  - Gastroenterology (IBD)
+  - Migraine management (co-written with neurology consultant, implemented system-wide across all GPs and trusts)
+- **Sankey chart patient flow analysis:** Developed Python-based Sankey chart analysis tool visualising patient journeys through high-cost drug pathways. Enabled trusts to audit compliance, identify improvement opportunities, and understand flow through complex treatment pathways visually
+- **ADHD medication shortage:** Provided strategic guidance during critical period, including primary care prescribing recommendations during ADHD medication shortage in partnership with Norfolk & Suffolk Foundation Trust (NSFT)
+
+**Technical environment:** Python, Blueteq platform, NHS data systems, secondary care activity databases, pathway development and visualisation tools
+
+---
+
+### NHS Norfolk & Waveney ICB — Deputy Head of Population Health & Data Analytics
+**July 2024 – Present | Norwich, Norfolk**
+
+**Interim Head of Population Health & Data Analytics (May 2025 – September 2025):** Served as acting head with direct accountability to Chief Pharmacist and presentation responsibilities to Chief Medical Director, following previous head's departure. Delivered exceptional results during organisational transition.
+
+Leading data analytics strategy for medicines optimisation across Norfolk & Waveney's population of over 1.2 million people.
+
+---
+
+## Key Projects & Achievements (Current Role)
+
+### Cost Optimisation Algorithm (Biggest Achievement)
+- **Problem:** Finding cost-effective medicine switches took months of manual work
+- **Solution:** Built Python algorithm that ingests 6 months of prescribing data, identifies products with same VMP (Virtual Medicinal Product), finds cheapest alternatives, extrapolates annual savings, and prioritises items for system-wide switches
+- **Technical approach:** Uses dm+d (Dictionary of Medicines and Devices) schema to group therapeutically equivalent products by ingredient, route, and form, then calculates cost-per-unit differentials
+- **Results:**
+  - Process reduced from months to 3 days for initial list generation
+  - Identified £2.8M annual savings potential across 14,000 patients (~£200 average per patient)
+  - Achieved 50% reduction in targeted prescribing within two months of deployment
+  - Dashboard focuses on low-risk, cost-effective switches (essentially identical generic medicines under different brands) — high impact, low effort
+
+### QIPP Efficiency Target Delivery
+- £14.6M+ efficiency opportunities identified by October 2025, exceeding QIPP target
+- Budget of £220M prescribing managed — currently under budget
+- Additional savings anticipated from dapagliflozin patent expiration
+- Historic invoice backlog fully cleared — reduced from over 500 invoices dating from 2019
+
+### Opioid Monitoring Dashboard
+- System-wide dashboard converting all opioid prescriptions to oral morphine equivalents (OME)
+- Deployed across Norfolk & Waveney for patient safety
+- Identifies high-risk patients and potential medication diversion
+- Patient-level analysis showing prescribers, dispensing pharmacies, and patterns
+- Connected to published evaluation research: system-wide opioid deprescribing intervention demonstrated 18.3% decrease in high-dose opioids (vs 6.9% national average) and 9.2% decrease in total opioid prescribing (vs 4% national average)
+- Working with Professor Debi Bhattacharya and data scientist Adam on difference-in-differences evaluation methodology for academic publication
+
+### Prescribing Incentive Scheme (Novel Design)
+- Transformed approach from single-target thresholds to flexible points-based system
+- Practices can target multiple indicators simultaneously
+- Novel mechanism allowing "overflow" points for priority switches
+- Patient-level tracking: one patient de-prescribed = one point
+- Indicators include: PPIs in children, pericyazine deprescribing, antipsychotics in dementia, anticholinergic burden reduction, iron supplementation, opioid deprescribing
+- Automated incentive scheme analysis: reduced months of manual work to 3 days
+- Created patient-level searches to centrally track GP data for incentive measures
+
+### Tirzepatide (Mounjaro) Implementation
+- Comprehensive analytical support for tirzepatide implementation following NICE TA1026
+- Monte Carlo modelling for financial projections with Dirichlet distributions for dose uncertainty
+- Predictive analytics for demand forecasting
+- Detailed cohort analysis
+- GP survey data analysis (~70 responses) informing capacity planning
+- Local Enhanced Service (LES) model development for primary care delivery
+- Risk register management and executive-level briefings
+- Cross-ICB collaboration with SNEE ICB to validate methodologies
+
+### DOAC Financial Modelling & Pharma Negotiation
+- Created interactive DOAC switching scenario modeller for executive stakeholders
+- Modelled complex rebate scheme with Daiichi Sankyo for edoxaban
+- Led pharmaceutical company negotiations, using market share leverage to secure rebate extension
+- Successfully negotiated rebate extension for merged ICB system (Norfolk & Suffolk)
+- Built financial dashboard showing switching scenarios, rebate thresholds, and break-even analysis
+
+### Polypharmacy Prescribing Dashboard
+- Indicators: average active ingredients, distinct medicines, oral morphine equivalent (90 days), anticholinergic burden score, Johns Hopkins emergency admission risk (12m), inpatient admission risk (6m), mortality risk score
+- Person Need Cluster and Healthcare Resource groupings
+- Population-level and practice-level views
+
+### Data Infrastructure Transformation
+- Led team transition from practice-level EPACT data to patient-level SQL-based analytics
+- Created self-serve data model empowering medicines optimisation colleagues
+- Developed comprehensive medicines data infrastructure integrating all dm+d products with:
+  - Standardised strength calculations
+  - Morphine equivalent conversions
+  - Anticholinergic Burden scoring
+  - Single source of truth for all medicines analytics across the ICS
+- Direct access to ICB databases (Snowflake) — unusual for a pharmacy role
+- Integration of multiple data sources: ePACT2, OpenPrescribing, Eclipse, Fingertips, ICB data warehouse, Blueteq, secondary care activity data
+
+### AI/LLM Work
+- Fine-tuned an 11B parameter LLM to decode free-text prescription directions into daily quantities
+- Converts directions like "take two tablets three times a day" into structured data
+- Enables identification of overprescribing patterns and potential controlled drug misuse
+- Auto-updating analysis identifying patients with high oral morphine equivalent across multiple prescribers/pharmacies
+- Explored Claude agents for clinical pharmacy review at scale
+- Researched pharmacogenomics applications — using medication persistence patterns as proxies for pharmacogenomic variants (CYP2D6, CYP2C19 etc.)
+- Investigated prescribing cascades in PGx-actionable medications
+
+### Community Pharmacy Innovation
+- Researched PGD (Patient Group Directive) framework for community pharmacy-led DOAC switching
+- Designed payment model: £20 per pharmacist consultation, £5 GP admin fee
+- Legal analysis concluded pharmacist independent prescriber model is legally safer than PGD route
+- Exploring community pharmacy services for compliance aids, Norfolk Medicine Support Service
+
+### ICB Merger Preparations
+- Preparing for Norfolk & Waveney merger with Suffolk (SNEE ICB) from April 2026
+- Leading formulary alignment work between systems
+- Coordinating Blueteq alignment across ICB borders
+- Comparing incentive schemes and metrics between Norfolk and Suffolk
+- High-cost drug pathway harmonisation
+- Using AI tools (Copilot) to compare policy differences between systems
+
+### Other Notable Work
+- Antimicrobial stewardship work and audits at system level
+- Core20PLUS5 targeted interventions (health inequalities)
+- Patient adherence indicators development
+- Clinical pathway indicators implementation
+- TAG (Technology Appraisal Guidance) document generation automation using VBA
+- Supporting NICE Technology Appraisal implementation across the system
+- Horizon scanning for new medicines and upcoming patent expiries
+
+---
+
+## Technical Skills
+
+### Programming & Data
+- **Python** (primary language, ~6–7 years): pandas, numpy, matplotlib, data analysis, algorithm development, automation, machine learning, API integration, financial modelling
+- **SQL** (daily use, possibly more than Python now): Snowflake, NHS databases, complex joins, CTEs, window functions
+- **Power BI**: Dashboard development, DAX measures, interactive reporting
+- **Excel/VBA** (advanced): Pivot tables, macros, automation, interactive workbooks
+- **JavaScript/TypeScript** (hobby level): Web development, personal website
+- **DuckDB**: Local data warehousing experiments
+
+### Machine Learning & AI
+- Fine-tuned LLMs (11B parameter model for prescription direction parsing)
+- Monte Carlo simulation modelling
+- Predictive analytics and demand forecasting
+- Black-Scholes options pricing models
+- Gamma mapping from options open interest
+- Experience with cloud GPU (A100) for model deployment
+- 3D medical imaging AI model deployment (experimental)
+
+### Healthcare Data Systems
+- dm+d (Dictionary of Medicines and Devices) — deep schema knowledge (VTM, VMP, VMPP, AMP, AMPP hierarchies)
+- Blueteq (prior approval system)
+- ePACT2 (NHS BSA prescribing data)
+- OpenPrescribing
+- Eclipse
+- Fingertips (population health indicators)
+- NHS BSA prescribing datasets
+- Secondary care activity data
+- Johns Hopkins ACG system (risk stratification)
+- Patient-level prescribing and dispensing data
+
+### Tools & Platforms
+- Jupyter Notebooks / DataSpell
+- Git
+- Home Assistant (extensive home automation)
+- Unraid server administration
+- ESPHome / ESP32 firmware
+- 3D printing (Bambu Lab printers, PETG, ASA materials)
+- Claude Code (command line agentic coding)
+
+### Certifications
+- GPhC Registered Pharmacist (August 2016 – Present)
+- Snowflake: Hands-On Essentials — Data Warehousing Workshop
+- NHS Leadership Academy: Mary Seacole Programme (78%, 2018)
+- No formal data science qualifications — entirely self-taught
+
+---
+
+## Daily Work Breakdown
+
+Typical week splits roughly:
+- **~40% meetings and strategy:** Stakeholder engagement, national/regional calls, working with colleagues on projects, supporting decisions with data, understanding the current climate and opportunities for collaboration across medicines optimisation teams
+- **~40% coding and analysis:** Writing Python scripts, SQL queries, building Power BI dashboards, curating insights for stakeholders in a way they will listen to
+- **~20% problem-solving:** Figuring out how to solve problems, navigating challenges, political landscape
+
+Key insight: "curating insights in a way where stakeholders will listen" — the communication/political piece is as important as the technical work.
+
+---
+
+## Speaking & Public Engagement
+
+### UEA "Careers in Data" Panel (November 2025)
+- Guest panelist at University of East Anglia
+- Spoke about journey from self-taught coding to NHS data leadership
+- Audience: current UEA students interested in data careers
+- Unique positioning: only panelist combining clinical healthcare with self-taught data skills
+- Key messages delivered: you don't need a CS degree, build real things that solve real problems, domain expertise + coding > pure technical skills
+
+### UEA "Inspirational Roles in Pharmacy" Presentation (September 2025)
+- Invited back to alma mater for 10–15 minute presentation on non-traditional pharmacy career
+- Presented to first-year pharmacy students
+- Focused on demonstrating unconventional career paths within pharmacy
+
+---
+
+## Career Goals & Transition Strategy
+
+### Current Direction
+Actively exploring transition from NHS to private sector, targeting pharmaceutical, health-tech, and consulting companies. Recognises that private sector organisations are more likely to use external recruiters than NHS roles.
+
+### Target Roles
+- Senior Manager / Associate Director level (considers Director/Head titles premature at 32 without private sector experience)
+- Medical Affairs
+- Market Access
+- Health Economics and Outcomes Research (HEOR)
+- Healthcare IT Consulting / Principal Consultant
+- Real-World Evidence analysis
+- Digital Health Product Management
+- Population Health Strategy
+
+### Positioning
+- "Pharmacist who builds health tech solutions" — NOT "pharmacist trying to transition into tech"
+- Core differentiator: clinical domain expertise + technical capability + strategic leadership at scale
+- NHS language translation needed: "Deputy Head of Population Health and Data Analytics" maps to "Senior Manager, HEOR" or "Principal Consultant, Population Health Strategy" in private sector terms
+- UK professional communication values evidence-based understatement over American-style self-promotion
+
+### Contacts & Network
+- Connection at Prescribing Services (established contact)
+- Guest panelist alongside data professionals from Aviva, UEA bioinformatics, and social impact data roles
+- LPC representative experience (community pharmacy sector network)
+- Cross-ICB relationships (Suffolk/SNEE colleagues)
+
+---
+
+## Education Summary
+
+| Qualification | Institution | Date | Grade/Notes |
+|---|---|---|---|
+| MPharm (Hons) | University of East Anglia | 2011–2015 | 2:1. Research project: 75.1% (Distinction). OSCE: 80%. Failed exams years 1–3 |
+| A-Levels | Highworth Grammar School | 2009–2011 | Maths (A*), Chemistry (B), Politics (C) |
+| Mary Seacole Programme | NHS Leadership Academy | Apr–Oct 2018 | 78% |
+| Snowflake Badge | Snowflake | — | Hands-On Essentials: Data Warehousing |
+
+---
+
+## Personal Interests & Technical Hobbies
+
+- **Home automation:** Extensive Home Assistant setup, multiple Raspberry Pis, ESP32 microcontrollers, ESPHome firmware
+- **Unraid server:** Running home server infrastructure
+- **3D printing:** Bambu Lab printers, PETG and ASA materials, designing enclosures for electronics projects
+- **Electronics:** ESP32 projects including environmental monitoring (BME280/BME680), presence detection (LD2410 mmWave), e-ink displays. Planned greenhouse automation project (soil moisture sensors, automated watering)
+- **LED neon projects:** WS2811 neon rope LEDs (108 LEDs/meter, 2x 5m sets), 4-way LED controller, 24V 15A power supply
+- **Financial markets:** Built Black-Scholes options pricing and gamma mapping tools — first major Python project
+- **Photography:** Listed as personal interest
+- **Father:** Married with young children, values work-life balance
+
+---
+
+## Key Quantified Metrics (Portfolio Highlights)
+
+| Metric | Value |
+|---|---|
+| Efficiency savings identified | £14.6M+ (by October 2025) |
+| Prescribing budget managed | £220M annual |
+| Population served | 1.2 million |
+| Cost optimisation algorithm savings | £2.8M potential across 14,000 patients |
+| Prescribing reduction (targeted areas) | 50% within 2 months |
+| Blueteq form reduction | 70% |
+| Time saved (Blueteq automation) | 200 hours immediately + 30 hours/month ongoing |
+| Time saved (incentive analysis) | Months → 3 days per cycle |
+| National pharmacy solution revenue | ~£1M potential across Tesco estate |
+| NMS completion rate improvement | Under 10% → 50–60% |
+| Opioid prescribing reduction (NW vs national) | 18.3% vs 6.9% (high-dose) |
+| Invoice backlog cleared | 500+ invoices from 2019 → current |
+
+---
+
+## Philosophy & Approach
+
+### On Data-Driven Healthcare
+"What is the question you want answered?" — Andy's framing for colleagues. Not "what's going on with this drug?" but specific, targeted questions that allow data to provide actionable insight rather than vague trends.
+
+### On the Clinical-Technical Bridge
+"The skills gap in healthcare isn't just technical people or just clinical people — it's people who can speak both languages. That gap is your opportunity."
+
+### On Population vs Individual Impact
+"As a community pharmacist, we would dispense 6,000 items a month to probably 3,000 patients. I had lovely relationships with patients — I've cried with patients when their significant others died. But the population of our system is 1.1–1.2 million people. Being able to directly target 50,000 people — if you can incentivise GPs to do a single piece of work cost-effectively that prevents even some of them from having a fall and going to A&E with a broken hip — you can't see that direct impact, but I know it's making a difference."
+
+### On Self-Teaching
+"Don't wait for the perfect course. Find something that annoys you, break it down into steps, Google each step. Your first code will be bad. That's fine — mine was awful."
+
+### On Communication
+"I spend more time in PowerPoint than Python — that's not taught but it's critical." Analysis is worthless if no one understands it.
+
+---
+
+## Website Structure Recommendations (From Previous Discussions)
+
+### Current Site
+- andy.charlwood.xyz — single-page design, personal voice, clean domain
+- Includes LinkedIn links, downloadable CV
+- Currently structured more as narrative CV than portfolio
+
+### Recommended Restructure
+1. **Hero section** (20 seconds to hook) — name, role, value proposition
+2. **Featured projects** (the differentiator — should be immediately visible)
+3. **Technical skills** (prove capability)
+4. **Abbreviated career highlights**
+5. **Contact/links**
+
+### Priority Projects for Case Studies
+1. Cost optimisation algorithm (£2.8M savings, 50% reduction in 2 months)
+2. Opioid monitoring dashboard (patient safety, system-wide)
+3. Tirzepatide Monte Carlo modelling (financial risk, executive decision-making)
+4. DOAC switching scenario modeller (interactive tool for executives)
+5. Prescribing incentive scheme (novel design, patient-level tracking)
+
+---
+
+## Organisational Context
+
+### Norfolk & Waveney ICB Structure
+- Part of NHS Norfolk & Waveney Integrated Care Board
+- Medicines optimisation team sits within broader ICS structure
+- Population health pillar looks 2–5 years ahead to understand risks and posture the system
+- BI team exists separately but historically poor collaboration with medicines optimisation
+- Andy has unusual direct access to ICB databases — typically pharmacy roles don't have this
+
+### ICB Merger (April 2026)
+- Norfolk & Waveney merging with Suffolk (from SNEE ICB)
+- New system will include: NHS Ipswich and East Suffolk (06L), NHS West Suffolk (07K), NHS Norfolk and Waveney (26A)
+- North East Essex (06T) joining Essex ICB
+- Significant alignment work ongoing: formularies, incentive schemes, Blueteq, pathways, policies
+
+### Organisational Challenges
+- Model ICB Blueprint indicates medicines optimisation marked for "review for transfer" to providers
+- Data function deprioritised during ICB merger preparations
+- Team morale affected by organisational restructuring
+- Previous head departed end of 2024, creating leadership gap Andy filled as interim
+
+---
+
+*This document compiled from conversations spanning March 2024 – February 2026. Intended as a comprehensive knowledge base for portfolio website development.*