Obituary - Dr Julian Costello

Despite being born in Coventry Julian Costello, who has died at the age of 66, trained and practised in Wales for almost his entire career, and considered himself very much an honorary Welshman. Mechanically-minded from an early age, he brought enthusiasm, thoughtfulness and innovation to his practice, and to his second career in clinical informatics.

He decided his career path at the age of 14, and entered the Welsh National School of Medicine in 1973. His interest in gadgets was invaluable when anything broke down in his student house, and he became known as ‘Mr Fixit’.

After his vocational training he entered the oldest practice in Newport as partner in 1984. Dilapidated premises forced the pace of change and within a year Julian had become a GP trainer, and masterminded the installation of the computer system in the purpose-built new surgery.

Julian’s organisational skills saw the practice move to a more stable business model, and his burgeoning interest in IT saw him join the Meditel User Group, as well as the Primary Healthcare Specialist Group (PHCSG) of the British Computer Society, helping to shape the functionality of GP systems to improve patient care.

In 1997 Julian was appointed as one of the medical consultants at AAH Meditel, and eventually his interest became overriding and he left his surgery in 2004 to pursue his second career. He maintained his clinical skills with out-of-hours and locum work so that he could have a fuller understanding of the IT requirements of front-line clinicians.

Clinical coding became one of his main interests, and his appointments reflected his expertise. He became clinical lead at Niche Health, while his work with NHS Wales Informatics Service (NWIS) brought his knowledge and expertise in clinical terminology to the advancement of healthcare IT in his adopted country.

In 2005 he was a member of the Connecting for Health team dispatched to iSoft’s Chennai development facility in India, to advise on the ill-fated Lorenzo GP system. As well as playing a full part in the discussions Julian immersed himself into the local culture, investing in the local dress, including a Nehru jacket, and posing for photos alongside the impressive-looking commissionaire at the team’s hotel!

In 2016 he was appointed senior clinical adviser to NHS Digital as part of the Expert Reference Group, and at one time or another he sat on the Joint GP IT Committee, and the Informatics Group of the Royal College of GPs, as well as the Committee of the PHCSG.

Just three years ago Julian moved to the East Midlands to be nearer his wife’s family, but he continued doing the work he loved with NWIS, IGPR, NHS Digital and SNOMED, and he was elected a Founding Fellow of the Faculty of Clinical Informatics.

Colleagues recall his cheerful enthusiasm, and warm and welcoming nature which meant he was often the first to greet new members to any group. Widely knowledgeable, yet often unassuming, it seemed his head was clearly bursting with ideas to make NHS IT better, and benefit both the patient and the clinician.

He took the news of his final diagnosis with his usual defiant optimism, and was exchanging supportive emails with his colleagues until a few days before his death just four weeks later. He leaves a wife, Kerri, a step-daughter, Rhiannon, and step-son, Russ, as well as a son, Huw, and daughter, Ruth, from his first marriage.

Julian Costello MB BCh MRCGP FBCS FFCI, GP and clinical informatician, b. 2 December 1954 in Coventry, d. 24 January 2021 in Derby, of carcinoma of the head of pancreas.