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Lauren Hoodless

Lauren Hoodless

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Digital Health Networks Debate on ICB Digital Priorities

by Lauren Hoodless January 5, 2023
written by Lauren Hoodless

The new integrated care boards (ICBs) need to recognise that digital is at the heart of transformation and make the most of the opportunities that greater integration brings.

This includes growing the digital workforce and supporting the increasing role of shared care records – memorably described by one panellist at a recent Digital Health Networks debate as “fantastic integration engines”.

The latest in the Digital Health Networks Debate series took place at the end of October, just a short time after England’s 42 ICBs became legal entities.  It brought together leaders from across the country to discuss ICB digital priorities.

The panellists, all of whom are closely involved in development of ICBs, were able to share experiences from their own patch, and shine some light on emerging priorities and direction.

Care around the patient

According to Dermot Ryan, director of frontline digitisation, NHS England and NHS Improvement, the creation of ICBs has meant a paradigm shift. “It’s transitioning away from care being provided by organisations and people fitting in with that, to care being defined around the patient. In the context of that shift, digital strategies have to be focused on how digital supports integrated care.”

Ryan warned ICBs against “walking before they could run”. “There’s loads of great advances in what can be done in healthcare, with artificial intelligence and automation,” he said. “But I think you need to focus on the foundations first, before going after these things in earnest.”

Linda Vernon, acting digital culture and transformation clinical lead, Lancashire & South Cumbria Integrated Care Board, said that digital should be an integral part of ICBs’ strategies. “We all know that digital transformation is just a part of transformation – so I think the fact that we’re doing separate digital plans probably isn’t the right approach,” she said.

“I agree to an extent that we have to walk before we can run, but there’s something around us not getting so bogged down in the basics and fundamentals that we stifle innovation.”

A chance to be proactive

There’s an opportunity with the ICBs to think strategically and to be proactive rather than reactive, she added. “This has given us a chance to really think about where are we going to invest our time and energy, and have we got the capacity to deliver across the wider system.”

ICBs have lead responsibility for joining up digital strategies across integrated care systems, and obviously they have many and competing priorities. But the panel debated to what extent their role was mainly in co-ordinating what was going on locally, or actually setting digital strategy in a more directive way.

According to Andy Williams, interim chief digital and information officer, Humber & North Yorkshire Health & Care Partnership, the focus should be on how different organisations within the ICB area work together with more shared resource over time. How this will happen will become more obvious as financial systems begin to align – and if there is a period of political stability, he added.

“I’ve had the pleasure of sitting on the IC board meetings and it’s a wide, diverse group of organisations that are represented there,” he said. “Yet they’ve all got the system and the patient at heart, and they’re all trying to figure out what is it as individual organisations to benefit the greater good, the greater whole.”

Place-based approach

Balancing organisational priorities with ICB priorities means looking at joint priorities – and taking a place-based approach, Williams added. “It’s a really good start in terms of the different organisations in a place coming together and talking as partners about what could we do that makes a difference to solve some of these really difficult problems – around waiting lists, ambulance queues, elective recovery, that everyone is really struggling with.”

Vernon gave the example of her area which has had experience of working across boundaries as an STP then ICS. “There’s already been a lot of joint working at place,” she explained. “We had five places within our geography with four acute trusts and councils already working really closely together at place.”

This helps with optimising and sharing workforce, as well as working together at scale on big issues such as cybersecurity, she added.

ICB structures shape digital plan

Her area had a well-established digital strategy for the original ICS, she said, which was reviewed last year to ensure it was fit for purpose. “Increasingly there are structures within the ICB that are going to help shape the plan as it unfolds.”

In the chair Lisa Emery, chief transformation, innovation and digital officer, Sussex Health & Care, and NHS Sussex, raised the issue of legislation and the role of mandation in the system.  Ryan said it was a “mixed bag”. “We definitely need mandation and legislation in the tool box… and sometimes you have to use them as an option of last resort, but it’s certainly not an option of first resort.”

Williams said that he was in favour of light touch legislation but emphasised that having the right culture in an organisation was key to making positive change. That includes having proper inclusive conversations and coming to agreement about the best way forward.

Vernon agreed that co-design was crucial. “I’m always in favour of the carrot rather than the stick,” she said. “If we design services with the people who are going to deliver them and use them, whether that’s digital or not digital, we have a much better chance of adoption, of people feeling part of that bigger community doing something together.”

Investing in the digital workforce is also key, the panel agreed. Ryan said it was important to have a talent pipeline. As well as growing the digital workforce, improving digital skills in the wider workforce is crucial. “There’s no doubt that as digital becomes more interwoven into the delivery of healthcare to patients that we need to consider digital as a kind of core skill set alongside the other skill sets that make up the NHS,” he added.

New era shared care records

Shared care records will only become more important in the future, the panel agreed. Vernon suggested they have a key role to play in ICBs’ assessment of their digital maturity. “We have an established shared care record… we’ve done a brilliant job of setting that foundation,” she said. “But we’re now starting to think of next stages, which is around the structure of data sharing so that we can facilitate real-time views of patient data – that I can see as a patient, perhaps, as well as being shared across different sectors and different clinicians and boundaries, such as care homes.”

Williams emphasised that shared care records should be a priority for ICBs as they can “stick” different sectors and domains together, and drive integration. “For me, things like shared care records can be used as fantastic integration engines, as information sharing records and as data platforms as well.”

January 5, 2023 0 comments
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A new programme of events dedicated to supporting the next generation of digital leaders

by Lauren Hoodless November 25, 2022
written by Lauren Hoodless

Dedicated to future and aspiring Chief Clinical Information Officers (CCIOs), Chief Information Officers (CIOs) and Chief Nursing Information Officers (CNIOs), these events will offer invaluable advice and guidance for anyone considering a similar career path.

Our panellists will share their career journeys, reflecting on the early days in their role, looking back at expectation vs reality, challenges faced, surprises along the way, and key takeaways.

We also look to CCIOs, CIOs and CNIOs who have been in the post for several years to enhance this peer learning opportunity by offering any advice they have for anyone looking to move into these roles.
Network members are invited to attend and enjoy inspiring, thought-provoking discussion, join in the conversation, and ask questions.

The events form part of the Digital Health Networks’ commitment to supporting the next generation of digital leaders to continue the growth and development of the community.

They build on the success of recent community activity of this kind, such as the 35 under 35 Summer Schools bursary scheme, and the group mentoring programmes launched by both the CNIO and CCIO Advisory Panels.

We have six events lined up which will focus on CCIOs, CIOs and CNIOs.

Book your place now

CCIO Spotlight Series, Episode #1
13 Jan 1230-1315

CIO Spotlight Series, Episode #1
20 Jan 1230-1315

CCIO Spotlight Series, Episode #2
10 Feb 1230-1315

CIO Spotlight Series, Episode #2
17 Feb 1230-1315

CNIO Spotlight Series, Episode #1
21 Apr, 1230-1315

CNIO Spotlight Series, Episode #2
2 Jun, 1230-1315

November 25, 2022 0 comments
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A first for AHPs at Digital Health Summer School 2022

by Lauren Hoodless September 5, 2022
written by Lauren Hoodless

AHPs Summer SchoolDuring Digital Health Summer Schools at the University of York in July there was a gathering of digital Allied Health Professionals (AHPs) and some very welcome non-AHP friends. We wanted to build on the momentum from the digital AHP and pharmacy session we had earlier in the year at Rewired. We wanted to grow the community of digital AHPs, encourage those in the room to lead from the front, and to discuss how we might influence those not in the room to better engage with the network.

We invited the chief AHP Officers (CAHPOs) from the 4 countries in the UK to be part of the session and meet their digital leaders. Disappointingly none were able to attend. Although, Suzanne Rastrick, a CAHPO in England, nominated Natasha Phillips, the chief nursing information officer (CNIO) at NHS England, to be a part of the session in her place. We were very grateful for Natasha attending and sharing with the group a summary of the work completed and planned for the nursing profession in England. Having been in post for just over two years, Natasha and her team have made some excellent progress, some of which is already having an impact in the digital AHP world, and some providing learning for us. Having allies such as Natasha and her personal pledge of support will help the AHP workforce shape our digital agenda.

My #DigitalAHP pledge is to use every opportunity to be an ally to & advocate for this amazing bunch and all digital AHPs #StrongerTogether #DeliveringOurDigitalFuture pic.twitter.com/oaXtGdY5UH

— Dr Natasha Phillips RN (@NHSCNIO) July 15, 2022

Building upon the attendance at Rewired, 27 AHPs and friends gathered on day two. An impressive turn out given that Summer School 2022 attendance was just over 300 peers. After an introductory canter through the policy and strategy activity in the last five years, exploring some of the learning (light) from these as well as the missed opportunities (shade), the group were asked to make digital commitments. Using the themes of identity, leadership and learning, digital leaders in the room were asked to consider a commitment to be completed next week, next month and next year.

Core themes included:

  • Connecting with the current literature, guidelines, and competency frameworks
  • Getting familiar with existing networks and tribes and increasing participation
  • Investing time in organisational, regional and national role modelling and leadership

One example of the commitments made is from Ali Toft, AHP Information Officer (CAHPIO) and Occupational Therapist at Great Ormond Street Hospital.

Ali pledged to:

Next week

  • Follow up on new contacts made at Summer School and reach out to others.
  • Begin to consider and draft areas for development.

Next month

  • Review newly published strategies and ones I haven’t seen before.
  • Explore new networks and opportunities I’m not currently aware of or accessing productively.
  • Do myself an action plan which begins to focus across identity, learning and leadership. A plan with bite-sized, manageable chunks.

Next year

  • Refocus and work with colleagues to review our organisation digital implementation plan in co-production with the people.
  •  Ongoing…. shout, question, ask and challenge!

The activism and passion from the group was seen in their responses and included key terms such as:

AHP piece

During the session our wonderful peer, Nathan Kershaw who flew in from New Zealand for the event created a digital AHP channel for Discourse for us. This is open to all wish to inspire, share and collaborate.

The energy, appetite, and leadership for advancing digitally ready, mature, and enabled AHP is obvious. This has been recognised by the good people at Digital Health. Together, we are pleased to announce Rewired 2023 will host the first ever Digital AHP Summit. This will be on day 2 of the conference and be run jointly with our colleagues from pharmacy. It is our intention to invite the 4 CAHPOs and present the digital activity across the UK. We would love for AHPs to share their work at Rewired 2023.

There will be opportunities in the Digital AHP Summit and across the other stages. We know there is a wealth of innovation and new ways of working and we really must do better at sharing.

So, here it’s the call the AHP call to action:

  • Please submit and share your work at Rewired 2023 here. Submissions closes on 31 October 2022.
  • If you’re not sure what or how to present your work, or for any other digital AHP questions, please do reach out via the digital AHP channel on Discourse

Finally, we are sad that our friend and extremely valued colleague Melissa leaves us to go back home to Oz in the next few months. We are equally excited about international digital AHP activity in the future! Melissa will be taking over the CCIO twitter handle this month, so please do take time to join in the conversation.

The CCIO Advisory Panel have maintained an AHP seat to ensure a strong voice for workforce and we are delighted to welcome the wonderful and passionate Anna Awoliyi.  Euan McComiskie will remain the digital AHP voice on the CNIO advisory panel.

We look forward to seeing even more digital AHPs at Rewired and interacting with you virtually before then.

Onwards and upwards for digital AHPs: the untapped potential of digital health!

September 5, 2022 0 comments
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Summer Schools 2022 bursary holders reflect on their experience

by Lauren Hoodless September 5, 2022
written by Lauren Hoodless

A few months on from Digital Health Summer Schools, some of the NHS Digital bursary holders have reflected on their experience of the event.

NHS Digital provided bursaries to 20 women from ethnic minority groups to attend Summer Schools in York in July 2022.

The event provided aspiring leaders with the opportunity to engage in rewarding education, networking, and best practice exchange while learning from the very best digital and healthcare leaders including Tim Ferris, Simon Bolton, Sonia Patel and the Shuri team.

Presentations and interactive workshops covered the future of the digital profession, the role of the ICS and the use of data and digital tools to improve and manage the health of citizens.

Below you can hear some testimonials from Star Tshabalala, Amanda Francis, Tayo Iloh, and Rebecca Mansoor, who attended the event.

“I was filled with excitement at the prospect of attending. At the event there were many opportunities to meet with other Clinical Informaticians including several people from NHS Digital. Digital leaders were challenged to address health inequalities and variations in the digital capabilities and experiences of both staff and patients that are determined by where a person lives or works. As a Shuri Network Nurse Fellow, it was a privilege to witness the great work being done by both members and allies in giving women from ethnic minority groups an opportunity to explore the digital world.”

 

Star Tshabalala 

“It was great to meet so many new and interesting people all passionate about the future of the NHS and improving its services by digitisation. The keynote discussions were tremendously informative, and I was encouraged by the attention given to managing convergence and developing digital skills and digital capabilities while transforming the workforce. The sessions made me realise how much knowledge and learning is available via the Shuri Network. It was both uplifting and rewarding to learn that inequalities in the workforce are being addressed and schemes organised to redress the balance.”

 

Amanda Francis

“It was an incredible opportunity to gain top-notch knowledge and guidance from industry leaders. It was a great platform to learn about various aspects of digital health trends, challenges and new ways of working within the system, Overall, it was a wonderful experience. I had a great time, met some interesting individuals, and developed some productive relationships. Even though it was a challenging, thought-provoking conference, I would still highly recommend it to colleagues looking to attend in the future.”

 

Tayo Iloh

“The summer school is the first in-person event I have been to in a long time because of the pandemic. I was slightly apprehensive but didn’t have to worry as the whole programme was setup to help people feel comfortable and make meaningful professional contacts. I hope to keep in touch with some of the people I met and use these contacts to further relationships between NHS Digital and the frontline NHS. There was so much passion and enthusiasm for digital initiatives within healthcare, and I am sure that networking events such as these contribute to improvements and enhancements in patient care.”

 

Rebecca Mansoor

Reflecting on the event, NHS Digital’s interim chief medical officer and chair of the Shuri Network, Shera Chok, said: “This was the most diverse audience in the Summer School history. There was a real buzz and energy from having aspiring digital leaders from different backgrounds at the conference as they are the future of digital health in the NHS and care. It was a great success and we hope to repeat the bursary programme next year.”

September 5, 2022 0 comments
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Digital Health Awards 2022 winner profile: Rob Ratcliffe

by Lauren Hoodless August 15, 2022
written by Lauren Hoodless

Rob RatcliffeWhat is your current role?  

I am currently a district nursing clinical lead at Midlands Partnership NHS Foundation Trust and have been for the past few years.

How did you get to where you are now? 

I started my NHS career as a clinical support worker some 24 years ago. I didn’t think for one second that I would become a registered nurse at that point due to having dyslexia. I was actively encouraged to apply to undertake my pre-registration course at a local university and that’s when I started to get interested in digital ways to support me through the programme. I started the course in September 2002 and have never looked back since.

How did it feel to win Rising Star in Digital Nursing? 

I still can’t really believe it. I was nominated by IT colleagues at work due to a project that I had been working on. I have previously worked on several IT projects however the roll out of total mobile is by far the largest. I am not sure if winning has really sunk in at all yet. I do keep looking at the award every now and then to remind myself.

At the end of the day, I am a nurse who loves the thought of improving things for patients and staff. Using digital in my work place has really helped me both inform the patients that I work with about their health needs and also has helped staff by speeding up the documentation element of providing care in a patient’s home. The use of a tablet device enables us to use lots of digital in the hope that this will improve the outcomes for our patients.

What is the most challenging part of your role? 

No day is ever the same. I am community based and therefore travel to the majority of my patients. We do run ambulatory clinic services alongside home visits, however it’s the home care that I really love. Some of the main challenges are the huge health inequalities within the areas that I cover.

I also look at all incidents raised for my area and feed back to the reporter (hopefully in a timely manner). Having enough hours in the day is another challenge, and just trying to ensure that we do the best we can as a service, ensuring the patient is truly at the heart of everything that we do.

Within your organisation, what is the most significant digital achievement of the past 12 months? 

I work for a very forward thinking organisation. Midlands Partnership Foundation Trust is relatively new – it has its own digital strategy and really listens to staff to see what the needs of services are. There are currently lots of things going on within the trust. As the trust covers both physical and mental health services there has been lots of work done by IT and ward-based staff on remote monitoring of patients within inpatient settings.

The trust is currently looking at dictation software and has spent the last 12 months engaging with staff to ensure it is getting things right, working hugely on the current connectivity and performance when out and about. All community nursing staff (physical health) now have laptops, tablets and phones to use which makes life much less stressful.

Probably the most significant achievement for the trust is the rollout of total mobile in which I have been heavily involved. It has enabled community nursing to really look at the way it was working and change it for the better using digital.

What is the largest barrier to achieving digital transformation?

I think at the beginning it was connectivity, especially when out in the community. The trust covers the whole of North, South and East Staffordshire and staff like to be involved in new clinical systems, appearing to disengage if they feel that they are not being listened to.

Whenever a new system is being developed it has to be fit for purpose and do the job it is supposed to do, and ideally save clinicians time.

What do you hope to digitally achieve within your role and organisation over the next 12 months?

I have worked for the organisation for the last 14 years and will hopefully continue to engage with the clinical staff and drive forward the trust’s digital agenda to ensure that digital is truly embedded in everyday practice.

My new work stream is to start to look at the way in which we communicate with our GP colleagues and care agencies. It will of course have a digital answer, however it’s just looking to ensure it will work for all.

You can find out who scooped each award here

August 15, 2022 0 comments
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Digital Health Awards 2022 winner profile: Peter Thomas

by Lauren Hoodless August 11, 2022
written by Lauren Hoodless

What is your current role? Peter Thomas award win

I am CCIO at Moorfields Eye Hospital and director of digital medicine there. My role is to support the development of a digital environment that actively benefits clinical services, as well as to champion a move towards digitally-delivered services. I’m also on secondment part-time to NHS Digital where I act as a clinical lead for digital on the national eyecare programme.

How did you become a CCIO?

I’d been interested in the application of technology to clinical practice for many years before I became a consultant paediatric ophthalmologist at Moorfields in 2017. Earlier in my career I had spent time working in the IT industry and had undertaken a PhD in computational neuroscience.

After I joined Moorfields, I was appointed to a new role working under the CCIO as clinical director of digital innovation where I focused on novel applications of technology to support clinical care. I took over as CCIO last year as a natural career progression from the innovation role.

To get myself ready to be a CCIO, I joined cohort two of the NHS Digital Academy, and took every opportunity to professionalise in clinical informatics, including fellowship of the Faculty of Clinical Informatics.

How did it feel to win CCIO of the Year?

Fantastic. We’ve taken a new approach to delivering clinical informatics at Moorfields, founding the UK’s first department of digital medicine. As with anything new, it’s great when the profession recognises that you’re going in the right direction. Although it’s my name on the award, I’m really only a representative of the brilliant team at Moorfields.

What is the most challenging part of your role?

It’s an interesting time in digital transformation of healthcare because there are so many different areas that you could choose to focus on. At Moorfields we have some of the most capable and innovative clinicians and researchers anywhere in the world and it would be easy to work on innovation projects full time.

However, I have to balance that against a very significant transformation programme to get our core infrastructure ready for a new hospital move in 2026. Getting the balance right is a challenge.

Within your organisation, what is the most significant digital achievement of the past 12 months?

From a clinical informatics perspective, it has been the creation of a department of digital medicine. As part of my Digital Academy research, I gathered feedback from 40 other digital leaders in the NHS to discover how they bring the clinical and technology aspects of digital transformation together.

The new department arose from that work and is supporting us to develop a team of digital clinicians who are professionalising as clinical informaticians and specialising in topics such as digital safety, exclusion, engagement, and innovation. This puts us in a much better place going forwards as we now have an engine to drive clinical informatics that is formalised, well embedded, and sufficiently resourced.

What is the largest barrier to achieving digital transformation?

Looking across the entire healthcare sector, I think it’s the scale and breadth of the change needed. We have hospitals and institutions that, in some cases, have centuries of tradition and process built around traditional models of medicine.

We’re now expecting those same organisations to deliver digital services that we would normally associate with digitally-native organisations that boast large IT departments and have their entire business model built around digital health. At the same time, those hospitals are also struggling with significant pressures and constraints. It’s a process that will take time.

What do you hope to digitally achieve within your role and organisation over the next 12 months?

We have significant improvements to our core systems in the pipeline, and we’ve built the foundations to begin moving exciting technologies like remote monitoring and clinical AI out of research and pilot programmes and into routine clinical care. In the next 12 months, I’d like to implement more of these future-looking technologies into routine care.

What advice would you give to anyone who is thinking of becoming a CCIO?

Take every opportunity to professionalise – there’s a huge chasm between the understanding I had as a clinician-enthusiast, and the understanding I’m developing now through things like the NHS Digital Academy.

Many will still be coming into clinical informatics without knowing that there is a network of professionals across the UK who can support you, and a whole host of conferences and professional development activities that you can use to build a network (such as the excellent Digital Health Summer Schools).

August 11, 2022 0 comments
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Digital Health Awards 2022 winner profile: Prof Louise Hicks

by Lauren Hoodless August 2, 2022
written by Lauren Hoodless

The Digital Health Awards 2022 took place on the middle night of Summer Schools in York and CNIO of the Year was won by Professor Louise Hicks. The CNIO at Barts Health NHS Trust revealed all to Digital Health, including her role and journey to this point, how she felt when she won the award and her digital ambitions over the next 12 months.Prof Louise Hicks

What is your current role?

CNIO and director of development at Barts Health NHS Trust.

How did you become a CNIO?

Intensely committed to outstanding nursing care, I was in a development role and had an opportunity to use digital transformation to not only enhance quality and reduce variation but also create a strong nursing voice for change. I started out by mapping out a vision and engaging a team of passionate and skilled people, which included patient perspectives.

Building a relationship with informatics leaders locally, nationally and through Cerner really inspired me to want to lead this agenda. I have had fantastic support from my CNO [chief nursing officer], CIO [chief information officer] and CCIO [chief clinical information officer] who really encouraged the development. I also have a great relationship with the whole clinical informatics leadership team that has developed – deputy CCIOs, medical clinical informatics leads, digital midwives and pharmacists, nursing informatics officers and lead nurses.

Importantly though is the leadership and support through the hospital directors of nursing and group directors of midwifery and allied health. You have to have this team ambition and commitment.

One of the big motivations of developing nursing informatics and getting adoption though was that many people said, ‘you’ll never be able to do this’. There was an underlying distrust in informatics and digital solutions and there had been a prior nursing solution in place that wasn’t really used. This was a positive challenge, not only to me but also to the fabulous nursing informatics team that has developed since 2018.

I could see that being the CNIO has a wider opportunity to also impact population health and enhance outcomes for patients and the community. I have had a clinical and academic career that has also included education, research and community engagement alongside coaching, transformation and organisational development. All of these have been incredibly helpful in the CNIO role.

In 2018 we took a team to Kansas City to the Cerner Conference. We used this as an opportunity to galvanise our nursing and multiprofessional clinical informatics vision. From this we developed our Barts Health We Connect vision and my CNIO role formally began.

How did it feel to win CNIO of the Year?

I was overwhelmed! It is such a wonderful achievement and I am truly overjoyed. It’s a great recognition of the nursing contribution to clinical informatics and is so important. I feel that it is a result of masses of support and the commitment and passion of many, not least the nursing informatics team at Barts Health, who are an inspiring and talented group of professionals but also other CNIOs that I’ve networked with and always been so supportive. There is a great camaraderie between CNIOs and we are very happy to share perspectives, solutions and resources. Even though we work with different systems and suppliers, the core is about the patient and NMAHP [nursing, midwifery and allied health professions] as professional excellence.

Since the award I’ve received so many congratulations and good wishes – it’s so kind and positive. It creates a wave of further motivation to do so much more! It’s great for nursing teams to share in this award and recognise that the integration of informatics as part of the caring role is essential.

What is the most challenging part of your role?

Time and resource. At the moment we are growing and need to be strategic and tactical in how we align ongoing resources. We have ambitious plans but these need to be fully supported through robust investment. We are developing strong business cases and have much support so the future is certainly bright.

It’s really important to ensure a robust infrastructure and career framework that enables nurses and clinical teams to see informatics as a great career opportunity. It requires us to have greater national consistency and talent management. We have the talent but we need to enhance the framework.

If we get these two aspects right then the inclusive ambitions to create better population health and remove digital poverty in communities become an easier aspiration.

Within your organisation, what is the most significant digital achievement of the past 12 months?

During our response to Covid, between peaks, we implemented ePMA [electronic prescribing and medicines administration] on 127 of our wards and areas across four hospitals. We established a 90-day assurance and preparation programme followed by 90 days of fantastic go lives across our organisation. It was wonderful to get teams focused on the detail and energy of this and to spread our We Connect method of team development.

It’s been a fabulous achievement that has galvanised the positive power of working with a fantastic clinical informatics team, IT and clinical systems with each of our hospitals.

What is the largest barrier to achieving digital transformation?

The largest barrier would be in thinking it can’t be done!! I never think this – there is always a solution. However, we need the investment to ensure we have the right talent and skills in the right place plus the joined up thinking and strategies to ensure aspirations are systematically achieved and progressed.

We really must ensure that we are truly listening to our communities and not leaving people behind or marginalised. It is really important in our transformation plans to ensure inequalities are tackled and new solutions are in place to prevent exclusion.

What do you hope to digitally achieve within your role and organisation over the next 12 months?

Over the next 12 months we have an exciting agenda and plan to continue to optimise our nursing and clinical records system. Further enhanced implementation that targets women and children, critical and perioperative care and builds on the flow of data and information to impact clinical decision making are just some of the plans.

People are at the heart of informatics development so making sure our core team have the support and development opportunity in place that they need for the next phase of the journey and their career ambitions plus supporting and expanding our fabulous team of 500 superusers is essential.

We are developing impressive education and research opportunities so look forward to working with our Higher Education and Life sciences partners.

The next 12 months has to also include supporting the Shuri Fellowship as an ally and also committing to mentor, coach and support those wanting to develop their careers. We had five fellows on cohort one and they have done so well. Ensuring that this is available alongside other fellowships and digital developments is key to our strategy and also staff satisfaction.

During the next 12 months we will also be continuously improving using data and information. We have achieved much in developing medication safety, improved sepsis screening. enhanced management of deteriorating patients and understanding core nursing criteria and we are targeting more here.

We have had the pleasure of forming closer relationships with Barking, Havering and Redbridge University NHS Trust and over the next 12 months look forward to supporting plans and people as needed.

What advice would you give to anyone who is thinking of becoming a CNIO?

  • Go for it! Think about the skills and talents you would bring to the role and the specific leadership and transformation needed. Not all CNIOs are the same – we bring particular unique talents to the role and can use them to achieve what’s needed.
  • Talk through your career plans with other CNIOs or digital transformation leaders.
  • Talk to the chief nurse or your director of nursing.
  • Get a sponsor who can support you in your career ambitions and will speak out for you.
  • Do a digital fellowship or equivalent – Florence Nightingale, Digital Health.
  • Get a mentor and/or coach – the Digital Health CNIO Advisory Panel is launching a mentor scheme this year for example.
  • Shadow a CNIO and CCIO – look at different models and ideas.
  • Get involved with Digital Health – events, discourse, Summer School, round tables and seminars.
  • Who is your system provider – do they offer development? Access this and understand more.
  • Learn – set yourself a development plan, appreciate your talents and explore opportunities to enhance your skills (working with a coach or mentor will also help here) – integrate this in your annual appraisal and personal development plan.
  • Get involved in your organisation – develop relationships with NMAHP and IT leadership.
  • What do you feel passionate about that digital transformation makes the difference? Get involved in a programme of work in this area – test it out.
  • Enjoy! It’s a brilliant role – it can be called different things in different places so when you are looking for roles be sure to look widely for nursing and clinical informatics lead roles.
August 2, 2022 0 comments
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Looking back at my first in person Digital Health Summer Schools

by Lauren Hoodless July 21, 2022
written by Lauren Hoodless

In recent years, Digital Health Networks have made an active effort to include more nurses which has helped to drive the digital nursing agenda. I signed up to the CNIO network two years ago and attended my first in person Summer Schools event on July 14 and 15 2022. It was one of the most welcoming environments in health care I have ever experienced.

The BBQ on the first night was a great start to the networking. I was pleased to meet so many nurses face-to-face, having connected on twitter, and they offered their congratulations for being shortlisted for future digital leader of the year. The general buzz for the days to follow was great, with seasoned summer school attendees supporting and guiding us newcomers through the event.

NHS mergers and Integrated Care

The kick off to the event was interesting, we got a real insight from Simon Bolton, and I appreciated that he tackled the mergers of NHS England and NHS Digital head on. He talked about wanting to listen and speak to people to get the purpose of NHS England right.

Then later there was a panel which covered Integrated Care Systems (ICSs) which provided me with such a great insight. The best speaker here was Rushownara Miah (head of business intelligence at Pennine Care NHS Foundation Trust). Hearing her talk about the opportunities that she sees available with the data set my researcher brain going and I gave her an instant followon twitter.

On that note, my standout session from day one was the introduction to Artificial Intelligence (AI). Haris Shuaib (consultant clinical scientist – Guy’s and St Thomas’ NHS Foundation Trust) spoke my language and got me excited about AI, and not in the classic ‘tech will change everything’ way. He gave very real-world examples of the limitations and the options for AI. Plus, when I went to speak to him after for a chat on the bus, he was open to discussing the options for its impact on nursing. This is an area that we are currently looking at as part of the Phillips Ives Review, and I am looking forward to catching up with him again to explore the topic more.

The gala dinner was well co-ordinated, it can be quite daunting to be told that you have to spend the night sat on a table with a group of people you do not yet know. However, I sat next to the wonderful Devesh Sinha (CCIOBarking, Havering and Redbridge University Hospitals NHS Trust ) and Peter Thomas (CCIO of the year from Moorfields), they both made it extremely easy. We discussed research, career journeys, next steps, and NHS culture with such enthusiasm.

Split screens and Phillips Ives

The keynote of day two was by one of my favourite speakers – Matthew Taylor (CEO NHS Confederation), I heard repetition of his split screen analogy throughout the rest of the day. The analogy perfectly depicted the need in the NHS to focus on both the immediate problems and the long-term strategy for resilience in the future. I am always impressed by how well he speaks and how he works the audience, he never professes to have the all the answers, but he is realistic of the state the NHS is currently in.

This was followed by a laughter filled talk from Rhidian Hurle (CCIO NHS Wales Informatics Service), I enjoyed this as I think we need to hear more from the other nations. I am quite jealous of the Welsh infrastructure, and I want to see and understand the impact of their investments.

Then Natasha Phillips (CNIO at NHS England) spread the message of the Phillips Ives Review – this filled me with pride, that I am currently working one of the biggest reviews and shaping of the nursing workforce that we have ever seen. Next up was Sonia Patel (CIO at NHS England) and she acknowledged that we are improving on the diversity in the room, but we still have a long way to go. This is something I whole heartedly agree with, my challenge to digital health networks is to keep increasing a diverse number of future leaders in the room.

The closing session of the day was my opportunity to speak on, ‘Preventing the Brain Drain’. It was with a fantastic panel; Melissa Andison (associate CCIO at Surrey and Borders Partnership NHS Foundation Trust), Darren Mckenna (director of Digital Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust) and Stacey Hatton (CNIO at Barnsley NHS Foundation Trust), chaired by Jon Hoeksma (CEO at Digital Health). When I was first asked to speak on this panel, I was not sure that I had anything to offer the room on the subject. Then I began to think about what has kept me working in the NHS and what has kept me passionate. I have been fortunate and supported in my career to reach for the stars and explore my passions. I am currently doing my MSc in Advanced Clinical Practice and I was supported to apply to the Florence Nightingale Foundation, from which I gained my fellowship with NHS England. I hope the session influenced some digital leaders and gave them something to consider. Staff retention starts with organisational culture.

Summer Schools have once again ignited my passion. I honestly believe that in the digital health space we have some of the best individuals all striving to improve care for the patient and people who use our services. If we maintain this energy, passion, and drive – I know the transformation that we need will happen within the NHS.

July 21, 2022 0 comments
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Digital Health CIOs speak out on EPR convergence and levelling up plans

by Lauren Hoodless June 13, 2022
written by Lauren Hoodless

Levelling up piece Back in February, the Secretary of State for Health and Social Care, Sajid Javid, said that he wants 90% of NHS trusts to have an EPR in place by December 2023, with the remaining 10% in the process of implementing them.

Then in March, NHS leaders were reportedly told that they must draw up plans to level-up and converge the electronic patient records (EPRs) in use across Integrated Care System (ICS) boundaries.

This target to level up EPR provision across the NHS is in line with the Long Term Plan commitment for providers to achieve a core level of digitisation by March 2025 and demonstrates a clear change in direction on nationally directed digital transformation.

A new policy direction: But is it the right one?

There is no doubt that many people are firmly behind the plans to level up and converge the EPRs in use across ICS boundaries, as the thoughts of some of the CIO Advisory Panel members demonstrate, however these views are far from unanimous.

Someone who is arguably best placed of all the CIO panel members to give their opinion is Kate Walker, digital programme director at Suffolk and North East Essex ICS, who knows exactly how important levelling up and convergence is for ICSs.

“I feel levelling up and convergence is really important to drive out as it will improve care and to allow us to be able to use that core infrastructure to innovate and be adaptive,” she said.

Her thoughts were echoed by those of the director of health informatics at The Rotherham NHS Foundation Trust, James Rawlinson. He believes that “the principle is sound and it’s a reasonable principle to put into the NHS… it makes a lot of sense”.

The broad idea of convergence and levelling up was celebrated by most, with Dan West, chief digital information officer at the Department of Health in Northern Ireland, saying “the notion of convergence is logically sensible” and Darren McKenna, CIO at Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust emphasising that “in principle it’s the right thing to do”.

However, Paul Jones, chief digital information officer at Leeds Teaching Hospitals NHS Trust, raised his concerns about focusing too heavily on EPRs.

“My worry about the focus on EPR levels is that it’s to the detriment of everything else, as if that is the only problem that we’ve got in digital healthcare in England,” he told Digital Health News.

“I think too much focus on it as a national thing just doesn’t feel appropriate from where I’m sat in West Yorkshire.”

Jones’ concerns about the plans are shared by the CIO at University Hospital Southampton NHS Foundation Trust, Adrian Byrne. His view is that “the way our service runs in this country, it’s inevitable that you have more than one system, so a utopian view of running everything from one system seems a far stretch”.

As many have alluded to, the idea and principle of levelling up and convergence is a solid one, but there are doubts about where priorities should lie and whether a single system in an organisation like the NHS could function efficiently.

HIMSS EMRAM: A framework that splits opinion

The idea for levelling up across the country and reducing health inequalities is for all trusts and organisations to achieve a minimum of HIMSS Level 5. The HIMSS Analytics Electronic Medical Record Adoption Model (EMRAM) incorporates methodology and algorithms to automatically score hospitals around the world relative to their EPR capabilities.

For trusts to achieve Level 5, they must have full physician documentation using structured templates and intrusion/device protection, along with everything required up to and including Level 4.

When asked about this emphasis on HIMSS, Lisa Franklin, CIO at Hampshire and Isle of Wight Integrated Care System, said: “It’s right we should be looking at HIMSS Level 5 and clearly it would be desirable for there to be one single system across an entire ICS.”

Fellow CIO Amy Freeman, who is based at Mid Cheshire Hospitals NHS Foundation Trust, also looks upon the HIMSS framework favourably, emphasising that it is a good that we are “making sure that everybody has a minimum capability that is a standard we would all be willing to accept”.

“I’m quite pleased that it appears that they’re going to be using the HIMSS EMRAM model. In the NHS we quite often think we’re special and we need a special assessment of our own,” she added.

“The fact we’ve picked a benchmarking tool that’s been around for a long time and is well-proven across the globe gives more credence to the standard.”

But Leeds Teaching Hospitals’ Jones views were once again not as rosy as many of the other panel members, stressing that he personally “wouldn’t get hung up about HIMSS Level 5” and that “it shouldn’t be a project plan”.

“The way that the HIMSS judging is done, if you’re not doing one thing in HIMSS Level 0 but you’re doing everything else up to HIMSS Level 5, then you get graded as HIMSS Level 0,” he said.

“I really object to those sorts of frameworks being treated as project plans and as targets because I don’t think a framework developed in abstract should be driving the investments of individual hospitals.”

There is a stark contrast of opinion on the HIMMS EMRAM model, but the general view is that the framework can set a good standard for trusts around the country to aim for, despite it not being a perfect benchmark for some.

EPR targets: Realistic or fanciful?

The question of whether the EPR targets set out by Sajid Javid are realistic and achievable or fanciful and over-ambitious has also succeeded in diving opinion within the CIO Advisory panel.

Franklin (from Mid Cheshire Hospitals) saw both sides of the argument, claiming that it is feasible to have EPRs across all settings in ICSs, but is an unrealistic target without proper support.

“If the question is about whether the aim of achieving EPRs across all settings in ICSs is achievable, of course it is, if we invest in the people who haven’t got EPRs,” she said.

“If the question is about whether the aim of getting one or two EPRs per ICS is realistic, no, not without significant funding which we know isn’t available.”

While Rotherham’s Rawlinson doubted that we will be able to achieve the EPR targets in the timeframe set out.

He said that it is “not necessarily realistic in any short period of time at all” and that “it will be a five, ten-year minimum type of ambition” rather than something that can be done in less than a couple of years.

The panel members were once again very split on whether these targets set out can be achieved and although many agree with the intention and the idea in principle of these ambitions, how they will be accomplished remains the key question.

A healthcare cultural shift on the horizon

There is a cultural shift on the horizon in the way the NHS and UK healthcare system operates and delivers healthcare. The CIO Advisory Panel members were all very enthusiastic and excited about the impact on healthcare that this change in policy direction and the EPR targets set out would have if everything went to plan.

On the potential impact, Walker said: “Don’t get me wrong, it would be staggering. To have a digitised ecosystem for our trusts is massive, but the cultural shift in healthcare delivery will also be huge.

“So, it isn’t just the procurement or mobilisation, it is the complete transformation of the way health and care is done within those organisational boundaries.”

Although the broad concepts of levelling up and convergence were generally looked upon in a positive light by members of the Digital Health Networks CIO Advisory Panel, the way in which the new policy direction will be implemented and achieved, particularly in the time frame set out, left some lacking confidence in the plans.

Part two of our series on levelling up and EPR convergence will be focused on the CCIO and CNIO Advisory Panels.

June 13, 2022 0 comments
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Looking beyond job titles in the world of data, digital and clinical informatics

by Lauren Hoodless May 23, 2022
written by Lauren Hoodless

Job DescriptionIt’s hard not to notice the emergence and flurry of job titles (CCIO, CNIO, CAHPIO, CPIO, CMIO, CXIO, CDIO, CIO, CSIO and CHCIO) under the umbrella of data, digital and clinical informatics in the last few years.

While CIO, CNIO and CCIO job titles have been the front runners for a few years in the data, digital and informatics world, the variety of roles is expanding rapidly, and it is vital that we keep up. More importantly we must ensure job titles are a true reflection of the skills, knowledge, expertise and experience required to meet the demands, provision and delivery of health and care required across systems and for the 21st century.

Informaticians often ask for advice on how to further their careers from others in the industry and the myriad of titles no doubt makes this for an interesting conversation.

With the UK looking to have an additional 32000 jobs in informatics, there could be an argument for the necessity of titles.

Is there a right or wrong path? How many more “C” job titles are envisaged over the next 5-10 years?

Where is the evidence to support the accelerated growth?

Is it time to have a joined-up conversation and review on professionalisation of roles?

Tailored job descriptions

Kaur, who is co-vice chair of the CCIO Digital Health Advisory Panel and the only non CCIO and pharmacy representative, points to the fact that midwives and allied health professionals (AHP) are badged under CNIO job adverts, with the advertisement itself often having a heavy focus on nursing with little or no information related to the other groups.

Also, where do pharmacists, pharmacy technicians, biomedical scientists, ODPs and others who fall into a traditional or non-traditional support services category fit? Job descriptions aren’t always tailored to cater for these groups. Where are the career pathways outlined for different staff to successfully obtain digital roles with clear training pathways to achieve their goals and have the required skillset to flourish in their posts?

Kaur  is an aspiring CCIO who has been involved in the development of the exemplar CCIO JD by the Faculty of Clinical Informatics published in autumn 2021 and has spoken recently at Digital Health Rewired on the Office of the CCIO panel.

Kaur challenges digital health leaders to dispel the myth that only doctors, and nurses can take CCIO and CNIO roles. We need to champion each other and truly recognise that the voice of data, digital and clinical informatics is fundamental, and these roles can be led by a variety of individuals from different healthcare disciplines. Kaur  is an advocate for embedding digital and clinical informatics learning and development from the grass roots at undergraduate level where possible but also not stifling anyone in achieving their dreams to become digital leaders no matter their current career position.

She  firmly believes that teams are richer as a multi-disciplinary network and barriers to current success within the data, digital and clinical informatics field includes the ever-growing number of titles, non-inclusive job descriptions and advertisements and disparity of pay. These need to be addressed and society needs to work collaboratively to bring professionals together from clinical, non-clinical, technical, non-technical and operational fields to enable technology to deliver excellent person-centred care.

Time for a review?

It’s a similar picture for Adejolu, a respected Systems leader and National Associate CNIO, who believes it is time to critically review digital and informatics job titles used across the NHS.

She says, she is often inundated with questions from nurses and midwives interested in digital and informatics asking how many digital courses or programmes they need to undergo before becoming a CCIO, CIO, CIM, CAHPIO or CNIO? How long would it take to get there or for those who already have credible systems experience, they worry if their current career portfolio, work history is extensive or sufficient enough to command such a job title like this now and in the future

“The truth is, there is no straight-forward answer, this is often a mixed bag, you have those who have had structured career pathway, building, and developing diverse system-wide competencies and capabilities along the way, those who have worked their way up, those who may have completed a digital programmes or course, in some cases, this may have proved instrumental in paving a way to becoming a CCIO a CIO, those who  say “my boss thinks I will be good for this” and those who say they just fell into the role etc,” she says.

Adejolu believes it’s time to push the “pause button” on the creation of any more digital and informatics job titles and move away from what now seems like an elite, exclusive and hierarchy of more digital and informatics job titles which only seems to alienate and diminish real opportunities for experienced and skilled professionals across systems. Our focus must be on broader skills development, transforming the workforce, distributed leadership and partnership working so everyone is fully supported to excel, thrive, succeed, bring their best self, work to high standards to deliver the safest digital/informatics transformation and the best possible and safer care for our patients and the population.

Data, digital assisted technologies and informatics is truly an exciting place to be, she adds, but job titles need an urgent review, a structured, unified core competency framework and leadership that truly inspires and encourages innovation, creativity, skills development, without the added burden, pressure or fixation on obtaining job titles as a replacement for skills, knowledge, experience, of real system change.

“As we transition into the world of Integrated Care Systems, working in partnership with Integrated Care Boards, we need to painstakingly stocktake and baseline what we currently have vs what we need across systems, standardise job titles and job descriptions, establish continuous talent and skills development pipelines, encourage diverse talents across systems, increase workplace jobs and opportunities, promote an inclusive and broader learning and development portfolio for ALL clinical professions and champion a culture of innovative geniuses through collaboration, where creativity is the norm and less about job titles,” Adejolu concludes.

May 23, 2022 0 comments
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