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Digital Health Awards 2022 winner profile: Rob Ratcliffe

by Lauren Hoodless
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

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Digital Health Awards 2022 winner profile: Peter Thomas

by Lauren Hoodless
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).

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Digital Health Awards 2022 winner profile: Prof Louise Hicks

by Lauren Hoodless
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.
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