Secondary Care, Voice

How can we make the most of a rapidly digitalised landscape, whilst still looking after our NHS people?

By Niamh McKenna, Chief Information Officer, NHS Resolution

As a Board Member at Skills for Health, I was thrilled to host their recent digital focussed event, ‘2020: A Catalyst for Rapid NHS Digital Transformation’. Joining panellists from NHS England & Improvement, Health Education England, and Microsoft, we looked to dissect the rapid acceleration of digitalisation in our NHS over the last twelve months, and what this means for our sector and our workforce.

The two hour event hosted over 100 attendees and live-streamed on YouTube, allowing delegates to hear about the key considerations for the impact of a new digital-first way of working.

Looking at the good and the bad from the last twelve months, the panellists shared insight into digital-first training, technology fatigue on the workforce, revolutionary digital approaches from case studies on COVID-19 wards, and much more. However, with recent evidence of the impact of digitalisation on wellbeing and fatigue, not everyone in our NHS and Tech world share a common view on whether digital-only working is the future.

Like many others, I’m currently working almost exclusively from home. Yet, we should remember we’ve all had a significantly different lived experience of digitalisation than those on the front-line in the last 12 months, not just in healthcare, but key workers across many vital sectors. It’s important to appreciate that everyone is having a very individual experience, based on our own unique set of challenges. There is also so much that’s been challenging in 2020, including digital-fatigue, burnout, stress, and anxiety, need for training, lack of feeling connected, home-schooling, digital exclusion.

But it’s not all bad, there is a lot that is good and there are positive changes – for example, better infrastructure, breaking down barriers, better accessibility and an appreciation for some hitherto unappreciated jobs.

And of course, one very positive sign is the recent promising news on vaccines. But even if it does the job, it’s unlikely we’ll go back to the way things were before, but that doesn’t mean we’ll stay as we are now. A combined approach gives us the added benefit of taking the good forward, and leaving the not so good, behind.

One highlight for me, is that we have better infrastructure and capabilities to adapt quickly to a digital-first world than we thought. Digital and workforce transformation in our NHS and health sector is now something we can tackle with courage and ingenuity, sometimes in a matter of days and hours, which may have seemed impossible this time last year.

One important topic associated with digital is the role of learning for our NHS workforce, and Henrietta Mbeah-Bankas, Head of Blended Learning and Digital Literacy at Health Education England, raised some interesting opportunities, challenges, and considerations around digital learning for the workforce:

“Properly defining digital literacy is one of the first vital steps for a digital transformation strategy to succeed, we can’t continue to make assumptions like ‘Millennials are digital-natives’.

“There are three groups we need to consider to properly develop an inclusive digital transformation strategy that will be effective – the digitally engaged, digitally ambivalent, and those that say, ‘I don’t do tech’. For me there’s also a fourth group, those who are actually digitally excluded. Until you understand the barriers these people have and consider how they’ll approach digital solutions, you can’t begin to create an inclusive digital strategy that will ensure everyone comes on the journey with you.

“Learning accessibility is one of the most crucial aspects of a successful digital strategy, and [..] using data to understand how people are learning and accessing learning, gives us information to know how we should be providing learning to staff, in the most accessible and effective way, to improve retention, and provide relevant learning as and when they need it. Intelligent signposting enhances the learning experience for the individual, rather than a ‘one-style-fits all approach’

“Crucially, the conversation needs to change from ‘I don’t do tech’ to ‘What can tech do for me?’

I love that idea of ‘tell me what your problems are, and I’ll help you solve them, it’s not about the tech, it’s about the solution’.

Daniel Langton, Director of Customer and Partner Experience at Microsoft and Skills for Health Board Member, shared some insightful research on the health and wellbeing impact of digital-first and remote working:

“At Microsoft, when the pandemic first hit, we had over five billion ‘meeting minutes’ recorded in a single day across Microsoft Teams. This was unprecedented, and what we realised was that our system had, almost overnight, become critical national infrastructure for the country and the NHS in particular, on a scale we had never seen before.

“What we saw was that the adoption in the NHS at enormous pace was successful, in particular in the exploration of skills and the change in culture. Organisations that already had a strong digital skills strategy and were embracing cultural adoption were the most successful. Secondly, leadership became even more important.

“Now, we’re starting to think about recovery, we’re starting to assess how digital acceleration has impacted us as individuals. Our research at Microsoft has found that stress levels are significantly higher over virtual meetings; and we’re trying to think about that from a technology input by considering how the platforms can give individuals more choice about how they engage over virtual meetings and how they “show up”.

“Certain types of use of the platform can create more fatigue. Some alarming statistics show for example that the volume of meetings is increasing, and 70% of meetings are over-running. Furthermore, 62% said they felt less connected to their teams when working from home.”

Many of us can probably relate to what the research is showing, but at least knowledge is power and by using this data to inform how digital platforms can be enhanced to help, not hinder, we can driver improvements at the ground level as well as for our NHS managers and leaders.

Dr Paul Rice, Regional Digital Transformation Director at NHS England & Improvement joined us from a particularly busy schedule, as he is currently involved in COVID-19 Vaccine development. Paul’s wealth of experience in digital transformation provided some interesting insights about the challenges we face both in a very public way, but also deep within the structure of our NHS.

“One thing we desperately need is a comprehensive approach to digital-first careers in the NHS to attract the next generation of talent who are digitally capable and will ensure we embrace transformation.

“Unfortunately, there’s a narrative in the public eye that the NHS ‘can’t do digital’. That’s simply not true, and contradicts with the immense rapid pace we’ve implemented digital transformation in response to COVID-19.

“There is however a digital divide between those coming into the workforce and those in the existing workforce. We need to ensure we don’t just do digital transformation, but that it’s fully inclusive for all people and roles in the NHS, to be successful.

“The digital aspirations of the sector of course cannot be realised without additional funding. That’s true, it’s always been true, and we are focused on increasing funding for digital innovation. As employers and leaders, we need to find ways to ensure that funding is well utilised and sustainable for the future.”

Adam Causon, Chief Operating Officer at Skills for Health provided some final reflections on the event:

“At Skills for Health, we’re constantly developing our understanding, particularly around quality assurance for our digital solutions such as elearning and workforce management rostering. There’s clearly so much to learn with everything changing so rapidly, and it’s been fantastic to hear from the panellists today with experiences through different lenses from cultural, learning, transformation, wellbeing, and technology. Events like today to share those experiences are absolutely invaluable”

My key take-away from this event was that we need to make sure we continue to embrace rapid digital transformation, use it as a catalyst to get stuff done, improve work, improve lives, and improve patient care. We must use all this data available to us to understand the good and the not so good outcomes from the pandemic to shape initiatives for our new future.

If we get it right, hopefully soon the new normal will surface, one where we’re not stressed and anxious on back-to-back zoom calls, but one where we have better connectivity, balanced with the need to engage with colleagues, teams and patients in the real-world.

This way, we will have our needs met, control of our future and make the most of a rapidly digitalised landscape, whilst retaining this sense of the importance of looking after each other.

A recording of this event is now available to watch on demand here, along with downloadable supportive resources shared by the panellists.

Author: Niamh McKenna, is Chief Information Officer at NHS Resolution, and is currently supporting the development of a major programme to enhance the technology capability of the NHS, whilst ensuring continued delivery of services effectively. Prior to joining NHS Resolution in August 2020, Niamh led Accenture Health UK, supporting the NHS in large scale & innovative programmes such as NHSmail & Secure Boundary.