On day one of the HETT Show 2021, one of the first sessions was based around the question, re-defining digital maturity what should the components be for place-based care?
In a panel discussion, hosted by Paul Rice, Chief Digital and Information Officer at Bradford Teaching Hospitals NHS FT and Airedale NHS FT, the assembled experts from NHS digital branches, hospitals and trusts, covered a wide berth of topics. Talking points included what digital maturity means to senior leadership, what’s needed from the NHS to support new targets and ‘what does good look like?’
Speakers on the panel, included:
- Mark Nicholas, Chief Social Worker at NHS Digital and Health Education England
- Stephen Slough, Chief Information Officer at Dorset CCG, Dorset County Hospital Foundation Trust & Dorset Health Care University Foundation Trust
- Sonia Patel, Chief Information Officer at NHSX
- Shankar Sridharan, Chief Clinical Information Officer at Great Ormond Street Hospital.
For the first round of comments, discussion centred around the core topic of ‘what should the components be for place-based care?’
Mark Nicolas, speaking from a social care perspective answered: “You’ve got to get the basics right first. So, from my point of view, the very first thing to start with is having a common understanding across the system; what we mean by health and social care.
“One of the things I tend to do if I’m speaking to mixed audiences…is to just explain exactly what we mean by social care. I think it’s a term that we often throw around that we don’t often define.
“Building on that then, there are a whole host of other areas that I think that we can we can usefully make some progress with, which ultimately would be success factors for proper place-based care.
“So issues like the sharing of data, for prioritisation, planning and performance…having a ‘fit for purpose’ digital infrastructure…having some kind of holistic commissioning of digital systems would be nice.
“Having that whole system approach to interoperability and working with the social care supplier market as well as the NHS supplier market. And of course, last but not least, the issue of work-place skills, the workforce skills and readiness, especially in social care.”
Stephen Slough added: “There’s a huge amount we need to do from a technology perspective…and a huge amount we need to do for upping the skills of our staff, be they clinical or even the technical staff. Keeping ahead of the pace of change in technology at the moment, shouldn’t be underestimated.
“But if we’re looking to transform health and social care into a more digital way of working and a more digital platform, we can’t leave the citizens – our patients, the public – out of that approach. There’s a huge amount we need to do to ensure that by progressing down a digital path we’re not excluding members of our digital populations.”
Giving a clinicians’ perspective on what digital maturity should mean, Shankar Sridharan also provided his thoughts: “Digital maturity means different things to different people…my analogy is that Great Ormond Street has always delivered good care. And we’ve been good clinically and academically, but we’ve done that, historically, despite technology.
“About four years ago we were in the lowest 10% of digital maturity. It’s like skiing wearing an American-style fridge on your back. Our digital maturity is now amazingly good and now it’s like skiing with a jet pack.
“So it was never about…just putting technology in for the sake of it, but using data analytics and tech to provide awesome care. To make clinical working friction-less, to make the patient a real partner in their care…we now have a hospital without walls, people can work from home…we wouldn’t have been able to do that without tech.
“Your digital maturity is fundamentally paramount to any healthcare provider or setting.”
Shankar also gave some insight into the reality of the scope of the change in hospitals, stating: “This is the ‘new normal’, where we can deliver a significant proportion of visits by video…our reality, I think, in hospitals has changed. We needed something like COVID, something massive to cause the seismic shift.
“Over half the appointments that we’re doing currently are could be done remotely and are…I’ve got a clinic tomorrow and I’m going through my list and I’m seeing half the patients face-to-face and half virtually.”
While Sonia wanted to focus on “the citizen”, explaining: “Ensuring as we are supporting, not only organisations and systems – all the way from our leaders to, sort of, our colleagues on the coalface and at the frontline – is to make sure that we’re working on the citizen agenda, hand-in-hand. And ensuring that we’re supporting the digital literacy and skills of our citizens. And when I refer to citizens, that’s our citizens in the broadest terms; our service users, our patients and also carers as well.”
On the subject of how professional bodies can do more to support…Shankar shared some interesting thoughts on medical training. He commented: “This cannot just be about doctors and the medical workforce – we’re only a small part of it.
“Medical training has to be different as well. We speak about skills but when I went to medical school, I was trained how to examine a patient. Now with a video consult you’ve given people technology but how do you do the actual consult? Because it’s different. There are subtle clues you miss from a patient walking into the room, for example. So we kind of need to think from the ground up and this needs to start at medical schools, in nursing training…”
In addition to these, Stephen was able to provide a useful case study. He outlined: “How do you bring yourselves together to work smarter and deliver better outcomes?…There’s a lot though that looks not only at what we’re doing but looking at what others are doing. So we’re working very closely with our colleagues at Hampshire on joining up care records…to improve data sharing between those two huge places.
“We’ve done a really good piece of innovation internally in Dorset. Where we’ve pulled together data from everybody. Local authorities [have been] a huge part of that. There’s a huge wealth of data in social care, not only around the people they care for…pulling in more information about ethnicity and deprivation has been hugely important into how we’ve approached the fight against COVID.
“Our BI teams were able to pull together a dashboard to enable us to track every aspect of how we approach and fight against the pandemic …now it’s enabled us to have a look at the vaccine uptake as well.
Finally, Sonia finished with her top three wishes.
She said: “If I take out my wishlist and I’m granted by the genie my top three wishes of…how the system can help us nationally, I think it definitely starts with a partnership approach.
“I think the first for me…colleagues that are listening in today, if your boards have not signed up to the board development being offered by Public Digital and Health Education England, I think that is one key thing that I would like colleagues to go back and encourage their boards to take up the offer. Because it’s valuable, it starts a conversation.
“Number two, I am really keen that we are encouraging our boards, particularly at ICS-level to ensure they have registered digital professions at the board.
“My third then is really from an ICS lense-point then, ensuring as they take up the next stages…as those plans start to converge into the future system…very early on in the planning processes…how does digital and data, not work as a technology work stream in itself, but help those various different staffing groups to enable them to work in an integrated and collaborative way. That is quite critical.”
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