For the lunchtime session of our final HTN Now Focus event of 2021, we were joined by a panel of guests from across the NHS, who shared their experiences of digital transformation in social care and care in the community.
As well as discussing learnings, best practice and practical approaches from programmes of work in Somerset and Dorset, to help inform the national conversation, speakers from a number of organisations also explained their personal stories and routes to working in health tech.
Dr Shera Chok, GP, Tower Hamlets, Co-founder and Chair, The Shuri Network and Deputy Chief Medical Officer, NHS Digital, chaired the live session.
While the panel included: Memory Kamwemba, Care Home Digital Outreach Team Communicator, Somerset CCG; Patricia Miller, Chief Executive, Dorset County Hospital NHS Foundation Trust and Dorset Integrated Care Board Chief Executive designate; Allison Nation, Associate Director – Digital Strategy, Directorate of Finance, Performance, Contracting and Digital, Somerset CCG; and Mark Nicholas, Chief Social Worker and Social Care Lead, NHS Digital.
Launching the virtual session, Dr Chok introduced our panellists and provided a little bit of background on The Shuri Network and the award-winning organisation’s beginnings, stating: “For those of you who don’t know the network, we are the first network for women from ethnic minorities in the NHS and care sector, who are interested in digital health and innovation.
“We’re two years old, we were born in 2019, just before the pandemic and we are supported by Health Education England and NHSX. At the heart of The Shuri Network are three things: improving patient safety and patient experience; increasing diversity and inclusion in digital health because we know it’s not a particularly diverse sector; and thirdly, helping the NHS and care to deliver digital innovations that our patients and our staff deserve.
“Despite the pandemic, what we’ve done is deliver real benefits to our members – and membership is free, so please do join if you haven’t joined us already. We’ve awarded bursaries to our members to join the Faculty of Clinical Informatics, we’ve created 45 fellowships, including 20 nurse fellows, and we’ve created over 65 digital shadowing opportunities to help our members gain the connections and the confidence to gain an insight into what people do…we know it’s really hard to make connections and build relationships when you’re just starting out on your career.”
“We’re not just talking about sharing health records with social care but sharing social care records with health”
Providing a snapshot of the national picture on social care digitisation, Mark joined the discussion, explaining recent policy and funding news, including the emphasis on remote monitoring and Shared Care Records, the need for digital skills training and the improvement of data.
“One of the things we’re hoping to develop, with NHSX, is to achieve that nirvana of being able to share care records across health and social care. Bi-directional rather than one-way – so we’re not just talking about sharing health records with social care but also also sharing social care records with health,” Mark said.
On the latest skills and tech review of the sector, Mark added: “One of the problems that we’ve had…is the low levels of digital skills and low levels of digitisation in social care. That’s a general statement but it is a problem in terms of being able to integrate fully on a digital basis with the healthcare system. There’s lots of really interesting stuff in the tech review about the fragmented nature of the tech market in social care, about familiarity with tech and opportunity to use it within the workforce.”
Mark also touched on the need for more social care data, and the work going into securing that, before Dr Chok handed over to Allison, who added to the discussion about digital connectivity and skills for the workforce.
Allison spoke of the initiative to offer people who work in care homes the opportunity to upgrade their digital skills and also about work at Somerset CCG, commenting: “We saw the need, an opportunity that arose in the digital strategy space, about how we needed to address the connectivity issues for social care – particularly around care homes and not forgetting domiciliary care – having a look at access, Wi-Fi, [and] devices.”
“Building it into our new ICS digital data strategy…around that data, that insight intelligence, is really important…but we needed to get into the grassroots, which is where Memory came in. I had a phrase, ‘joining the DOTs’ [the Digital Outreach Team]…Memory, I’m delighted to say is part of that DOTs team. We have a series of DOTs working across the system in health and care. Memory works with care homes and links into primary care.”
“Some of the care homes that I visited still had their iPads locked up”
Alison then handed over to Memory, who explained her role and shared some of her work projects as part of a Digital Outreach Team. Memory mentioned how, since March, the work has been based around supporting care homes in Somerset with their digital tools and signposting them towards help for their Data Security and Protection Toolkit (DSPT), to keep residents’ data safe.
“What we discovered in Somerset, was that those care homes who had done the DSPT, it is because they have a parent organisation that has done that for them. But for those small homes who don’t have somebody in IT or tech…DSPT is a challenge,” Memory stated.
Other work included, Memory said, assisting care homes with activating their NHS mail accounts, proxy access to medication online, and asking about how they are using the iPads offered to them by NHSX. “Surprisingly, some of the care homes that I visited still had their iPads locked up – they hadn’t been activated, they hadn’t been used. We can see that technology is up there and people’s confidence to use technology is down here, so there is a huge difference between the two, a huge gap that we need to try to cover, so that people can be more confident to use technology in everything that they do. This will improve the efficiency of how the care homes are working…they can use that time to provide care to the residents.”
Dr Chok added: “Memory, that was powerful. What you just illustrated is that, when you’re trying to implement a change, whatever the change is – whether it’s digital or quality – you need facilitators on the ground, supporting our staff, holding their hands and almost building their confidence up…we need people like you in health, in social care, helping our frontline staff to take the iPads out of the box and turn them on.”
Patricia, who will soon be leading the Dorset ICS, then also added her perspective on making sure the patient journey is supported by digital: “We can get a little bit carried away with process transaction, particularly around digital, and forget that, actually, it’s not implementing technology for technology’s sake – it’s about digital supporting business change that improves the service for the people we’re here to care for, as well as the experience of staff when they’re at work.”
“When I think about some of the changes that have been made or are about to be made to some of our NHS estates, and the pace of change there…the change is already here. It’s already started. What we’ve got to do is build on the strengths of what the NHS has already delivered in the digital space – but do it at a faster pace, and do it in a deeper way that really adds advantage and value to our communities.”
“How do we really insist that social and health inequalities are not barriers?”
Citing how robotics in surgery and virtual platforms and consultations have been accelerated by COVID, the Chief Executive stated, “We’re not starting at a low base but we do need to move forward at a faster pace”, and noted that there was a need within ICSs to engage with the public on tech, while still providing guidance on how to live healthier, longer lives, and how to take ownership for quality of life.
“How do we really insist that social and health inequalities are not barriers to a new technologically-enabled health and care system? And that, whatever we do in terms of change, those things around social justice and health inequalities are really embedded into the way that we work going forward? That includes the digital solutions that we put in place,” Patricia added, before explaining how Dorset has gained a digital advantage through its information system, which is providing “real, genuine insights” into the needs of its population. It is doing this, Patricia said, through data that can be broken down by ethnicity and level of deprivation, and used to target interventions and profile patient groups.
Patricia added that they have also developed the Dorset Care Record, which is a “summary record that overlays all of our systems” and has “provided the transparency that clinical health and care teams need to make sure that they’re taking the right interventions with different groups”. Technology-enabled place-based care is also something Patricia is expecting to see more of and the Chief Exec stressed the importance of clinical and patient engagement, as well as co-design and delivery of digital solutions, and skills readiness for staff.
“You can take massive risks, and most of the time those risks will work out”
The panel then turned to a discussion about their own personal journeys into digital and health tech careers.
Dr Chok stated, “one of the key aims of The Shuri Network is to inspire women from minority groups that they can be digital leaders and they can be healthcare leaders, because there are so few of us”, and asked Memory and Patricia to share their lived experiences of embarking on work and projects in tech.
Memory, who arrived in the UK last year and was previously a support worker in a care home, explained: “I didn’t know I would end up doing what I’m doing right now. The world of technology is so huge…we can learn everything, there is nothing we can’t learn and do.
“I knew that I needed to grow as an individual, it comes with a mindset. If you want to achieve something, you need to be a challenge-seeking person, you don’t need to settle…you need to have a growth mindset.
“One thing that inspired me to join the digital team is by looking at what other people are doing. That inspired me because I can learn from other people…when I saw the job advert online, even though I hadn’t worked in the digital sector and didn’t know anything, I just submitted my application and said ‘whatever happens, I’m just going to apply’.
“I learnt on the job…I’ve learnt quite a lot of things that I’m now able to teach other care homes…we don’t have to be scared to apply for jobs, even though sometimes you may see the job description and say ‘I don’t have experience in doing this’, but you just need to go for it.”
Patricia, who began her career in digital and rose to become a Chief Executive, also shared her career route, explaining: “I knew I wanted to do something that benefitted communities and one of the reasons I’ve ended up here is that every time I reached a ceiling of responsibility or accountability, I then thought I now need to get into the next job, so I’ve got a wider scope to make decisions.
“Sometimes, as women in general, we can hold ourselves back…in that we’ll only apply for a job if we look at the job description in the advert and think that we can do 99 per cent of it. Actually, I think, one of the things I’ve benefitted from is not being like that for a lot of my career. I’ve taken huge risks in the jobs I’ve applied for. I remember once applying for a job in digital and it was two bands higher than the job I had.
“I have always taken chances…you can learn a huge amount when you’re on the job. As long as you can do 50 per cent of it and the skills you’ve got are transferrable, you can take massive risks, and most of the time those risks will work out.”
Patricia also noted the importance of mentorship and choosing the right person to be your mentor, as well as having a career plan and knowing what you want to get out of your current role.
“Believe in yourself. Women – particularly women from ethnic minority backgrounds – we’re told all the time, ‘you can’t do this, you can’t do that, you’ll never achieve the other’…that just made me double down on wanting to get to that next place because I knew that I could and I wanted to prove people wrong.”
Dr Chok added: “That advice is just so valuable and it chimes with what Memory was saying…the way I’ve looked at my career…for me, it’s building a brick wall and each job I do is a brick in that wall and it gives me a bit of additional experience…or helps me build networks and connections…whatever comes next, I have that basis.”
Catch up on the full session via the video below: