Panel discussion: achieving long-term outcomes with digital workforce systems

For our most recent panel discussion, we were joined by three health tech professionals including Matthew Hutton, digital lead for Northamptonshire ICS; Ramandeep Kaur, chief clinical information officer at NHS University Hospitals of Northamptonshire; and Dan Chilcott, client enablement director at Patchwork Health. Matthew, Ramandeep and Dan discussed how digital workforce systems can be utilised to achieve long-term outcomes, covering procurement all the way through to change management, adoption, and outcomes.

Introducing our panellists

With each of our panellists sharing an introduction to themselves and their background, Matthew highlighted how, prior to his current role as digital lead at Northamptonshire ICS, he spent 20 years mainly working in communications for central government, as well as working for hospital trusts in Northamptonshire and a mental health charity, delivering a range of projects and programmes.

“Now, my main focus is the shared care record across our system, the data behind all that, and how we use that for all sorts of purposes relating to population, health, and health inequalities,” he said. “I’ve gone from managing single big projects, to managing a lot of wide-ranging projects with lots of different stakeholders.”

Daniel shared how he came to be working in his current role with Patchwork Health, which he describes as an “end-to-end workforce management solution covering everything from junior doctor rota compliance to agency supply chains”. He noted that he brought around 15 years of lived experience of NHS workforce management to the role, having managed a number of NHS workforce improvement projects at department, trust, and ICS level. “I’ve got a real passion for improving the workforce space, so it made perfect sense to transition across to the supplier side, so I could continue to use that experience an effective way,” he explained.

Prior to taking on her current role as CCIO at University Hospitals of Northamptonshire, Ramandeep worked as a pharmacist, and shared that she brings that perspective to her work in supporting digital transformation across Northamptonshire.

Starting with procurement

Kicking off the discussion, the panellists discussed finding the right platform and their priorities in terms of the procurement process.

Matthew highlighted the importance of putting stakeholders first, across clinical, operational, and HR. “That’s where the real requirements are, and it’s having a flexible conversation at that point. I always use the MoSCoW method: must have, should have, could have, and won’t have,” he said. “That helps bring people to a decision about the requirements.”

The next stage, he said, covers the digital technology assessment criteria that your organisation has. “That’s really important from an NHS perspective, that you have a process of assessment behind all of your technical purchases.”

Matthew also noted the need to ensure that solutions are interoperable, because “for workforce systems this is a big issue at the moment, because we have a number of people working agency or bank across different organisations, and the more congruent we can be with the way we develop our systems together, then the better chance our workforce has of working more harmoniously across the system”.

Daniel added his thoughts from a supplier perspective, stating that most often the two factors looked at most closely during procurement are features and price, which can mean sometimes losing sight of the value that could potentially be offered by a solution.

“There’s no point just putting tech in for tech’s sake,” he said. “It’s looking at what the problems are that we’re trying to solve – will this solution allow us to get there? I also think it’s important to look at how innovative a provider has been, and what other factors are in the running. Do you need to employ huge teams of experts, which would be costly; and on the social side, are people going to use it? At tender some of these other questions aren’t necessarily being asked, or being given the same priority in that process.”

Change management

We moved on to discuss change management, and what good change management should look like, asking our panellists for their insights and perspectives on this topic.

Matthew talked about how health is “very different to other industries” in terms of risk appetite, due to the need to consider the clinical safety element.

“In Northamptonshire, both Ramandeep and I are very much ‘boots on the ground’ type leaders,” he reflected. “Ramandeep covered both hospitals with digital workshop days, which included the whole hospital, and there’s constant moving around the hospital to meet teams. It’s about ensuring that change is happening appropriately, and appointing change champions in different areas.”

At an ICS level, Matthew noted that he recently visited 33 GP surgeries on one day, to deliver materials and talk to practice managers. “I’m very aware that change management within healthcare requires boots on the ground, and all the training and stuff you can deliver doesn’t replace that face to face interaction,” he said.

Ramandeep agreed with Matthew on the importance of being active in getting everyone involved in the change management process and thinking about standardisation.

“Going from paper to digital is not just about replacing paper for the sake of it; you need to think about how you really transform that process,” she stated. “Having different teams involved in that early engagement – everyone who is going to use the system, right the way from finance colleagues to your corporate team and communications team – gives you a really good foundation.”

Dan also emphasised the benefits of identifying stakeholders early on in the process, adding that there needs to be empathy around what people may be dealing with in terms of change fatigue, and that this should be factored in when implementing technology.

“It’s good to see where that can be implemented to support another programme of work, or to be aligned as an enabler of achieving that outcome as well, in order to minimise the amount of changes happening. It’s being able to take people on that journey, and making sure what you are implementing is not an extra burden, but will add some value to to them and their patients.”

Stakeholder engagement

Ramandeep offered us some insight into her experiences around stakeholder engagement, including from running three-monthly digital roadshows to help engage with teams from around the trust.

“There are lots of different communication channels, and it’s not just about sending out an e-mail in the hopes that people will read it. We’ve designed these roadshows that are open to anyone in the hospital to come and attend, and we’ve got all of our six digital teams there. Merchandise never goes amiss, so definitely reach out to suppliers to get some freebies! The other concept that we’ve also introduced is digital responders, who actually go out there and ask people whether they have any digital issues, to find out how we can help. Digital is important for everyone in the organisation, and I think if you can carry that ethos through, then that really helps with that communication and stakeholder engagement.”

Training and adoption

How can you train large numbers of staff on clinical software, with figures in the hundreds and often thousands?

Ramandeep suggested looking at this in two parts. “It’s about having that robust digital training team, firstly in your own space, because I think they are an absolute asset to all of our organisations. Then it’s about thinking on a wider scale, to the people requiring training.”

She commented that a hybrid approach is “definitely something that is really essential. If we say that everyone needs to go out and complete an e-learning package, that may not be suitable for everyone. People have different learning needs and different learning styles, and we need to be able to give people a different option for training.” She suggested asking sites that have already gone live how they achieved it and utilising user guides to support in this area, as well as making training available in bite-sized chunks.

You also have to be clear on what your target is and stick to it, she pointed out; how many people need to be trained before you are going live? This can be difficult with how busy staff teams are, Ramandeep acknowledged, noting that she has seen some areas incentivise training in order to support uptake.

“It goes back to stakeholder engagement and the change management process – it all ties into one in terms of getting people trained, and getting people to understand why they need to be trained.”

Daniel agreed with the need to break training down into bite-sized chunks, stating that that was the methodology in place at Patchwork, and that this made it much easier than trying to learn an entire new system, which would be “overwhelming”.

He also spoke of Patchwork’s approach to training “champions”, saying: “As a supplier, it’s not possible to train 100 percent of people. But what we can do is train and deploy champions, who can act as ongoing support for the organisation. We try to embed that into the system as well The way I describe it is: we’ve all logged into Facebook at some point and made a post, and we haven’t needed someone from Facebook to come and show us how to do that, it’s just clear through effective product design. If we can’t put a system in front of a user and them be able to work it out, then we’ve not done our job properly. End users can always come through to us for support, if needed, too.”

Daniel also shared how Patchwork uses questions coming in from end users to improve products, and focus in on things that might need changing.

Matthew highlighted the need for ongoing training, since if an organisation is running a month-long training programme, those who completed it in the first week “are going to have forgotten by the time you go live”.

“The key is data,” he said. “Not just data around training, but actually about the use of the system and whether you are getting adoption right. For example, I sat in a control room in the mental health charity I worked in and watched people enter their rosters every day for six weeks, to make sure that things were being done right. Projects aren’t over when they go live, you need to focus on ensuring that adoption and the way people have been trained is effective.”

Measuring success

Daniel discussed how Patchwork currently measures success, highlighting the collection of as much baseline data as possible, including qualitative feedback from users. He also noted the importance of deciding collectively with partners what “good” looks like and benchmarking success early on, to enable outcomes to be measured against these at a later date.

“Early in my career, we didn’t set any of that benchmarking,” he reflected. “It’s important to bring actual requirements into consideration – often they are around effective clinical delivery in the case of workforce projects, looking at costs related to temporary staffing, time-releasing benefits, and so on. It’s not just about putting that bit of technology in, there’s ongoing touch points throughout, and we always check those with our partners.”

Ramandeep raised the importance of quantitative measures too, using the example of EPR implementation. In particular, she noted how it would be necessary to measure factors such as reduction in number of incidents reported and changes in service desk ticket numbers.

“Winning the hearts and minds of people, and getting that culture change in place, is really important from an adoption perspective,” she said. “It’s also key to ensure accountability for benefits realisations; so if you said at the outset that a certain benchmark was going to be achieved, is there someone who is accountable for ensuring that that benefit is realised?”

Matthew shared that one of the things he had observed was how “we haven’t got smart about the data that we’ve got in our systems”.

He explained: “The more we can learn about how we can use data effectively and track outcomes, the more we can look at things like the service received, whether people are engaged and happy at work, and so on. We have to learn how to do things differently, still treating people with dignity and respect, and still focusing on the safety and quality of what we do.”

Using an example from Northamptonshire, Matthew shared how a digital academy has been set up which supports data skills across all organisations, including councils, GPs, hospitals, mental health and community. This has been essential to building pathways and “systems of the future”, he said, as it enables more intelligent use of data with better outcomes. Matthew previously joined HTN to discuss this project in more detail here.

The panel discussion can be viewed in full below, and more information on Patchwork Health can be found here.

We’d like to thank all of our panellists for taking the time to share with us their thoughts and insights on this topic.