As part of this month’s HTN Now, we held a panel discussion to share advice, ideas and experiences for anyone working in a digital role within healthcare, or looking to move into one.
We were joined by three digital leaders: Jeffrey Wood, Deputy Director for ICT at Princess Alexandra Hospital, Dr Tamara Everington, Chief Clinical Information Officer at Hampshire Hospitals NHS FT, and Morgan Thanigasalam, Clinical Lead for Digital Innovation and Transformation at Sherwood Forest Hospital. With a combined background in technology, clinical work and working across multi-disciplinary teams to develop digital solutions, discussion generated plenty of food for thought.
Developing digital organisations
Kicking off the conversation, Tamara identified the need to “start from the ground and recognise that there is not a level starting pitch.” She highlighted the fact that colleagues often self-rate their confidence with technology as low, even when they regularly use their own devices outside the work environment, and as such there is a need to help people better their understanding and confidence with using digital tools.
Hampshire NHS Trust supports staff to learn through the QI Academy, NHS Elect and a training platform called Green Brain that provides training to help staff in their roles, whether mandatory or role-specific. “We’ve invested in developing a virtual health hub experience in partnership with the University of Winchester,” Tamara said. “Basically, talk to everybody, try and build up skills from the ground, and get key roles in place, is what’s needed.”
Jeffrey agreed, adding that he believes that it is important to explain what digital actually is as a starting point. “There’s a common fallacy across most industries that IT is digital,” he said. “IT isn’t digital – we support the digital transformation, we are the technical answer to some of those questions, but digital is about the outcome from a business question. That’s about the people, the process, our communications, the change and the transformation… it’s continuous change, it’s changing the culture within the organisation so that it can adapt to those changes, and at the end point, what we’re really trying to do is ensure that our patients are better looked after.”
Touching briefly on some of the projects Princess Alexandra Hospital has worked on recently, such as moving to the cloud and developing telephony, Jeffrey discussed how they have made an effort to engage with a patient panel with more regularity, to find out what people need, who they need, and find the right support.
Morgan picked up the point about identifying the right people for tasks. “What we’ve done well at Sherwood Forest, we’ve recruited clinical staff to digital transformation roles rather than all non-clinical or all clinical,” he said. “We’ve had a good blend with our IT team… to collaboratively deliver our respective bits of the transformation.”
He agreed with Jeffrey’s comment on the need for clarity around what digital really means, sharing his own experiences of people fixating on the technology aspect: “People recognise me as a clinical person but more and more, you lose that over the time. The assumption is about the technology, and it’s not, it’s about the people…. to my mind, there’s a difference between [someone] who is dealing with transformation in its broadest sense, and somebody who is particularly interested in digital transformation. There is digital transformation as an enabler for wider transformation, and there is digital transformation for the delivery of digital projects. It’s teasing out who is interested in which, and helping them in their careers to fill the right roles that work for them and work for us.”
“You can come into digital from wherever you want to.”
Moving on to discussing the advice they would give to people starting a career in digital healthcare, or thinking of starting, the panelists agreed that it’s not necessary to come from a technology-based background.
“All you need to be is interested in making improvement happen,” said Tamara, “and you need to have some basic understanding of problems.” She described how, in her own role, colleagues often come to her with “a shopping list” of technology that they want, “but quite often they haven’t actually thought that the problem is that they’re trying to fix.”
“There’s so many varied ways to get into digital,” Jeffrey said. “There’s a big difference between digital skills, which is the ability to use technology, and skills for digital, which is so much broader – it’s about the ability to adapt, it’s about new ways of working, managing change. Anyone can have those skillsets, it doesn’t have to be technology.”
On how people can make a start, Jeffrey suggested that people can look at ways to develop new ideas in their own areas, start a digital project that aims to provide a solution for an existing problem such as the use of outdated tech, or look for a secondment opportunity.
When you view digital as trying to solve a problem, Morgan said, you realise, “That’s not specific to digital, it’s transferable skills. The one thing we need to help with, it’s the fear of the technology, and de-mystify – actually, it isn’t really about technology. We’re certainly not about complicated technology. [That’s how] we can do a lot to help people who really want to come into the industry.”
Morgan also highlighted networking as a valuable tool in starting a digital career. “Speak to people, drop us an email, I know we will all talk to people and that’s true around the country as well… network with them, and they’re going to point you to so many things that are out there, that help you decide whether you really want to dip your toes in.”
“When you’re starting out, it’s all about the people,” confirmed Tamara. “It’s all about getting to know a whole range of people from all sorts of backgrounds, inside and outside of the organisation. There’s inspiration all over the shop.”
A tip to your past self
Asked what is the one thing he wishes he had known when he first started out, Morgan said, “The big thing for me, I came in with a lot of clinical skills and knowledge, but I didn’t know the people who were involved in a non-clinical perspective – how they worked, how best to work with them. I’d tell myself to spend more time finding out about the people I’ll be working with.”
“When I started, I was taught medicine,” said Tamara, “how to make diagnoses, that was the world we lived in. Things moved on without me knowing it – there was a whole new world of understanding yourself, how you function as a leader, how change come about, how you can collaborate to deliver effective change. The best thing you can do is step back and learn a bit more about yourself – the leader you want to be.”
Looking back on his work, Jeffrey added, “Digital has made it clear to me that it’s okay to fail. Don’t be afraid when things go wrong, there’s not an organisation out there that puts everything out 100 percent perfect each time.” He shared a mantra: “Digital is about fail fast, fail often, and fail better… to fail is sometimes to say, yes, I’m intending on not getting this perfect. I’m going to make sure everyone is aware of that… we’ll adapt and change and develop over time. Just learn from every single mistake, and know it’s okay to make them.”
Continuing the momentum
Next, conversation turned to the progress made in the digital world as a result of the COVID-19 pandemic, and how we can continue to build upon it. Jeffrey commented on the importance of communicating successes and building a network of people who understand how digital can help and why it is important: “Digital should be part of our organisation’s DNA, it’s not a separate field in its own right. Everything we do should be making it easier for patients or end-users and everyone in between, like HR and finance.”
Morgan agreed, adding that, “striving for perfection hampers us and stops us delivering improvement. When people say something will go wrong, I ask, ‘How often does it go wrong at the moment?’ We can make so much progress and improve without being perfect.”
In order for digital to continue to develop, Tamara said, it needs to align with the organisation’s priorities. “It needs to be clear that what you are going to deliver is going to release benefit for the organisation, or even potential unintended consequences – is that okay? Will that get in the way of achieving objectives?”
Commenting on Professor Ben Goldacre’s recent report into the use of data in the NHS, Tamara added that using data in real-time “is the way forward, to help you make decisions in the moment.”
She also highlighted a need to separate from the old from the new, letting go of old systems when possible rather than holding onto them alongside new digital alternatives, thus doubling the workload and leading to digital being viewed as a burden.
Morgan noted that it is important to protect against “digitisation for digitisation’s sake” and that “there’s got to be a reason.” On the subject of the pandemic, he said, “We have to reflect on how much the world might slip back following COVID. Were some things done just for the sake of it as we had to be seen to react quickly? We need to not forget lessons, whilst also not being constrained by it. We have to accept that we haven’t just moved to digital and the job is done – we need to take people on that journey with us.”
Making a change
The panel ended with a question on change for the panelists to ponder: if you could fix one thing, what would it be?
“Culture,” said Jeffrey, bringing focus to the NHS’s tendency to be legacy-bound. “We are trying to push a massive amount of change in a short amount of time and they’re not used to it, it’s not their main purpose.”
Morgan chose resourcing: “it’s a thorny issue not unique to the NHS,” he said, said that planning would be a lot easier and they could focus on delivering things they want to deliver if there was more clarity on available resources, with longer timescales.
Tamara picked up on a similar point, suggesting that working together on one system would enhance collaboration and efficiency. “We need a funding model whereby the people who are using the system pay for what they need, and we can help people coordinate resources in the right fashion.”
Many thanks to Tamara, Jeffrey and Morgan for their time and thoughts; you can watch the below:
