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The digital future is upon us and our NHS workforce must be prepared.
The bedrock of change and preparation for the digital future lies in the NHS Five Year
Forward View (FYFV).
As long ago as 2014, FYFV contributors and authors identified the need for greater use of technology to enable delivery of new models of care. Through the review, they also pledged to encourage greater investment in training for existing staff and to charge HEE with the co-ordination of efforts to develop a more flexible workforce, able to provide high-quality care, wherever and whenever the patient is in need.
In the intervening years, much has changed, and technology advances have been applied to new models of care such as increased interaction between doctors and patients via digital platforms. It was recognised that early attempts to harness the power of technology often stalled due to the oscillation between two opposite approaches to information technology adoption – neither of which ultimately made sense. At times the NHS employed highly centralised national procurements and implementations. When they have failed due to lack of local engagement and lack of sensitivity to local circumstances, efforts veered to the opposite extreme of ‘letting a thousand flowers bloom'.
The resultant failure to harness the shared benefits that come from interoperable systems on the larger scale, have led to waste and inefficiency. But it should also be remembered that waste also comes from small local enterprise solutions even down to the level of individual databases and when multiplied on the scale found throughout NHS services, this waste adds up to a considerable amount of money and human effort.
In order to achieve the demonstrable change required through the Five Year Forward initiatives, the NHS workforce must first be developed to use and engage with technology as a ‘way of life’ This applies not only in the performance of tasks but, perhaps more importantly, as a way of continuously developing themselves and recording their competence. Managers must be assured of the competence of staff at all levels to deliver safe and effective patient care.
Fast forward to mid- 2018 and the political landscape has changed, although the drivers
for change remain the same.
New Health and Social Care Secretary Matt Hancock has clearly stated his top three priorities as technology, workforce and illness prevention. One of his early speeches laid out quite specifically, the place for technology ‘let this be clear: technology transformation is coming. The opportunities of new technology, done right across the whole of health and social care, are vast. Let’s work together to seize them.’
In June 2018, the publication of the Topol Review Interim Report, highlights the need to prepare the healthcare workforce
to deliver the digital future.
A key question emerging is - what does this technological advancement mean for the selection, curricula, education, training, development and lifelong learning of current and future NHS staff?
Building on their early findings, this Review is proposing three key principles, which should govern the NHS’s future workforce strategy, one of which is:
- ‘Gift of time: Whenever possible, the adoption of technology should be used to give more time for care, creating an environment in which the patient-clinician relationship is enhanced.’
This is where the use of training, education and competence assurance through the use of technology, will truly realise measurable time savings, time that will be available to use in the delivery of frontline health and care services.
The number of staff in the NHS show the scale and complexity of the workforce and reveal the challenge of workforce development.
If we only consider the 366,000 clinical support staff, and the view of Dean Royles, Director and Strategic Advisor at Skills
for Health expressed in July 2018, we can see the potential for change and improvement
is evident and at scale.
Royles said the ‘ability to move from good to great is particularly evident in our support staff. Around 30% of the NHS workforce provide support to clinical staff. These staff have an enormous amount of patient contact time and yet it is clear we under-appreciate them and under invest in their training, development and education.’
Royles’ advice to NHS leaders is simple:
- Develop a support staff workforce strategy.
- Invest in apprenticeships.
- See support staff as an important part of the future registered workforce pipeline.
The creation of a workforce development strategy, setting career pathways through the apprenticeship route and the assessment of competence for the here and now, together with the assessment of a talent pipeline for the future are all achievable now through the CareShield Myrus platform. A platform with both learning input and assessment against measurable criteria, Myrus provides full dashboard reporting with the ability to drill down to service level and by individual staff member. Reporting on key metrics such as achievement rates gives competence management, observations of practice and behaviours in action give managers competence assurance and measures of progress against learning pathways provide key information on the talent pipeline in each area.
A change in leadership at the CQC.
From 1 July 2018, Ian Trenholm has been appointed as CQC’s new Chief Executive taking over the role from Sir David Behan.
As the former Chief Executive of NHS Blood and Transplant since 2014, the CQC has made a clear statement on how it sees the direction of health and social care.
Peter Wyman, Chair of CQC, said: ‘Ian was chosen from an outstanding field for his significant leadership experience coupled with his commitment to making a difference to people’s lives. His track record of delivering technological innovation at scale in order to deliver benefits for people was the deciding factor - given both CQC’s strategic focus on delivering an intelligence-driven approach to regulation, and the increasingly central role that technology has in transforming outcomes across the health and care system.’
The regulator is setting clear direction not only for the future, but also for the present. The use of technology in the delivery of all health and care services is essential. The use of technology in workforce development is what will drive service delivery.