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Women in digital leadership looking through an intersectional lens

by Lauren Hoodless
written by Lauren Hoodless

As part of a commitment to continue collaboration and growth within the community of female digital leaders, the Shuri Network and Health Innovation West Midlands hosted a networking workshop for previous Shuri Network bursary holders in February 2024. The collaboration aimed to create a dynamic platform where women in digital leadership roles, especially in the healthcare sector, could come together to exchange insights, engage in enriching discussions, and foster a community of practice. 

The event emphasised the importance of empowering women in the digital age and provided a supportive environment for sharing stories, experiences, and expertise. Participants were encouraged to get to know their peers through networking and understanding the diverse backgrounds of those in attendance. The programme focused on the importance of diversity and intersectionality in digital leadership, providing key insights into challenges faced and opportunities for women in the field, and engaged participants in real stories from female leaders in the digital space.

To ensure a tangible outcome to the event, all participants were introduced to the concept of communities of practice and invited to provide their thoughts on potential topics and themes for a community of practice for women in digital leadership, and how to prioritise these suggestions. Having participants actively contribute to the formation of a community of practice continues to drive positive change for women in digital.

To get involved in the work surrounding women in digital leadership or the community of practice, please contact Reena Sidhu, Commercial Enterprise Lead – Digital Innovation, Health Innovation West Midlands: reena.sidhu@healthinnovationwm.org

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ICS leaders discuss integration, sustainability of shared care records

by Lauren Hoodless
written by Lauren Hoodless

The session on “ICS Digital Priorities Unveiled: Shaping the Future of the NHS”, focused on shared care records and wider issues associated with the digital maturity agenda.  

Hannah Wall, stakeholder relationship senior manager for the Connecting Care Records Programme at NHS England, told the audience at Horizon Leeds that full deployment of the National Record Locator Service (NRLS) – a project to link shared care records across the country to enable clinicians to access patient information nationally for direct care purposes – continues to be key part of the national agenda. She added that 20% of acute provision for patients takes place outside their home integrated care board. 

The NHSE program is commissioned to March 2025 to build on the existing network of shared records with five core priorities: a record-sharing strategy that avoids duplication; interoperability between shared care records with an emphasis on creating a read-only shared care record at the NRLS level; levelling up shared care records, including links with primary and secondary care and expansion of their length and breadth; convergence of records; and sustainability. 

Embedding in a community 

Laura Godtschalk, shared care record programme manager at Leicester, Leicestershire & Rutland ICS (LLR), said that LRR’s decision in April 2020 to form a partnership with the Interweave shared care portal allowed it to join a community of other ICSs that had already been using Interweave’s application for some time “so we could learn and try to walk a trodden path.”  

Health and social care organisations were already working together in LLR, Godtschalk said, and the shared care records project helped to bring them closer together.

Although interoperability and organisational digital maturity posed huge challenges, getting staff engaged in helping to design the system “helped with embedding and the use and that transfer of it to a thing actually being used on a day-to-day basis,” she said.

“We’re hearing some absolutely brilliant stories coming back of where the benefits have been realised and people are saving time.”  

LRR is currently looking at how shared records can be used to empower patients and improve preventative healthcare “as part of direct care, not necessarily just as public health management,” Godtschalk said, adding that efforts are underway to link records into the NHS App.  

“A shared care record is not a national product; it is something held by local ICBs, and we see real value in putting suppliers together to get the benefits associated with that,” she said. 

Shared care records are already contributing to better care management, said Joe McGuigan, ICB director of digital operations and assurance for Lancashire and South Cumbria, noting that across some 600 care homes in his region, 1200 hospital admissions have been avoided since the shared records were introduced. 

During the Q&A session, audience members and speakers reflected on the challenges in making projects such as shared care records sustainable without devolving more funding from the national to the ICB level. Wall acknowledged that NHSE is committed to ensuring the sustainability of shared care records post 2025, and helping ICBs to do this. 

The most recent Digital Health Networks Exchange event took place December 2023 in London, where it was highlighted that results from the first year of the Digital Maturity Assessment (DMA) have shown that only 10 to 30% of the 90% of NHS trusts with an electronic patient record (EPR) have key functionality and are therefore making full use of their system.

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Shuri Network Summer Schools Bursary Blog

by Lauren Hoodless
written by Lauren Hoodless

Digital Health Summer Schools serves as a vital platform for healthcare professionals to exchange knowledge and experiences. However, their impact multiplies when they prioritise inclusivity and representation across all communities. Black and Asian women, often underrepresented in the healthcare industry, deserve a seat at these tables. Their voices, too long unheard, can reshape the landscape of healthcare.

According to a report by The King’s Fund, health inequalities persist between ethnic minority and white groups, as well as among different ethnic minority subgroups. Some ethnic minorities report poorer health and less satisfactory experiences with healthcare services compared to their white counterparts. This underscores the urgency of diverse representation in digital health conferences.

For Black and Asian women, attending this conference offers unique advantages. Here are my thoughts and top tips:

Pre event preparation

  1. Apply: By participating, you immerse yourself in a space teeming with like-minded individuals.
  2. Attend: Overcome nervousness, seek out a conference buddy, and actively engage in discussions.
  3. LinkedIn and X (formerly Twitter): Set up profiles on these platforms. Whilst connecting via email is more effective, and you’ll learn about others in greater detail.
  4. Prepare your questions. The conference is a great opportunity to learn from experts and peers, so don’t be shy to ask questions during the sessions or during breaks.

During the conference

  1. Seek: Explore various groups attending—your crew might be waiting. Consider connecting with communities like the Shuri network, Health Innovation West Midlands, National Digital Shared Decision-making Council and the Midlands Digital Share Decision Making Council.
  2. Network: Prepare to be pleasantly surprised by the wealth of knowledge, talent, and experience you encounter.
  3. Connect: Remarkably, 1 in 10 conversations at these events leads to lasting connections. Sometimes less is more…
  4. Speak Up: As a woman of colour, recognise that you have a seat at the table. Market yourself and your work boldly.
  5. Feedback Matters: Constructive feedback fuels growth and improvement. The Shuri Network has gone from a lunchtime ‘add on’ to being tabled on the main agenda. I am hoping that their session next year will be tabled before lunch, preferably on Day 1.
  6. Take notes and photos. You will be exposed to a lot of new ideas and information, so it’s helpful to jot down some notes and take photos of the slides, posters, or products that interest you.
  7. Share your experience. You can use social media to share your thoughts, insights, and feedback about the conference with your online network.You can also follow the official conference hashtag.
  8. Have fun. The conference is not only about learning, but also about having fun and enjoying yourself.

Selfcare

  1. Dress comfortably. Unless you are dressing to impress, the conference venue is large and you will be walking a lot, so wear comfortable shoes and clothing. You might also want to bring a sweater or a jacket, as the temperature in the rooms can vary.
  2. Stay hydrated and energised. The conference days are long and packed with information, so it’s important to drink plenty of water and eat healthy snacks.I always bring a refillable water bottle as there are plenty of water stations around the venue.
  3. Reflect: Amid the whirlwind of information, take short walks during lunch and before dinner. Soothe your supercharged mind.
  4. Safety First: After the conference, ensure a safe journey home. The real community-building begins when you’re back, and genuine connections persist.

Next steps

  1. Reflect and apply. After the conference, take some time to reflect on what you have learned and how you can apply it to your practice.You can also follow up with the people you have met and the speakers you have heard, to continue the dialogue and the learning. Note: If you’ve emailed me, I will be in touch to arrange a follow up Teams call, if I haven’t done so, please do give me a nudge.
  2. Repeat: Mark your calendar for the next Digital Summer School in 12 months. Keep the momentum going!


Words of encouragement

  • Conferences are not just events; they’re catalysts for lasting impact.
  • Diversity fuels innovation, and digital health conferences are fertile ground for cultivating it.

I will leave you with these wise words by Oprah Winfrey, a remarkable black entrepreneur and inventor.

“I am where I am because of the bridges that I crossed. Sojourner Truth was a bridge. Harriet Tubman was a bridge. Ida B. Wells was a bridge. Madame C. J. Walker was a bridge. Fannie Lou Hamer was a bridge.”

These words remind us that our achievements are built upon the legacy of those who paved the way before us. Let their resilience and innovation inspire our own journey!

__________________________________________________________________________________________

Biography

Kumbi Kariwo is a registered Learning Disability Nurse and has worked in the NHS for 22 years. In this time, she has taken up a number of roles within community settings as her passion has been to improve patient/service user experience when accessing health care through education with a focus on early prevention.

In 2016 she set up the Young Peoples Sexual Health Service. This Service was nominated for the NHS Parliamentary Awards and commended by CQC as one of the services making a difference to address inequalities in Birmingham.

Inequalities have always been present in our communities however Covid-19 has further highlighted the disparity to equal access in relation to health and social need.

In 2021, Kumbi was successfully appointed as the first Chief of Nursing Fellow at Birmingham Community Health Care Trust where she spent 18 months developing her clinical excellence and research capacity within Digital Health and Health Inequalities. Her continued aim as an Equality and Inclusion Project Lead, is to utilise her knowledge, experience and skillset in addressing patient inequalities and access to services.

Memberships

Chair: Midlands Digital Shared Decision-Making Council for Nurses, Midwives & AHPs
CHIME member
Florence Nightingale Foundation Innovation and Entrepreneurship
National Digital Shared Decision-Making Council – Midlands Representative
Shuri Network Member
Queens Nursing Institute Research Forum

Awards

Trojan Mouse (Steady and incremental approach to transformation) Award at the Healthcare Excellence Through Technology

Publications

Kariwo.K., Chapman.M., Oozageer Gunowa,N., (2023) Wounds International:   How does skin tones affect staff confidence when dealing with pressure ulcers, Vol 14 Issue 2 https://woundsinternational.com/journal-articles/how-does-skin-tones-affect-staff-confidence-when-dealing-with-pressure-ulcers/

Dhoonmoon, L., Fletcher, J., Atkin, L., Bagdadi,N., Enoc, M.,  Kariwo,K., Marshall, A., Neesha Oozageer Gunowa,N., Pankhurst,S., Sidambe,V., Spencer.,S., (2021) Wounds UK: Best Practice Statement Addressing skin tone bias in wound care: assessing signs and symptoms in people with dark skin tones. https://www.wounds-uk.com/resources/details/addressing-skin-tone-bias-wound-care-assessing-signs-and-symptoms-people-dark-skin-tones

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Shuri Network Digital Fellowship – My Journey

by Lauren Hoodless
written by Lauren Hoodless

In the heart of Black History Month, I find myself reflecting on a transformative experience that has not only shaped my professional trajectory but has also profoundly impacted my personal growth. As I recount my time with the Shuri Network Digital Fellowship, I am overwhelmed with gratitude for the countless doors it opened, the skills it honed, and the remarkable connections it fostered.

A Transformative Journey Begins

Joining the Shuri Network Digital Fellowship felt like stepping into a world where possibilities were endless. The programme, with its focus on empowering black and minority ethnic women in digital health, was not just an opportunity—it was a life-changing event. From the very beginning, the fellowship resonated deeply with me, making me feel like there was a seat for me at this table.

Personal and Professional Growth

The Shuri Network Digital Fellowship did more than just enhance my knowledge and skills – it opened doors to unprecedented opportunities.

On a personal level, the fellowship challenged me to embrace my identity with pride and confidence. Surrounded by brilliant, like-minded individuals, I felt a sense of belonging and empowerment that I had never experienced before. The camaraderie among my fellow Shuri members became a pillar of support, fostering an environment where we uplifted each other, celebrated achievements, and shared challenges.

Professionally, the fellowship was a game-changer. The weekly learning sessions with industry experts enriched my understanding of digital health and provided incredible insight into the various opportunities and roles available in this field.

The individual coaching sessions became a profound journey of self-discovery in which I gained a deeper understanding of myself and my potential. This introspection not only fuelled my personal growth, but also empowered me to navigate my professional path with newfound confidence and purpose.

One of the most significant outcomes of the fellowship has been landing my new job as a Digital Midwife. This role perfectly combines my passion for midwifery and technology. The support and mentorship I received from my Shuri Fellowship played a crucial role in making this career transition possible.

Moreover, the fellowship has facilitated invaluable connections and shadowing opportunities. Through these connections, I found myself involved in a groundbreaking research initiative that aims to tackle health inequalities in maternity care. The ability to contribute to meaningful research and collaborate with experts in the field is a testament to the network’s power in creating pathways for impactful work. This fellowship has not only propelled my career but also empowers me to continue pushing boundaries and making a difference.

A Heartfelt Salute to My Shuri Sisters

As I look back on my journey with the Shuri Network Digital Fellowship, I am inspired not only by my own growth but also by the collective strength of my Shuri sisters. In the spirit of Black History Month, I salute each and every one of these remarkable women who continue to break barriers, shatter glass ceilings, and redefine what is possible.

In Conclusion

The Shuri Network Digital Fellowship is more than just a programme – it is a catalyst for change, a beacon of hope, and a testament to the power of unity and empowerment. To my Shuri sisters, thank you for being a source of inspiration and strength. To anyone considering applying for the Shuri Fellowship, just do it! It will change your life.

The Shuri Network Digital Fellowships

For 2024/25 the Shuri Network will be expanding the Fellowships to all ICS staff so will be launching this in early 2024 to engage CCIOs, CNIOs, CEOs and CIOs.

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CNIO HandbookFeaturedNews

CNIO Handbook Final chapter

by David Teece
written by David Teece

One of the very first things I ever did in clinical informatics was to build a team of outstanding people.

In 2015, shortly after becoming director of development at Barts Health, an informal steering group of nurses who – like me – wanted to make sure the nursing voice was heard in digital projects was formed.

A few years later, I’d formally add the chief nursing information officer role to my responsibilities. But the importance of teamwork has never changed.

Getting a clinical informatics project off the ground, and then running effectively, can never involve only one person. It needs involvement across all clinical user groups (each of which may have slightly different needs and priorities) as well as across the IT side (both the internal IT staff and those working vendor-side). It needs, in short, teamwork.

Negotiation and trust

For me, that means that personal leadership style is key to success in the CNIO role. I’m very committed to collaboration, participation, and facilitation that enables an understanding of where everyone’s coming from. I like to build on the strengths of a team and create a strong user voice, bringing people together through engagement and towards a shared goal. Helping teams to be truly empowered in their digital development and journey is also important to sustained outcomes, growth of talent, and the satisfaction of team members.

That probably sounds like it’s straight out of a textbook. But all I’m really saying is that success in the CNIO role is about how you negotiate with people and how you build collaborative trust. It’s about making sure that teamwork is inclusive and builds understanding across all domains of the health informatics world. That way, you get the best out of the technical and clinical aspects of people’s skills and responsibilities.

I have expertise in, and a strong passion for, the development of outstanding care, nursing practice, the NHS, and organisational development and transformation. I’m not an IT technical expert but the NHS Digital Pioneer Fellowship and further training and development have really helped to expand my skills, critical thinking and system knowledge. The Digital Health CNIO Network, Summer Schools and regional CNIO groups have also been fabulous sources of rich information. So over the years I’ve developed skills in health informatics and recognise the opportunity to bring together a multi-professional team and enable a shared perspective on the digital solution. It makes a real difference to adoption if the patient and user voice are part of the team and early co-design – bringing in creative ideas and positive momentum and a satisfaction in the work. Really understanding what matters to everyone as part of the programme team is essential. By working and learning together, we get the best possible outcome.

The importance of identity

We have built an excellent clinical informatics team at Barts Health as part of a programme we call “We Connect”. Having a brand and team identity has been a positive motivator. The progamme is recognised across our group of hospitals, not just for digital transformation but for an energising approach to teamwork and change implementation methods.

The CNIO role is a lovely combination of clinical insight, health informatics and the ability to enable people to want to come on board. It’s about the ability to collaborate to enable often large-scale change and digital transformation, to reduce unwarranted variation and simultaneously achieve positive quality improvement. The core is engaging people at the heart of the development and raising the profile of health informatics, as well as bolstering digital competence and capability among fellow clinicians.

Negotiation skills are important in working with the team and wider workforce. Making sure the changes and developments really reflect excellence in the clinical workflow and are clinically led is crucial. Listening to teams, understanding what they need and then helping them to get it is important. Getting people involved early helps get a good balance between generic and specialist requirements and enables a seamless design. Building a wider team including super-users, digital champions and ambassadors does much to extend knowledge, skills and involvement and they are a fabulous positive energy and resource for wards and services. When people are part of the solution and can share in the improvement it all changes for the good.

That informal steering group created back in 2015 has grown to become a formal nursing informatics infrastructure. We have a nursing informatics officer at each of our four main hospital sites, a deputy and a lead informatics nurse, and then hundreds of super users. I report into the chief nursing officer, meaning informatics is central to nursing at the trust and have a close working relationship with the CIO and CCIO. The collective clinical informatics leadership team has a strong bond and the support has been truly amazing.

Our teams played a huge part in successful implementation of the electronic prescribing and medicines administration (EPMA) project back in 2021 and designed new functions and workflows right through the complexities of covid waves. This has built on our earlier implementation work, enabling digital development in nursing across the whole Barts Health Group. We have EPMA pharmacists and digital midwives, a growing allied health professionals informatics group, and medical clinical informatics leads too. We’re all continuously working together with our clinical systems and IT colleagues to enhance outcomes for our patients and our communities.

Build your rope team

During the We Connect nursing programme, I was reminded of a presentation I’d heard several years before. When we were implementing our Cerner EPR, we went as a team over to their headquarters in Kansas for a conference. One of the speakers was Erik Weihenmayer, the first blind person to reach the summit of Mount Everest.

His inspiring presentation introduced us to the idea of a rope team – the people who are with you as you adventure; who will save you from falling. It was an idea that really stuck with us as a nursing informatics team. Any time we implement a new digital project, we’re really clear about who is on our  rope team. As we began to implement the EPMA project, I received a postcard from one of the teams involved. It was a picture of climbers on a rope team. There was something really nice about that – about people feeling they were part of a team in which everyone had one another’s backs and sharing that same adventure.

Our team has expanded over time and there is a strong core of people who have really developed nursing informatics. We continue to integrate health informatics in everyone’s day, helping others to take their careers forward through the likes of fellowships, mentorship, coaching, our What Good Looks Like Strategy, and shared decision-making councils. They are true health informatics ambassadors and signal the very best of nursing and its impact. I am proud to work with such an amazing team of professionals.

Louise Hicks is CNIO and director of development at Barts Health Trust, one of the largest NHS trusts in England, and a visiting professor at City University of London. She became CNIO at Barts in 2019, having initially joined the trust as an improvement and transformation programme director. Louise previously worked in higher education and in clinical practice, of which she has over 40 years’ experience.

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FeaturedNews

A new programme of events dedicated to supporting the next generation of digital leaders

by Lauren Hoodless
written by Lauren Hoodless

Dedicated to future and aspiring Chief Clinical Information Officers (CCIOs), Chief Information Officers (CIOs) and Chief Nursing Information Officers (CNIOs), these events will offer invaluable advice and guidance for anyone considering a similar career path.

Our panellists will share their career journeys, reflecting on the early days in their role, looking back at expectation vs reality, challenges faced, surprises along the way, and key takeaways.

We also look to CCIOs, CIOs and CNIOs who have been in the post for several years to enhance this peer learning opportunity by offering any advice they have for anyone looking to move into these roles.
Network members are invited to attend and enjoy inspiring, thought-provoking discussion, join in the conversation, and ask questions.

The events form part of the Digital Health Networks’ commitment to supporting the next generation of digital leaders to continue the growth and development of the community.

They build on the success of recent community activity of this kind, such as the 35 under 35 Summer Schools bursary scheme, and the group mentoring programmes launched by both the CNIO and CCIO Advisory Panels.

We have six events lined up which will focus on CCIOs, CIOs and CNIOs.

Book your place now

CCIO Spotlight Series, Episode #1
13 Jan 1230-1315

CIO Spotlight Series, Episode #1
20 Jan 1230-1315

CCIO Spotlight Series, Episode #2
10 Feb 1230-1315

CIO Spotlight Series, Episode #2
17 Feb 1230-1315

CNIO Spotlight Series, Episode #1
21 Apr, 1230-1315

CNIO Spotlight Series, Episode #2
2 Jun, 1230-1315

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A Networks debate on the Federated Data Platform

by Michele
written by Michele

Following the announcement that NHS England is to develop a national data platform to help transform and improve the way the health service operates, Digital Health hosted a Networks debate on the subject. Hannah Crouch reports.  

In April 2022 a notice was published which revealed that NHS England was looking to develop a Federated Data Platform to help create “an ecosystem of technologies and services implemented across the NHS in England”. 

Several months on and little information about the platform has been made publicly available, other than the £360million price tag attached to it.  

In August 2022, Digital Health hosted its first Networks debate on the Federated Data Platform and invited members of the Networks along with other key figures to take part.  

Issues surrounding data privacy and who gets access to what was spoken about at length. For Dr Jorge Cardoso, chief technology officer at London Medical Imaging and AI Centre for Value-based Healthcare, having a national health data platform will “allow more and better data to be used throughout the country”. 

“I think what is interesting about this [the Federated Data Platform] is that it is all about data and data privacy and how do we build the right infrastructure that gives people the confidence that the data is going to be used appropriately and that everything is being tracked and logged and audited so that we can make sure that this data is only used by the people that should be using it,” he added. 

Sticking with the theme of confidence in the platform, Dr Susheel Varma, who is head of artificial intelligence (AI) and data science at the Information Commissioner’s Office (ICO), stressed the importance of public engagement. 

“You need to be able to engage with the public and explain to them directly how the data is being collected, why it’s being collected, what is the purpose of its use and where is it being held,” he argued. 

“You need to explain the entire process end to end and understanding that takes time along with engagement and continuous engagement. 

“Building a platform is like asking people to raise their hands, maintain the trust and the platform is asking their hands raised.” 

Dr Varma also urged for transparency and openness during the process. 

“Every platform that you’re building, the procurement process needs to be transparent open to the public so we can bring them along for the journey,” he added. 

Questions on timing and PR 

For those on the panel who come from the provider side of things, there were questions raised about the timing and whether the platform could become a “PR issue”. 

Will Brailsford, who is an advanced intelligence analyst for Wales’ Collaborative Health Intelligence Service (CHIS), agreed “in principle” with the idea of a Federated Data Platform, adding that benefits can include population health management and helping to train AI. 

“I do question the timing of the FDP,” he added. 

“We’re in a difficult period coming out of the pandemic, with the cost-of-living crisis and I don’t necessarily see the development of centralised data sources and necessary investment when front-line services are struggling as much as they are. 

“There is a need, I really do think so, I just question the timing somewhat.” 

This issue was echoed by Shauna McMahon, CIO at Northern Lincolnshire and Goole NHS Foundation Trust and Hull University Teaching Hospital NHS Trust. 

“There is perhaps a PR issue around this and linking back to the timing, certainly people are very sensitive about data and privacy, there is still a public relations issue around it,” she said. 

“The other piece I reflected on was the financial burden, there are still trusts out that that can’t run yet and do not have a fully paperless environment. 

“We may be underestimating the huge task here. You can’t close your eyes to the amount of money that been put in the paper for this platform, we are looking at potential strikes on the front line and it doesn’t play well for them to be told there is no money, but we have all this money for something of this magnitude. 

“I am not discounting that the idea isn’t right, I am just not sure the timing is good.” 

In response to concerns raised about costs, NHS England and Improvement’s chief data and analytics officer, Ming Tang, stressed that the money for the platform has already been allocated.  

“From a timing perspective, we’ve just gone through the outline business case and it has been approved by the secretary of state,” she told the audience.  

“The money was allocated as part of the 2022 spending review, we – like everybody else – had big chunks of that cut off, so we’re not safe from cuts at all but we have profiled it differently and we ended up giving back about £16million this year. 

“We are now going through the treasury approval and so once we get the treasury approvals then we’ll go out to procurement.” 

Looking at timelines 

Tang also went on to explain the procurement process which included some draft timelines. This includes the contract notice going out for tender in early September which will then be followed by screening process where potential suppliers will be asked to take part in a proof-of-concept test. Final bids are expected in January with a contract award pencilled in for Spring next financial year.   

“People see the big number (£360million) – that’s a lot of spend but in the context of where we are in the NHS, each ICS [Integrated Care System] were going out to tender for anything between one and five million, times that by 42 and you can see that this is actually not an expensive thing,” Tang added. 

“The £360million is over five years, which is roughly £70 million per year, and has the potential to cover the whole of the NHS.” 

Return on investment 

For those working within the NHS, they want to know how the Federated Data Platform will benefit them and their organisations.  

“Where would be the return on investment and where do we get the value as a trust?” McMahon argued.  

“Where is the trade-off where we get to see that this is efficient, its helping us out – I’m struggling a little bit with that.” 

Responding to this, Tang set out the full uses of the platform, stressing that more than an analytics tool.  

“Don’t think about this [the Federated Data Platform] as one enormous data lake or one enormous data warehouse, that’s not the intention of the national data platform,” she said.  

“The data platform is really allowing data to be brought together for specific purposes or specific use cases.  

“We’ve developed five national uses cases which are broad enough to support the things that we already do within the data platform that we hold currently – that’s things like population health, supply chain and care coordination.   

“It is not about a data analytics tool, this is about creating applications and functionality to support the front line.” 

She continued: “Through the pandemic, we were able to make great strides in the way that the data was used, not just in the analytics world – which was great – but actually for the front-line to reduce the administrative burden.” 

Elephant in the room 

The debate chair, Dr Paul Jones, who is the vice-chair of the CIO advisory panel and chief digital information office at Leeds University Teaching Hospitals NHS Trust, did not shy away from the so called “elephant in the room”, Palantir.  

The US data analytics company has been heavily linked with the Federated Data Platform after it worked with the NHS on the NHS Covid-19 Data Store. However, Palantir’s involvement has raised some eyebrows across the NHS IT community. 

“Palantir is one of the providers that I am sure will be bidding for this work, we’re running an open procurement which means we are making provisions to enable other companies to participate as well,” NHS England and Improvement’s Tang explained.  

“Included in the contact is the fact that the platform is separated out from the privacy enhancing technology so that the platform supplier is separated from the people who hold the key for privacy. 

She continued: “If you don’t like Palantir, I guess there is a really strong feeling about Peter Thiel, he is no longer involved in the company, he has shares but he is not on the board anymore. 

“There is nothing I can say that will reinforce that but it is a really good technology, we used it during Covid, we are the data controllers. 

Tang also concluded the debate by stating “it is not a direct award”. 

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CNIO HandbookFeaturedNews

CNIO Handbook Chapter 6

by Michele
written by Michele

The CNIO role is often seen as a link between nurses working clinically and the IT department, but in my case it also involves being a link between two recently merged trusts covering acute and community services.

Differing approaches to informatics

The previous organisations had taken very different approaches to informatics. One had an electronic health record (EHR) used for all nursing documentation, with care planning having been completed electronically for around 20 years.

The other trust had a ‘best of breed’ style, using a number of smaller systems for specific tasks. Large parts of the nursing documentation, including care planning, had remained on paper.

The two organisations merged in April 2019, and a decision was made to implement the EHR across the entire trust. That implementation was relatively straightforward and on the whole was well received, but two large groups of nurses coming together to work on common documentation did highlight areas where work was required.

Care planning was the noticeable aspect where refinement was needed. The nurses who were new to electronic care planning spotted imperfections in the use of the system. Those who had used it for many years had often just learnt to work around those imperfections – but in so doing, it meant care planning wasn’t always as effective as it could be.

Simplifying documentation

For me, the care plan is the most important aspect of the nursing process. If we don’t have a plan our success is purely down to chance. If we don’t identify a goal or outcome how do we even know that we have succeeded? How can we compare the outcomes of our care with our peers, whether in the same organisation or beyond? Making sure the same care plans are used consistently helps reduce variation – everyone works to the same goals and the same outcomes, which improves patient care.

To make documentation and care planning work for nurses, and ultimately benefit patients, we need to make assessments and plans as easy to complete as possible. That includes using digital systems. As CNIO, I’m therefore currently undertaking a review of care planning across our trust.

The staff nurses who use the documentation on a regular basis are best placed to say what needs to be improved in the current system and to review and comment on suggested changes. On that basis I set up a project steering group with representatives from both hospital sites and a range of staff roles, including staff nurses in band 5 and 6 roles from a range of medical and surgical specialties, ward managers, matrons and IT.

The three key areas for improvement

The group met to debate experiences of using electronic care plans. It became clear there were three key areas for improvement:

  • How we use the electronic care planning system. Traditionally, we have used our care planning system to record and evaluate whether standards of care – support with hygiene, for instance – has been delivered. That’s meant nurses have had much less time to actually use the care plan functionality, and means we’ve never used the software’s ability to evaluate a patient’s care against a care plan.
  • The number of plans. We currently have 150 care plans. Some are automatically digitally activated for a patient but, if a nurse needs to add an additional plan, he or she has to search through the full list of plans. You either have to scroll through to try and find the one you need, but the names aren’t always as clear as they might be, or search. While nurses who have used the system for a while have got used to these imperfections, those who are new to the system pointed out that this was really challenging.
  • Training. It was felt specific training should be offered to nurses to make sure they were comfortable with how the digital care planning setup worked, as well with the general clinical practice around care planning.

I have also connected with fellow CNIOs and digital nurses to discuss the care planning. Via the Digital Health CNIO Network Discourse, I’ve understood that this planning is challenging for many nurses, regardless of whether a digital of a paper-based system is used. The issue is often one of time. I can therefore see that while digital working can help, there is also a practice issue – and that, as CNIO, I may need to look beyond the informatics element to truly transform care planning in the trust.

The organisation currently has around 150 separate care plans. Even though these can be completed digitally, there are so many that it is difficult for nurses to select between them and know the right one to use in the right situation. Our steering group has now identified around 30 subjects on which we think we need to focus plans, and we have ‘subject experts’ working on these.

We have also reviewed a different process for evaluating care plans within our EHR. This will place a greater emphasis on evaluating the care that has been given against the care that has been planned. There is the ability to do this within the care planning software, but we’ve nor previously used it. My plan is to pilot using it across a couple of wards to see if we might be introduce its use consistently.

What has been really important to my work so far on this project has been having the support and direction from the senior nursing, midwifery and allied health professional team. Around the time the trust merged, I was working as a nurse consultant in an operational role and giving what other time I had to the CNIO role. At that point, the CNIO reported into the IT team.

The benefits

The merger made the CNIO role more important still and so, with agreement, it moved to be part of the trust’s corporate senior nursing team reporting directly to the director of nursing. This meant I could support the team in understanding the importance of digital nursing, and the opportunities it provides, but also that I could understand the nursing priorities for the organisation. The team also offers me real support in implementing changes, like those to care planning.

The shared decision making approach with the steering group has also been very important. Feedback of clinical staff as the end users of the technology has led to some excellent and well received improvements in our electronic health record. I remember one particular example when we’d introduced an assessment for patients who were at risk of self-harm or falls and needed one to one nursing care, or to be in a bay where a nurse was always present. The idea was that, on a two-hourly basis, staff would record what support and interactions had been provided.

In conversations with teams, we heard that these assessments were typically completed by healthcare assistants – and clashed with the intentional care rounds they were completing. So we moved the document in the EHR so it sat within the care round checklists. By doing that, we moved from 20-30% completion of the assessment to around 90%.

We are fortunate that our EHR can be adapted to the way in which we work: we don’t just have to use a one-size-fits all, off the shelf setup. We can build and edit documents and assessments in a way that we find useful. The shared decision making process will help ensure that any changes we make to the digital care planning process enable nurses to provide good quality, safe care, in an efficient and secure way.

About the author: Melanie Robertson is chief nursing informatics officer and cancer lead clinician at South Tyneside and Sunderland NHS Foundation Trust. She initially took on CNIO responsibilities in 2018, reporting to the IT team. In February 2020, the role moved to report to the director of nursing. Melanie has been a registered nurse since 1994.

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A first for AHPs at Digital Health Summer School 2022

by Lauren Hoodless
written by Lauren Hoodless

AHPs Summer SchoolDuring Digital Health Summer Schools at the University of York in July there was a gathering of digital Allied Health Professionals (AHPs) and some very welcome non-AHP friends. We wanted to build on the momentum from the digital AHP and pharmacy session we had earlier in the year at Rewired. We wanted to grow the community of digital AHPs, encourage those in the room to lead from the front, and to discuss how we might influence those not in the room to better engage with the network.

We invited the chief AHP Officers (CAHPOs) from the 4 countries in the UK to be part of the session and meet their digital leaders. Disappointingly none were able to attend. Although, Suzanne Rastrick, a CAHPO in England, nominated Natasha Phillips, the chief nursing information officer (CNIO) at NHS England, to be a part of the session in her place. We were very grateful for Natasha attending and sharing with the group a summary of the work completed and planned for the nursing profession in England. Having been in post for just over two years, Natasha and her team have made some excellent progress, some of which is already having an impact in the digital AHP world, and some providing learning for us. Having allies such as Natasha and her personal pledge of support will help the AHP workforce shape our digital agenda.

Building upon the attendance at Rewired, 27 AHPs and friends gathered on day two. An impressive turn out given that Summer School 2022 attendance was just over 300 peers. After an introductory canter through the policy and strategy activity in the last five years, exploring some of the learning (light) from these as well as the missed opportunities (shade), the group were asked to make digital commitments. Using the themes of identity, leadership and learning, digital leaders in the room were asked to consider a commitment to be completed next week, next month and next year.

Core themes included:

  • Connecting with the current literature, guidelines, and competency frameworks
  • Getting familiar with existing networks and tribes and increasing participation
  • Investing time in organisational, regional and national role modelling and leadership

One example of the commitments made is from Ali Toft, AHP Information Officer (CAHPIO) and Occupational Therapist at Great Ormond Street Hospital.

Ali pledged to:

Next week

  • Follow up on new contacts made at Summer School and reach out to others.
  • Begin to consider and draft areas for development.

Next month

  • Review newly published strategies and ones I haven’t seen before.
  • Explore new networks and opportunities I’m not currently aware of or accessing productively.
  • Do myself an action plan which begins to focus across identity, learning and leadership. A plan with bite-sized, manageable chunks.

Next year

  • Refocus and work with colleagues to review our organisation digital implementation plan in co-production with the people.
  •  Ongoing…. shout, question, ask and challenge!

The activism and passion from the group was seen in their responses and included key terms such as:

AHP piece

During the session our wonderful peer, Nathan Kershaw who flew in from New Zealand for the event created a digital AHP channel for Discourse for us. This is open to all wish to inspire, share and collaborate.

The energy, appetite, and leadership for advancing digitally ready, mature, and enabled AHP is obvious. This has been recognised by the good people at Digital Health. Together, we are pleased to announce Rewired 2023 will host the first ever Digital AHP Summit. This will be on day 2 of the conference and be run jointly with our colleagues from pharmacy. It is our intention to invite the 4 CAHPOs and present the digital activity across the UK. We would love for AHPs to share their work at Rewired 2023.

There will be opportunities in the Digital AHP Summit and across the other stages. We know there is a wealth of innovation and new ways of working and we really must do better at sharing.

So, here it’s the call the AHP call to action:

  • Please submit and share your work at Rewired 2023 here. Submissions closes on 31 October 2022.
  • If you’re not sure what or how to present your work, or for any other digital AHP questions, please do reach out via the digital AHP channel on Discourse

Finally, we are sad that our friend and extremely valued colleague Melissa leaves us to go back home to Oz in the next few months. We are equally excited about international digital AHP activity in the future! Melissa will be taking over the CCIO twitter handle this month, so please do take time to join in the conversation.

The CCIO Advisory Panel have maintained an AHP seat to ensure a strong voice for workforce and we are delighted to welcome the wonderful and passionate Anna Awoliyi.  Euan McComiskie will remain the digital AHP voice on the CNIO advisory panel.

We look forward to seeing even more digital AHPs at Rewired and interacting with you virtually before then.

Onwards and upwards for digital AHPs: the untapped potential of digital health!

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Summer Schools 2022 bursary holders reflect on their experience

by Lauren Hoodless
written by Lauren Hoodless

A few months on from Digital Health Summer Schools, some of the NHS Digital bursary holders have reflected on their experience of the event.

NHS Digital provided bursaries to 20 women from ethnic minority groups to attend Summer Schools in York in July 2022.

The event provided aspiring leaders with the opportunity to engage in rewarding education, networking, and best practice exchange while learning from the very best digital and healthcare leaders including Tim Ferris, Simon Bolton, Sonia Patel and the Shuri team.

Presentations and interactive workshops covered the future of the digital profession, the role of the ICS and the use of data and digital tools to improve and manage the health of citizens.

Below you can hear some testimonials from Star Tshabalala, Amanda Francis, Tayo Iloh, and Rebecca Mansoor, who attended the event.

“I was filled with excitement at the prospect of attending. At the event there were many opportunities to meet with other Clinical Informaticians including several people from NHS Digital. Digital leaders were challenged to address health inequalities and variations in the digital capabilities and experiences of both staff and patients that are determined by where a person lives or works. As a Shuri Network Nurse Fellow, it was a privilege to witness the great work being done by both members and allies in giving women from ethnic minority groups an opportunity to explore the digital world.”

 

Star Tshabalala 

“It was great to meet so many new and interesting people all passionate about the future of the NHS and improving its services by digitisation. The keynote discussions were tremendously informative, and I was encouraged by the attention given to managing convergence and developing digital skills and digital capabilities while transforming the workforce. The sessions made me realise how much knowledge and learning is available via the Shuri Network. It was both uplifting and rewarding to learn that inequalities in the workforce are being addressed and schemes organised to redress the balance.”

 

Amanda Francis

“It was an incredible opportunity to gain top-notch knowledge and guidance from industry leaders. It was a great platform to learn about various aspects of digital health trends, challenges and new ways of working within the system, Overall, it was a wonderful experience. I had a great time, met some interesting individuals, and developed some productive relationships. Even though it was a challenging, thought-provoking conference, I would still highly recommend it to colleagues looking to attend in the future.”

 

Tayo Iloh

“The summer school is the first in-person event I have been to in a long time because of the pandemic. I was slightly apprehensive but didn’t have to worry as the whole programme was setup to help people feel comfortable and make meaningful professional contacts. I hope to keep in touch with some of the people I met and use these contacts to further relationships between NHS Digital and the frontline NHS. There was so much passion and enthusiasm for digital initiatives within healthcare, and I am sure that networking events such as these contribute to improvements and enhancements in patient care.”

 

Rebecca Mansoor

Reflecting on the event, NHS Digital’s interim chief medical officer and chair of the Shuri Network, Shera Chok, said: “This was the most diverse audience in the Summer School history. There was a real buzz and energy from having aspiring digital leaders from different backgrounds at the conference as they are the future of digital health in the NHS and care. It was a great success and we hope to repeat the bursary programme next year.”

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