Filling the NHS digital skills gap
Using technology to drive NHS productivity is a condition of the £20bn birthday present the government has recently promised. However, the digital skills to support this technological transformation do not grow on trees.
The Wachter report saw the lack of the necessary informatics skills as a key factor in the failure of the National Programme for IT; CIOs in the NHS are worried about the supply of good quality technical staff.
Meanwhile new skillsets are required. AI-based health applications are forecast to reach over $6.5bn (£4.9bn approx.) by 2021; in the next five years, the health and care sector is projected to be number one in the top 10 industries for IoT development. Data scientists are in demand the world over.
So who will build the future?
Health Education England (HEE) is due to publish its refreshed NHS workforce strategy next month. Will this be high on its agenda?
Faced with a global digital skills shortage but under pressure to deliver, the need for the NHS to ‘urgently address’ the recruitment and retention of specialists was highlighted in the recent Human Factor report from the National Centre for Universities and Business’s Task Force on Digital Health and Care.
It noted that a highly-skilled and knowledgeable workforce was a central requirement for “digital health and care to scale at the necessary speed“.
It is a fact not lost on Beverley Bryant, Chief Operating Officer at System C and Graphnet Care Alliance, who contributed to the report. Bryant was also involved in NHS England’s Personalised Health and Care framework, which recognised in 2016 that the NHS “does not systematically plan for or develop the crucial professional role [of informatics], where there is a global, competitive market for their skills”.
Bryant says there are specific needs to be addressed. “For me, the gap is in the ability to effect transformation. Often the technology gets implemented and people walk away. But we need to develop a workforce that can show people the benefits of technology.”
This needs to go beyond the efforts of individual champions that can make or break the adoption of digital innovations, she said. It needs to be recognised at the highest level, and there is still more to be done.
“When boards are trying to promote digital transformation, if they are struggling to recruit the right skills to lead, it can become easy to put it in the ‘too hard to do’ box. Other priorities take over,” she says. “We need to change the mindset.”
Part of this change in mindset is already underway, with a post-Wachter push to raise the digital skill levels of the NHS workforce, as witnessed by the NHS Digital Academy.
However, the issue over a potential lack of digital skills remains.
There are around 50,000 informatics staff in the NHS, and we do not really know if this is enough, or if they have the right skills.
“The NHS has never planned for non-clinical skills,” says James Freed, CIO for HEE. “It has always assumed the market will provide. We can’t make that assumption anymore.”
The key is to get informatics workforce planning on the agenda, and this is starting to happen. It is part of the imminent HEE workforce strategy, which sets the foundations for growth. Whether it has the whole solution is unknown; we don’t yet know the size of the problem.
"We are putting in place the necessary infrastructure, but we will know more about what is needed for the 30,000 plus organisations delivering health and care in a couple of years." For now, he says, "we have shifted the dial".
That infrastructure includes showing boards how good digital governance equates to good governance. Pilots of NHS board ‘inspiration sessions’ underway now are showing what can – and must – be done with digital. The results of these will be shared freely across the country.
Digital literacy must be improved
Increasing the digital literacy of the workforce is also a priority. Campaigns such as the Royal College of Nursing’s Every nurse an e-nurse show what can be done by reaching out to the profession through existing bodies, says Freed. Such organisations can set standards and encourage innovation adoption.
Professionalising the sector is also important; as outlined in the Wachter review. However trying to align the learning styles of the modern breed of agile software developers with traditional professional bodies may not be the best fit, admits Freed. Further change may yet happen.
Change is coming. In the wake of WannaCry, the dangers of disregarding technology became clear. There is the rise of the rockstar NHS CIO, with several featured names in the Top 100 CIOs. Fear and excitement are driving this change.
But are the necessary changes happening quickly enough? For some, perhaps not.
“The Francis report highlighted the need to share data and information across organisations, but it’s not been enough to make it happen yet,” says Bryant. “But it is starting to happen; it just needs to happen a bit quicker.”