In a world where litigation is commonplace and where professionals in the healthcare sector, such as doctors and nurses, have to be registered to prove their credentials - it will come as a surprise to many, that, for healthcare informatics professionals, registration is still optional.
How many Digital Informaticians are there in the health and social care sectors?
‘We don’t know with any certainty, but we estimate, based on our best available data and something called the electronic staff record, that there between 41,000 and 53,000 informaticians in the NHS. We don’t know how many we have in social care. That’s out of a workforce of 1.4 million in the NHS and 1.6 million in social care.
‘At the moment, they are doing a job which we know is creaking at the seams a little bit. There are issues with diversity and retention, and we know we are likely to need many more digital skills across the board.
‘When it comes to the use of the terms 'digital' and 'informatics' they are fairly interchangeable and mean anything to do with data, information, knowledge and technology.
‘Management consultants Mckinsey have estimated that we will need a 75 % increase in advanced and specialist and basic digital skills by 2030.’
Why is it important that the work of informaticians is professionalised?
‘As far as health and care are concerned, if we get it wrong, patients can be harmed. That includes GPs, or a surgeon operating on a patient to someone on the IT helpdesk. They all have a part to play and if the job is done badly people can be harmed or even killed. That is increasingly indefensible.’
Is the NHS keeping up with the pace of change?
‘Is any industry keeping up? The answer is no. It’s impossible to keep up fully and will be increasingly impossible. We have a doubling of the number of components on computer chips every two years or so for roughly the same price and see similar scales of change in data and knowledge space. Individuals or organisations can't keep up with that.
‘What we need to do is create an environment that helps the health and care industry to keep up as best as it can'.
Our research indicates that there are four ways of doing that:
- First, support the motivation, and build the confidence and experience in all staff. We know that increasingly, digital is a job that we all have to do, and that innovation is something that we can all contribute to.
- Second, is building and reinforcing knowledge and skills, again for every single member of our workforce.
- Third is how do we develop a culture which is supportive of rapid change and adaptability against a backdrop of a very risk-averse, highly hierarchical industry - mostly because of the consequences when things go wrong.
- Finally, there’s what we provide digitally as far as tools and services are concerned. We have an arguably immature market where we have a whole bunch of products and services - the benefits of which are not always clear. We have an environment where different digital products don’t talk to each other well; we have an environment where the product is not designed with the user in mind and thereby increases the time spent by medical staff on their work and that is not right for the 21st century. Our tools cannot make life harder for our staff or our patients - they must make life easier.
‘So, the final piece of the puzzle is how do we create a body of informaticians in the health and care world who can design, build and commission well and who are at their core, centred on the needs of the users they are supporting.’
The Health Secretary, Matt Hancock, is in favour of digital transformation. What is your organisation, Health Education England doing to promote digital transformation?
‘This year, for the first time, through the work led by NHSX, and largely pushed by the current Health Secretary, we’ve seen the inclusion in the Health England mandate for the development of digital skills for the NHS workforce and health and care workforce, which is a tremendously positive and powerful thing to do'.
‘What it means is we can bring our education resources and expertise to bear in trying to solve the problem of helping three million people across health and social care, become digitally ready'.
‘That’s an extremely big job; so, we're taking it step by step. We have, for instance published a capability framework for digital skills for all staff. We have mapped it against a self-assessment tool to enable individuals to work out where they are in terms of confidence, motivation and experience. We will be creating a personalised signposting tool for staff to identify where their gaps are in terms of their knowledge base, skills and motivation and where they can go to address it'.
‘We have been investing in professional bodies, like the Federation of Informatics Professionals (FEDIP) and Faculty of Clinical Informatics (FCI). That's had some stark impact, trying to get them into a position of financial independence so that they can be truly independent of the centre and support their user base. We’ve also invested in the NHS Digital Academy.’
What can be done to encourage people to sign up to FEDIP, which is backed by BCS, amongst others?
‘Several things - which I divide into sticks and carrots. I'm going to start with carrots. We are what you would describe in the health and care world, a 'voluntary profession'. If you're a doctor, nurse or allied health profession you cannot practice without being registered with the General Medical Council and you have to be assessed to be good enough'.
‘That doesn’t apply to informaticians, certainly in health and social Care. I hope that as a group of individuals we can coalesce around the organisations and professional bodies that we join, such as, for instance, the Govt Digital Service or more traditional professional bodies like BCS. My hope is the benefits of being able to articulate what ‘good’ looks like will be recognised. I hope, for instance, that the Chief Information Officers will be supporting the development of their staff'.
‘There are also ‘sticks.’'
‘Now, I expect over time we will see a growing recognition that not being good enough and not proving that you are good enough simply is not on'.
‘This is a world where if the wrong decisions are made about commissioning a system, or money is wasted on poor procurement, or on a system that doesn't support the exchange of information effectively, then you’re harming patients, and wasting tax-payers’ money'.
‘I can see a situation in the, not too distant future, where informaticians are going to need to apply for accreditation, registration or maybe even there will be a regulation route in the same way as for doctors and nurses - and I don’t think that’s too far off'.
‘I do know that how we establish that is not going to be a top-down ‘thou shalt’, it’s going to be very much consultative.’