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Supporting Digital Nurses, AHPs and Midwives

1 December 2020

At long last we are seeing progress in our understanding of the important strategic role to be played by digital lead nurses, allied health professionals and midwives.  Earlier this year, England’s first national chief nursing information officer (CNIO) was appointed to help push forward digitisation of the NHS - some four years behind the first national CCIO, a doctor.   This is an important appointment.  The majority of digital users in healthcare are nurses. Senior nurses, AHPs and midwives have a significant role to play in helping shape an organisation’s digital strategy and priorities.  

As a former head of nursing working for the last 6 years as a senior nurse for a supplier of clinical digital functionality, I have been observing with interest the creation of national and regional CNIO networks and the slow emergence of clinical digital lead roles in the healthcare organisations I work with.  These are still early days – as shown by the lack of standardisation and consistency.  The terminology, seniority and expectations of these roles vary widely, from CNIO at the top end of seniority and influence (which can also vary in grade and role expectations) to Band 6 or Band 7 digital lead nurses, AHPs, and midwives. These are often new roles within an organisation and, in district generals or smaller tertiary centres in particular, they can also be solitary ones, with one person working as a lone nurse, midwife or AHP within a project team. 

I have been the first incumbent of a couple of new advanced clinical practice roles in the NHS myself, and I understand the challenges and skills required to make a new role a success.  Most important, the individuals require a clear vision and understanding of the role and what is expected of them in it. They also need to be self-motivated, creative yet disciplined, have a good understanding of governance, a level of leadership and communication skills, and importantly they must learn how and when to say ‘no’.  The temptation to be viewed as adding value from the earliest opportunity often results in saying ‘yes’ to tasks which in the fullness of time render the role unmanageable.  Without these skills individuals may struggle to create a sustainable role which meets the developing needs of the organisation as it progresses digitally.       

To make it more difficult, digital leader positions often sit outside the usual professional structures, usually lying within the informatics department as part of a project/programme team. It is surprising how crossing the invisible boundaries that exist between teams fundamental to the operation of a single organisation can create cultural and contextual difficulties for clinicians new to the role.  The language is different, the perspective is different, and the focus of the project/programme can be different.  For a nurse used to working with patients and responding to constantly changing situations,  suddenly having to work to a project plan, with strict timings and alien structures, can create a sense of isolation and disconnect from their professional identity.  

Finally, the traditional support mechanisms available within clinical professional hierarchies are not necessarily on hand to support individual digital leaders - everyone might well still be learning about the impact of adopting clinical digital functionality.  Consequently, success for these roles and individuals can be a difficult journey.

My role today as a Clinical Adoption Specialist (CAS) within System C is to help organisations successfully plan for, prepare, roll out and optimise clinical functionality.  Part of this work involves working closely with the clinical leads, in some cases acting as professional coach and mentor to individuals trying to find their feet.  However, the CAS team can’t do this effectively across the breadth of the System C customer base, so the question was how could we extend this support to all clinical leads in our partner Trusts?   

The idea of the Digital Leads Network was born.  I spoke with some of our experienced customer CNIOs and with their support have organised the inaugural network meeting. The premise is to offer some formal content such as presentations on the national agenda, with input from senior practitioners in the field, product demonstrations, clinical safety workshops, and opportunities to share lessons learned with colleagues and to have more informal discussion sessions.  No-one should feel embarrassed to ask a question as the network aims to provide a supportive and safe environment.  We will also offer to ‘buddy’ less experienced individuals with experienced people from different organisations for some mentorship and/or coaching, dependent on need.  We will also have a Microsoft Teams chat to allow people to post questions or any interesting literature they’ve read, or lessons they want to share in between meetings.

As a supplier, we work in partnership with healthcare organisations towards a common goal of providing good clinical digital systems to support the improvement of patient outcomes and the work life of clinicians.  It is my hope that supporting our customer-based digital leads through this new network will help achieve this ambition.