Resources

0:06

Welcome to the webinar launch of The Phillips Ives Review. My name is Colette Fretton and I am the engagement facilitator for this review.

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And I will be introducing the speakers today. For those that have just joined we are using Slido to capture all the

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questions throughout this review, so as and when your questions come up, please put them into Slido.

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You can see on the screen how to access that, you can either use the

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QR code or you can log on online and post your questions there.

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And, we will answer as many as possible at the end of the session, but we will take all the questions and put them on the website shortly after this review.

0:58

You also will see that there's an option to like the question. So there, if there are questions on the Slido that you want to ask or really keen

1:06

to know the answer of, please like that question and the most liked questions will come to the top of the question list.

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So at the end of the session, we'll provide an opportunity for questions and answers. We will attempt to answer as many as possible, but as I said before, the,

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all of the questions will be answered and posted on our website, which you'll see at the end of this review.

1:28

I'd now like to introduce you to Dr. Natasha Phillips, the Chief Nursing Information Officer and Director

1:38

of Digital Clinical Safety for NHS England, and Chair of the

1:43

Phillips Ives Review, Natasha. Thank you very much Collette, and that's a very long title, isn't it?

1:49

So I felt for you there, trying to get through that. So I'm really thrilled that we are here at this point today and that there's so many

1:58

and such a diverse group of people who have joined us for the launch of what will be a really interesting year of discovery.

2:06

It's great to see that we've got not only multiple professions, represented here, but I think also, I noticed on the list, you know, we

2:15

have research, practice, education and leaders on the call, and those are obviously the pillars of our practice.

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So knowing that we've got that breadth is really great and I'm thrilled that people are coming along to find out more about what exactly this review is.

2:30

So I guess the thing is what is it? And well, today is the start of a big conversation.

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I'm hopeful it's going to be a rich conversation where we bring a wide breadth of expertise to examine the preparation of nurses and midwives

2:44

for working in the digital age. I guess, who are Phillips and Ives? Well, I'm Phillips, so I'm Natasha Phillips, Chief Nursing

2:52

Information Officer for England. You probably want to know a bit about, about why am I doing this? My background is as a nurse, twenty-seven plus years now, I think I stopped

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counting at twenty seven years, actually. I'm a passionate improver, and I hear that lots when I meet nurses who've taken

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an interest in the specialism that is nursing informatics or digital change.

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I've led quite a lot of large-scale change that has a digital flavor because essentially it's really difficult to do things about improving our NHS without

3:23

some component part, being about digital when that's the way we all live our lives.

3:28

And I guess what's important to me and why I'm Chief Nursing Officer for England is my values really.

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So I'm a passionate nurse, I think we have a very unique function, I'm very proud

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of the contribution we make to people's lives every day, in terms of helping them live their best lives, regardless of what disease they may or may not have.

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So a real passionate, nurse with a desire to make our nursing practice

3:57

or better all the time and a desire for all clinicians to advance their practice, circled around that patient.

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And I guess the other core value to me is about investing in staff. We can't do it without our staff.

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They need to feel valued. They need to feel heard. And importantly, we need our staff to have the right education to

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enable them to deliver outstanding care to our patients every day. And with things shifting so much with a digital focus that requires us to look

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deeply at what should that education look like, which is really why we find ourselves here in this review.

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And the final important thing to me, as a researcher is academic rigor. So that's why we're doing this review.

4:38

I've been in post now for two years. We've done lots of tactical things about this, but we've got a massive

4:44

change to deliver, and I think that the changes we make need to be carefully considered and evidence-based, which is why we're going about this review.

4:52

So that's why we're having this conversation now. And later you will hear about the focus and approach that we're taking

5:00

to this and we've taken quite a lot of time to think about that. So the team will bring that together and present it to you so that we do

5:07

have that real rigor behind what we do. But before I do that, I guess you want to know who Ives is,

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so I'm going to introduce you now to Jeanette Ives Erickson. She's Chief Nurse Emeritis at Mass General Hospital in the US, which

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last time I checked was the number one hospital in the US, she's the Chair of the Commission on Magnet Recognition.

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And, I think in her tenure as a Chief Nurse, she's had a relentless focus on practice, education, research, and leadership, focusing on really good

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professional practice environments to allow care to flourish, and I think that's some of the expertise that she brings to this review.

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I had the pleasure of meeting her when I was on my Florence Nightingale scholarship, and we've maintained a connection and she's really widely

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published in this area, and I think she's going to bring real expertise to our work. So I'm really thrilled that she said yes to being my vice-chair on this review.

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And I'm going to hand over to her now to say why she has agreed. So, Jeanette, over to you.

6:07

Well, thank you, Natasha, for that kind introduction and colleagues I am just

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delighted, in fact, I'm honored to be asked to be the vice chair of this review

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with my friend and colleague Natasha. As Natasha said, I was the Chief Nursing Officer at the Massachusetts

6:27

General Hospital having served for 21 years, I'm currently the president

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of a small, critical access hospital that happens to be 30 miles off

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the shores of Massachusetts called the Nantucket Cottage Hospital.

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So I've been able to see the broad needs of clinicians, and of course

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the patients that we serve, not only at an academic medical center,

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but in our rural health centers. My, my passion is pretty similar to Natasha.

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I cared deeply about the work of nurses and really the necessity

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of maintaining the integrity of the nurse patient relationship. And I think that, that is some of what we hope comes out of this.

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How does this digital age support the work of nurses so that we are more efficient

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and we can spend more times collaborating with colleagues across all disciplines.

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I'm also hoping my six years now, being on the magnet commission and the last

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three as the chair of the commission helps to bring some information

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regarding evidence-based practice and how evidence in nurse sensitive indicators really helped to elevate the quality of nursing practice.

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So again, I'm delighted to be with you. We have a lot of work to do, and we will be describing how we're going

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to get that work done in the next few minutes, but now I'm really

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honored to introduce James Freed. You can see from this slide that he has an impressive title, but he

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also has had an impressive career. His career has taken him through cancer research, change management

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and standards development. As well as being the Chief Information Officer, he is the Director of the

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programme responsible for delivering digital readiness to the three million

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staff in the health and care in England. Just one little nice fact about James in 2017, he was voted by his peers

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as one of the top 100 influencers globally in health IT as part

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of the hit 100 Twitter campaign. So you can, he's a fellow of the British Computer Society, and I think

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probably the best title he might enjoy is that once he was the governor

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for his daughter's primary school. So colleagues, James Freed.

9:17

Thank you ever so much. Gosh I'm quite impressed to myself there. Thank you.

9:23

Well, I should say, first of all, is I am absolutely thrilled to be able to support Jeanette and Natasha with this review.

9:29

It is necessary. It's absolutely needed. And I can't wait to see it get underway and see the sorts of

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things it starts to uncover. One of the things erm after that rather long introduction that you might have

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noticed is I'm not a nurse or a midwife. So my, so it's probably worth me explaining what my

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interest is in this review. I'm here to support and make sure that the outcomes of this review are

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as impactful as they possibly can be. So I'm the, I'm the senior responsible owner for a programme of work that

10:00

is looking to support the entirety of the NHS and indeed social care workforce to develop the digital skills required to work, operate, and

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indeed live in a 21st century society. And so this review will, building on the good start of the Topol Review, really

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contextualized the needs for the nursing and midwifery workforce and help me and my team work out how we can support you and your colleagues to be as contributory

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as you possibly can be to realise as much value as quickly as we possibly can do for those people we serve, the patients and their families and the general public.

10:39

I'm really interested for a number of reasons. So the nursing midwifery workforce comprises about half of our

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professionally qualified clinical workforce in this country. So it's a significant step towards understanding our overall needs.

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But one thing that I should say is that, this review is not about a review of technology.

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So we are, this is not about gadgets or widgets or digital, all the digital

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tool set is as a means to an end. And so that, that absolute focus that Natasha and Jeanette have both spoken

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about that passion for delivering more value to patients is absolutely what underpins the reason why we need to have these skills and need to make better

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use of data, information, knowledge, and technology in our day to day work. And I'm really excited to see what the review will uncover with regards

11:28

to how we need to plan for the future workforce, how we need to recruit, but also how we need to support the education and training of staff in post.

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It's a really interesting time. It's really hard to see what's going to happen in the future.

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And that's why this rigorous academic approach to the predictions that we need to make so that we can make some of those planning decisions now is so important.

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So thank you very much for inviting me. I'm now going to introduce our next speaker who's Tracey Eyre.

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She's the Programme Lead for Nursing and the Digital Readiness Education Team. Thank you very much, Tracey.

12:06

Thanks, James. Could we go to the next slide please? And thank you. So, as James mentioned, I'm Programme Lead for Nursing with the Digital

12:13

Readiness Education Team, and I'm also a member of Natasha's team. My background much like Natasha's is in ITU, but spent a number of years

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working as a digital nurse specialists. So everything we're doing is really close to my heart and I'm passionate

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about what it is that we're trying to do. So what I'm going to do is give you a little bit of a background of how we've come to where we have with the themes for the review, and

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then I'll be handing over to Judith Dando, who's our Programme Manager. Next slide please. Ian.

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So I think it's really important to share Natasha's vision; nurses and midwives being fundamental to the effective digital transformation of health and social care.

12:49

The whole vision of the programme is about providing tools and capabilities, so that our nursing and midwifery staff can lead and deliver

12:57

patient care in this environment. Next slide. So, we've already mentioned Topol.

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I thought it was worth giving you a little bit of background. So in 2019, Eric Topol delivered a report, which focused on providing a view

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of digital healthcare technologies and what their projected impact on the NHS workforce would be over the next 20 years.

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He identified a need to bridge the skills gap and future workforce pipeline, specifically highlighting the needs for technical staff.

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There was a limited focus on a specific needs of the nursing workforce. It's really difficult to apply those findings to the nursing and

13:31

midwifery profession at scale. And as you can see, this was the comment made by King's Fund, after release of the review.

13:38

But we know that the pandemics accelerated the use and adoption of digital devices and systems at the scale and pace that we haven't previously seen by frontline

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health and care staff in all settings, as well as the people using those services. Next slide, please.

13:54

So, why now? In 2021 the digital maturity assessment, highlighted a variability in the makeup

14:01

of digital health teams within an emerging population of digital health leaders in both nursing and midwifery, there was very much a feeling that they had been passive

14:10

recipients of technology, and hadn't been part of the decision-making process. It also identified a need to standardize and define clear education standards

14:19

for the entire workforce, including pre-registration nurses and midwives. So this includes those who are digitally enabled, so using technology

14:26

to further facilitate care, and those who want to specialize in a clinical informatics role, such as a specialist nurse, or midwife, through to a CNIO.

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Now the What Good Looks Like for Nursing was launched at the nursing summit at rewired in March this year.

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Now that's an operational guidance for chief nurses and directors of nurses to enable them to lead digital transformation in their organizations.

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So the Phillips Ives Review will build upon these, along with the findings and recommendations of Topol and importantly evidence from the pandemic so that we can

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determine the needs of the nursing and midwifery workforce with the approach that a nursing voice is needed in all places.

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It's vital that we have that understanding of what our current state is and focus on that future digital practice and needs of our workforce to

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provide clarity on the longterm view. This will lead to an education plan for those things that we need

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to do at a national and systemic level, so we have the workforce we need for this transformation.

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Next slide please. So, the review is going to address these four key questions, to examine

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the impact of technological advances, both in the here and now and over the next five, ten, twenty years.

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Now we thought really long and hard about how to address inclusion, equality, and diversity. And we made the decision to include it within each expert advisory panel,

15:48

rather than as a separate panel, by doing this, we can ensure that it's embedded and threaded throughout the discussions, and then contributing to

15:56

the focus of future recommendations. We'll also ensure that people in practice are at the heart of the review

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and those resulting recommendations. We're bringing together national and international experts with expertise

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beyond nursing and midwifery to investigate, critically appraise and make

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recommendations to ensure that the breadth of ambition and scope of future practice of that pre and post registration nursing and midwifery workforce is captured.

16:24

Next slide please. Ian. So you can see here, we have seven key themes. It may be that the, the graphic is a little small on your screen,

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don't worry because I'll go through this in the next slides. So again, as I've said, it's informed by Topol, the digital maturity assessment and

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What Good Looks Like for Nursing, and the challenges and rapid progress in the use of digital technology during the pandemic.

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So to ensure that we've got a robust joined up review, we've amalgamated these themes into three panels.

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Next slide please. So, panel one visits the Topol themes.

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We've already recognized that the pandemics moved digital technology at pace. For instance, Topol suggested that 50% of the workforce would be

17:05

using remote monitoring by 2028. We believe that this has already been exceeded, so we need to understand

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where we are to project what that future drops and progression will be. Now, the chairs for at panel one, we've got Professor Ruth Endacott.

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She's the Director of Nursing and Midwifery at the National Institute for Health Research, and she's also an honorary Professor at the School

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of Nursing and Midwifery, University of Plymouth, and again, a Professor of Clinical Nursing at Monash University in Melbourne, Australia.

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Cynthia Barginerer is the Chief Operating Officer in the American Institute for Healthcare Improvement.

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She's accountable for a broad set of responsibilities across that organisation, and she's been a Chief Operating Officer and a Chief Nursing

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Officer at a number of hospitals in the last eight years, eighteen years. So they're going to bring a wealth of experience to their panel.

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Next panel, please. Sorry, next slide please. So panel two, this is about delivering care to people wherever they are,

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whether they're at home, a care home, a prison, in the community, in social care or in a hospital.

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And we joined it with emerging technologies so that we can use it to support and progress that people led care.

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Our chairs for this panel: Molly McCarthy is the Chief Nursing Officer Strategist in the US Health and Life Science Sector for Microsoft.

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Her primary focus is business development and strategy for virtual health at Microsoft, and she brings over 20 years of experience in the healthcare industry.

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Our second co-chair Dr. Gemma Stacey is the Director of Academy and Deputy Chief Executive Officer at

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the Florence Nightingale Foundation. Gemma has more than twenty years experience as a mental health

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nurse and academic, and she's a Principal Fellow of the Higher Education Academy and a visiting Professor at the University of Derby.

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Next slide please. So our final panel three, this is all about our workforce.

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It's about the professionalisation of the digital nurse midwife specialist. And what does our future workforce look like?

19:03

Again, following on from Topol, it's been suggested that the NHS digital workforce requires an additional 32,000 technology and data staff by 2030.

19:13

Now, as nurses and midwives, we know that new technology and electronic patient records need our input as well as other clinical staff to ensure

19:21

that the system meets the need of the workforce and the people we serve. So for instance, how many nurses and midwives do we need to meet

19:28

these additional IT staff numbers. Now preparation for practice includes nurses and midwives

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at all levels of education. So from undergraduate through to postgraduate, as I've mentioned, including advanced clinical practice.

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Again, we need to understand what this means for the needs are of our workers, but also for the higher education institutes and education providers.

19:51

Now our chairs for this panel, we have Dr. Jen Bichel-Findlay, who is from Australia, and I believe she's on

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this call and it's probably some awful hour in the middle of night in Australia, so thanks for joining us.

20:02

Jen is a Fellow of the Australian College of Nursing and the Australasian Collective Health Informatics.

20:09

She's an Associate Fellow of the Australasian College of Health Services Management, and a board member of the Health Informatics Society of Australia.

20:16

She's currently the Chair of the New South Wales branch of the Health Informatics Society of Australia, and was fundamental in driving the development of competencies

20:24

and capabilities in that area. Professor Laura Serrant is the Regional Head of Nursing at Health Education

20:30

England for the Northeast Yorkshire and Humber area, and she's also a Professor of Nursing, in the Faculty of Health and Wellbeing at Sheffield Hallam University.

20:39

I can't impress on you how much we appreciate the co-chairs that we have and the experience that they're going to bring to their panels.

20:47

What I'm going to do now is hand you over to Judith, and she'll be able to tell you a little bit more about what we're doing and how you can get involved, Judith.

20:57

Thanks Tracey. So, Tracey's explained what we're going to do. And now I'm going to tell you a little bit about how we're going to do it.

21:05

So, each panel is going to be made up of the two co-chairs, who Tracey has just explained to you.

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There'll be a sort of prime subject matter expert. There'll be an educationalist and there will be nursing and

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midwifery fellows on each panel. They'll also be a range of additional SMEs depending on what the themes of

21:25

the panel are, and we will also have patient representatives in each panel.

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Across the three panels, they will be supported by an ethicist, a health economist, and our supporting review team.

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Next slide please. So why is this review important?

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Well, it's important because it's going to help us meet the aims of

21:51

Natasha as the CNIO of NHS England, to ensure that nurses and midwives

21:57

are empowered to practice and lead in a digitally enabled health and social care system, now, and in the future.

22:04

And we need to ensure that nursing and midwifery practice is fully supported by the use of digital technology and data science.

22:13

Next slide, please. So this is the review timeline. So we've pretty much hit the ground running on this.

22:20

We want to complete this by the end of March next year. And so we are pushing our review panels pretty hard.

22:30

We are aiming for the first panel to be up and running in the next couple of weeks, and then you'll see that there will be five formal panels up

22:38

until the interim report is published. And we're aiming to publish the interim report at the delayed CNO for England

22:47

summit, which is currently due to be on the 28th and 29th of September.

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So you can see we've got a lot of work to do in the next four months.

22:58

So once after the first panel session, then there will be evidence gathering.

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We have already provided our panels with some baseline evidence gathering. We've given them literature reviews, which are dated from

23:12

the end of the Topol review. So they will look at the evidence that we've already gathered.

23:19

But there's a lot more evidence out there and that's where all of you come in, please. So this is where we need to collect everything that's

23:27

out there and triangulate it. To do this, we'll be setting up round tables.

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We'll be setting up one-to-one interviews and we're intending to go along to the Digital Health Summer School.

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So there will be all sorts of things that we'll be doing in between the panel sessions, where we come out to you and talk to you about what you're

23:49

doing and we gather the evidence. And I'm going to ask you later, if you do have evidence that

23:54

you'd like to contribute, then we would really welcome that. So the evidence gathering will go on in June, and July.

24:02

Then the interim report writing will be done by the panels, with a view to that publication date as I mentioned at the end of September.

24:10

Then the interim report is coming out to consultation. And this again is where all of you come in, please, there will be

24:18

a two month consultation period. We will ensure that we send this out and we communicate with you widely.

24:24

There will be a platform which will allow you to contribute, to look at what we've produced and to feedback.

24:30

And at that stage, we will also have more conversations with all of you. So you are vital to this.

24:37

It is only an interim report and we need your feedback, please, and we need to pick your brains and your experience please, to feed into what will be the final report.

24:47

So after that consultation period, we will write the final report in December, January, and February with a view to having it produced in March.

24:56

And it will then be start to be circulated system-wide. We will formally publish report at the CNO Summit at the end of may.

25:06

And at the same time we will be endeavoring to, produce a timeline for

25:13

delivery of what the report recommends. So there will be a roadmap, a five-year roadmap for what we intend to deliver.

25:21

So, I've already mentioned how a little bit, how you can contribute, but you are all absolutely fundamental to this.

25:28

And when I say all of you, I mean, those who work within the NHS and those who work

25:34

outside the NHS, those who are midwives, and those who are nurses, and also those

25:39

of you who are neither or none of those, but work within the wider health and care sector in different professions, all of you can help contribute to this.

25:50

So please, after this, all those who tick the box to say that you are

25:55

happy to be kept informed, we will be sending you a form after the event

26:00

to allow you to volunteer your help. This will allow you to provide details of your subject matter expertise or

26:07

your specific area of interest and whether or not you are willing to, attend round table events for instance.

26:15

We will also ask you that if you have additional evidence that you would like to contribute, such as details of reports, research, and work that's going on in

26:23

your organisation, you can contribute that to us, and we would really welcome that.

26:29

You would come volunteer to join round table events or knowledge cafes. And as I mentioned, we want you to participate in the interim reports

26:37

consultation period in October, November, and we will ensure that, you know, that is happening and, how you can do that.

26:44

We have a website, the link is here. The link is also in the chat and we will keep that up to date with everything

26:51

that's happening with the review. Finally, we have a website address, so please contact us directly and we

27:01

will make sure that the right person or the right panel gets the information that you're providing us with.

27:07

Next slide, please Ian. So now we're going to go on to question time.

27:13

I think you're probably all on Slido now. So I'm now going to pass back over to Colette.

27:19

Thank you. Thank you Judith. And thank you to all the speakers.

27:25

So right at the beginning, I think some of you may have missed it as you joined slightly after the beginning. We offered you the opportunity to ask questions on Slido.

27:34

So for those who haven't seen this, you can either use your phone to access Slido via the QR code, or you can log on to Slido online via slido.com and

27:46

use the hash Phillips Ives Review. Oh, someone's said they've lost sound.

27:55

Can everyone else hear me? Yes. Yes. Great. Okay. Thank you, everyone. We've got some hands up, that's it.

28:04

A lot of responses. So there's an opportunity there to ask questions. You'll see when you log in that there's already been quite a

28:10

number of questions already. If you see a question that you're really keen to know the answer on,

28:16

please hit like, and it will move the question up in terms of the priorities.

28:24

So, what I'll do now, what I should say from the start is we will provide answers

28:29

to all the questions that have been given either during registration, where you were

28:34

offered the opportunity to ask questions and the questions that have been posted on Slido now, these will all be posted on the website shortly, along with the slides

28:44

from this presentation and the recording. Okay. So I'm now going to just take the questions from the top and, we'll

28:54

open it up to the speakers to answer these questions and we'll try and get through as many as possible.

29:01

So the most voted question at the moment is how do we ensure that digital skills

29:06

training is embedded and available, right from the beginning of careers, e.g. for student nurses and midwives?

29:15

Collette. Who would you like to pick that question up? Would Jeanette like to pick that up?

29:23

I'm happy to. One of the things, the beauty of the way in which these panels are set up is that

29:30

these are the types of questions that we want the panels and the participants

29:37

to engage in the conversation regarding digital skills training for students

29:46

through out their curriculum will become very important, not only for

29:52

current students, but for our future. So we do hope that the panel does pick that up.

29:57

And I believe it's panel three that we will be sending that information to,

30:04

and James, I know you have thought a lot about this, so could you add to this?

30:11

Yeah, I'd be happy to Janette. Thank you very much. So just to say, I mean one of the things that we were talking about

30:17

before this session was that we don't want to second guess what the output of the review will be, and obviously there'd be a huge amount of information

30:24

and perspective that we synthesized. I think it's unlikely that we're not going to see something, however, It's

30:30

going to require, digital skills training early on in formal career pathways.

30:36

So one of the reasons why Health Education England is involved in this whole process is because we've got already strong links with the

30:41

higher education institution sector. Not just those universities, but other education providers as well.

30:48

So, the governance bodies that influenced those institutions as well. So people like the council of deans, for instance.

30:54

So we do have ways in which we can influence or indeed commission training into formal and informal routes for learning.

31:02

But we want to be led by the evidence, we want to make the investments, which that are going to have the biggest bang for our buck effectively.

31:10

Thank you, James. Perhaps you could help us with the next question as well. And this is the other side of the the discussion is how do we ensure patients

31:20

who do not have digital resources or skills have equal access to services as I see a digital health gap emerging.

31:28

Yeah, this is true. So one of, one of the issues that we have, actually not just in the health service, but anywhere in government is that we can't pick and choose our audience for

31:36

the ones that are easy to serve we're there to serve the whole population. Of course. And that includes people who have difficulties or,

31:44

otherwise have fewer chances. So that includes digital literacy, includes health literacy issues.

31:49

And we come there to serve everyone. One of the reasons why the Digital Readiness Education Programme exists,

31:55

and this is not just limited to the support we provide not just nurses and midwives, but for the whole workforce is to support those of you designing

32:05

services to recognize that even when we're looking at digital tools a service needs to provide support for people who are less digitally literate.

32:15

And that means multiple channels in multiple ways. So we can support everyone in the way that they are best able to be supported.

32:23

So again, don't want to second guess what's going to come out of the review, but I have no doubt that it will address this issue.

32:29

Natasha you had, I did.

32:34

Thank you, Colette, and James has answered beautifully, but I would like to add one other thing, which is, firstly, to reiterate the review has

32:42

been structured so that we can answer exactly those types of questions because the review starts with our practice.

32:50

And so to add to it what I'd like to say is the nurse and midwife are uniquely placed in terms of our advocacy roles.

32:56

So I would be very surprised if this does not come out as part of the review that we should be coming away with some recommendations that say,

33:04

what do nurses and midwives need to pay attention to in this space? And therefore, how do they need to be prepared through education to be

33:11

able to pay attention to those things, whether they be a point of care nurse

33:17

or midwife or a nurse or midwife who is leading whole systems or nurse or

33:22

midwife who is leading digital change. Thank you. And Jeanette, did you have something you'd like to add?

33:29

I would add that one of the beauties of the way in which these panels are structured is that the voice of the patient will be present in each panel.

33:40

And so I think understanding from our patients, some of the limitations, the

33:47

fears, the expectations that they have. We should encourage, not only answering this question, but in all of the

33:55

panels and all of the questions that come up and hopefully the economists that are also joining these panels will help us to understand the impact

34:06

of not having equal access to care. So I think our panels are structured to answer these questions beautifully.

34:16

There's a comment there from, sorry, I didn't see, it jumped off my screen too quickly.

34:22

Midwifery have the maternity voice partnership, can also support co-production. Thank you, Terry, we will make sure, we work really closely with Jules Gudgeon,

34:31

who's our National Lead Digital Midwife. She's working closely with us on that and our Chief Midwifery Officer, Jackie

34:39

Dunkley-Bent, has given us a core list of key midwives that will contribute to this.

34:44

So they will bring exactly those sorts of things to the fore. But as we've said here, we're calling out for everyone to contribute.

34:51

So if you have a thought or an idea, Please use the channels we've created

34:56

to make sure that it comes through. So we do have that breadth of voice and really consider both nursing and

35:03

midwifery practice equally and carefully. Thank you.

35:08

So the next question, I'll put to Natasha is can this be the review where

35:14

we define and produce best practice guidelines for the term clinically led and

35:19

embed this is, so not limited to medic. Well, Claire, good to see you on the call.

35:26

I recognize that question and have felt that, to be honest, I'm not sure entirely

35:31

it will, but I'll tell you what it will do is it will bring a breadth of clinicians, not just nurses and midwives, to a deeper understanding of how we prepare

35:40

nurses and midwives, and probably form a template for maybe how others start to look at some of these questions.

35:46

I like to think that we can, we put, and certainly, the way

35:53

we've constructed the review is to put the patient at the center. So I'm not so sure that getting involved in the debate about who's

36:00

the clinician is always so helpful and I think it's bigger than digital. But perhaps it will end up with a statement that is how

36:07

we define clinically led. So I wouldn't rule it out, but I don't think this is the only place where that conversation happens and what the most important outcome that we come away

36:15

with is what do nurses and midwives need to practice safely and effectively

36:21

in digitally enabled healthcare. And that will require the panels to think about and who do they need to work with?

36:28

So where do they draw on other skills in order to do this work and who depends on us?

36:33

So some real rich debate and Claire, do register your interest if you're

36:38

interested in any of the round tables or submitting further thoughts.

36:45

So the next most voted question is, is there any plans to incorporate

36:52

digital clinical safety into statutory, mandatory training to help establish

36:58

a safety culture within trusts? I guess as the national digital clinical safety leaders, this one falls to me.

37:06

So, so within the bounds of this, I'm sure digital clinical safety will come up as a core competency for nurses who are leading digital change and having

37:16

an awareness for all other nurses. So I think what I would steer the person who's asked the question too, is to

37:22

look at our national digital clinical safety strategy, because that really clearly talks about how we move to a culture where digital clinical safety

37:32

is a core part of how we address core quality and safety and care delivery. And that means shifting from a place where we just have clinical safety

37:42

officers who look at two digital clinical safety standards, and approve cases for digital systems.

37:47

It looks to build on that, strengthen that, and think about how do we look at safety in its widest sense to make sure that the workforce is prepared.

37:56

So we have as, as one of the five core strategic aims within that, and four commitments that we've made nationally, a plan to scale up training,

38:05

significantly moving from a sort of foundation level training and awareness

38:11

level training, all the way through to that expert training, much like we do for things like safeguarding.

38:17

And, I guess the question about whether that's mandated will emerge as we do that work in the coming year.

38:24

But the most important thing is that we liberate knowledge and therefore scale up our training significantly.

38:33

Thank you, Natasha. The next most voted question is, is there any plan to incorporate

38:38

digital literacy into student nursing and midwives curriculum?

38:43

So I suppose the caveat for a lot of these things about what's going to come out of the review will be let's wait until we see what comes out of the review.

38:51

But also it's probably worth saying, we are where we are. And that means that we've started in some areas.

38:58

So, Health Education England has been commissioning over the last couple of years, some blended learning degrees, undergraduate degrees,

39:06

finessing, a relatively small number to explore what that looks like now. I believe that in some of those cases, the universities have

39:14

incorporated a tool called the digital skills assessment toolkit into the delivery of that curriculum.

39:20

What I'll do is I'll pop a little link into a video about what the digital skills assessment toolkit is.

39:25

It's a bit rough around the edges. So you have to bear with us on that one, but it will give you an idea about what it's trying to do.

39:31

In short, it's a way for individuals to assess against a common and broad digital

39:38

literacy framework, which is published on the HEE website, 32 questions, where

39:43

they think their role requires them to be and where they think they are themselves. And then there's a little bit of, there's an algorithm in the backend that

39:50

will point users of the digital skills assessment toolkit to some bite-size learning to help address the biggest gaps.

39:56

So I suppose that's a short answer. Sorry. A long answer to say yes. There is already, it is not nursing and midwifery specific, so that

40:05

digital literacy tool at the moment is aimed at the whole workforce. It'd be lovely to see what the review says in terms of how we make that more specific

40:14

and more nursing midwifery focused. I would only add that if we go back to the vision statement where we

40:20

began, and we think about the care that we want to deliver in the future

40:26

being safer and more efficient. We really have to build this work into the curriculums like James, I don't

40:37

want to decide what the panels are going to come out with for recommendations,

40:43

but, but for me, this question aligns beautifully with the vision statement.

40:49

Thank you, Jeanette. The next question I have is, will we be looking at a minimum standard of

40:58

education for a nurse informaticist CNIO, and will we be working with the NMC

41:04

on this for appropriate accreditation? Do you want me to take that one to start with?

41:12

Yes. Again, you know the drill, we're not second guessing.

41:17

We've deliberately gone back to do, you know, to commission a group of people and a big, robust piece of work to look at these questions in

41:25

depth rather than jump to answers. But I think it's probably reasonable to assume that we will come up with something

41:30

that says, this is the knowledge and skills our specialist workforce needs. And of course, if we do that, we need to commission programmes of education

41:39

that deliver those minimum skills. So I suspect yes, what it looks like, I don't know.

41:45

We have existing international models. I saw question four about why international, so I'm going to

41:50

weave the answer to that in here. We have examples of international models and colleagues in Australia,

41:56

in the US who have very defined roles of what a nurse informatician is

42:02

and defined programmes of education. Whether we go down that route, whether we take a more blended, collective

42:09

clinical view on what the education looks like, where we start in terms of that education from a bite-size to masters, to whatever it looks like.

42:17

We already have a model for specialist practice in this country, which is about starting as a clinical nurse specialist trainee through clinical

42:26

nurse specialist and nurse consultant. Perhaps we'll end up in that realm. But I think we need to let the panel do their work to determine that.

42:34

And then in answer to the NMC, well, they do set the pre and postgrad education standards but not specialist practice per se.

42:42

So I don't, we will engage with the NMC. They will be a core part of this work. And of course, when it's delivered, I have an oversight board that has the

42:51

Chief Nurse from the NMC, that has the president of the RCN and all the

42:57

key people that we need to have to oversee delivery of it, so they will be very tightly wound into what we do.

43:03

So they certainly have a contribution to make, but it's a bigger piece, which is why we take the collective leadership approach that we do.

43:11

Thank you. Okay. We've got time for a couple more questions. Will this review include recommendations of digital roles

43:19

within trusts for consistency, please. There's it's a perennial issue, isn't it?

43:24

The consistency of roles. And I noticed the question about the consistency of banding.

43:29

Let's start at the beginning. Who do we need? What do we need them to know? And let's define this with this review.

43:36

The review is focused on giving us a roadmap for education of the workforce.

43:43

The What Good Looks Like guidance alongside it is an operational plan for chief nurses to take up.

43:48

And that already gives them some indication of the roles they need. It doesn't go so far as to say here's a standardized set of

43:58

roles and responsibilities. I think in this review, we are likely to come to conclusion about what those are.

44:05

It is likely that in our further iterations of what good looks like guidance, we might pick that up, so that chief nurses have the

44:13

ingredients there to build their teams. So more of an idea about roles and responsibilities, I'm really mindful to

44:21

just set expectation that this is a great opportunity to understand the work that

44:27

we do, the knowledge and skills that we need, the shape of the workforce we need and therefore how we educate them.

44:33

But there are other component moving parts that also we'll need to take that work forward, in terms of operationalising it in practice and

44:44

conversations will no doubt continue, once we have these findings, which, which may take us to a point where we set some standards for organisations

44:54

in terms of what teams they have. But the first bit is this part, so let's do part one and see where we go with that.

45:01

I know that many digital nurses are crying out for this because we know we have variety from band sevens all the way through to band nines.

45:09

I think this is a big part of answering that and getting you to where you want to be. So the important part is to contribute, but importantly, I would always urge

45:18

everyone as well to stay curious about where this investigation takes us.

45:24

Thank you, Natasha. James, I think you've already answered this question, but let me ask it to you. Will there be a national digital literary assessment tool or survey?

45:33

Yes. Yeah, there is. So we're in a stage that's called private beta at the moment, which just means

45:40

we're trying to test it with a few select groups to make sure we're doing the right things and it is having impact.

45:46

But I think we're on the cusp of making that a bit more public. I've put a link in the chat, too, so, if your organisation doesn't have access now,

45:54

but you're interested in having a look and trialing it, there's a link to request more information and maybe request access.

46:02

There's also the link to our website there, which may not have answers to all of your questions, but it's a good first place to have a look.

46:07

Probably another question for James. Will we ever be in a position for standardised digital systems to

46:13

be used across the whole of NHS? Issues re procurement, security, quality, but can we overcome?

46:22

So that's out of the scope of this review, I think, and out of the scope of responsibility, but I will give you a personal response then if that's okay.

46:29

So, that implies that the standardisation across the countries a good thing, and sometimes that's true, and sometimes that isn't.

46:37

So what we learned from the national programme for IT is that ruthless standardisation does not equate to the best answer all times.

46:45

I worked for them between 2003 to 2006, and about 2008, the programme was referred to as the 12 billion pound failed NHS supercomputer,

46:53

we don't want to go back there. But at the same time, we know that there are problems that can be solved once for

46:58

all and should be solved once for all. What I see from working with colleagues in NHS England, you know, what was

47:05

NHSX and NHS digital is a real desire to get that balance right between what decisions need to be made locally.

47:12

What decisions needs to be pushed as far to the local as possible even to the bedside or to the patient?

47:17

You know I mean we've got consumer technologies nowadays, so not everything needs to be answered once for everyone.

47:22

And it's a, that's a really difficult question to answer. Yeah, thank you.

47:29

So we'll keep that out of this review. Two further questions and then I think we'll need to close.

47:36

Will slides be sent out? We said earlier in the presentation, the slides, the recording, and all the

47:42

questions that you've given to us will be posted on our website after this review.

47:47

You'll need to give us some time to just pull it all together. So, I would say within the next two weeks, you'll have access to all of the material.

47:55

Hopefully that answers that question. Then the last question is will there be a national framework

48:00

for competency assessment across the workforce for consistency?

48:07

I think again, we need to wait and see what the outcome of this review is as

48:13

to whether we have, there are already many existing competency frameworks, many existing national competency frameworks, our colleagues in Northern

48:21

Ireland and the Irish Republic, published one last week, so they will no doubt be given consideration.

48:27

But we need to think about is how are those frameworks taken up and where's the education that supports the acquisition of those competencies.

48:35

And the purpose of this review is to give us a roadmap for the education of nurses and midwives.

48:43

It's not the only thing we're doing. So many of the questions that we're being asked are being dealt with, but they're outside of the scope of this review.

48:49

But this review starts with the premise that if we invest in and

48:55

prepare nurses and midwives and for the work that we want them to do, then patients will have better outcomes.

49:00

And we need to relentlessly stay focused on that as panels. And I think that's the job of Jeanette, I and James as chairs and SRO to

49:09

make sure that we relentlessly stay focused on the outcome that we want to achieve to make sure that we deliver something that we can take forward

49:18

as a roadmap in the next five years. Thank you. And I think that draws us to the end of the presentation

49:26

and questions and answers. Ian, do you have one last slide?

49:31

So I'd like to thank everyone for attending and particularly the speakers for joining us. Um, I think Jeanette had to get up fairly early to be here

49:39

today, so thank you so much. And to those international participants that woke up early or

49:45

stayed up late, thank you so much. It's been great to have you here. We've given you the contact details, and we'll send you an email afterwards

49:53

with how to get in touch and how to express an interest in either attending or sending in information.

50:00

And it's really important that you're all part of this. So if you'd like to contribute, please fill out the expressions of

50:06

interest form that we'll send to you. And then we can get in touch and ask for more information. As we've also said, we've got an email address that you're

50:13

welcome to email us with anything. Okay, thank you very much. Does anyone else want to say anything before I stop recording?

50:22

Thank you everyone. Great questions and a wonderful beginning for this work.

50:29

Thank you so much. Thank you everyone for your time.