Exploring why we need a more inclusive and broader offering for the Digital Health Leadership programme (DHLP)

Aasha Cowey talks about the challenges and sucesses of working to achieve a more inclusive and broader offering.

When I first started to work on the future vision for the NHS Digital Academy and oversee the Cohort 4 application process working with a great team, I was absolutely utterly terrified.

Both prior to, and during my work on the expansion of the NHS Digital Academy, I could see how much the Digital Health Leadership Programme (DHLP) meant to people. Both those who had a place (many of which clearly had an amazing time and got loads from it, I know a lot of the alumni who are a great bunch) alongside those who were unsuccessful applicants – sometimes multiple times. The amount of emotion I see every year when places are announced can be overwhelming. I cried at least once during the Cohort 4 outcomes process trying to work through the disappointment, we had from some.

The DHLP offers 100 places every year which in reality is only scratching the surface, and representation of certain roles (for example, midwifery), women and people of colour has just not been good enough historically. I don’t want to ruin the sense of identity for those who have already gone through it, but it was crucial that we have begun to level the playing field. Our workforce is still very white and male, especially at senior levels – and this does feel a bit worse for those who aren’t coming through a clinical route. I haven’t done a significant piece of research here, but I still see a lot of ‘manels’ on conference panels or very male heavy chief information officer (CIO) nominations for example.

Motivations and challenges

We made quite a bold choice to exclude job titles for Cohort 4 and objectively rank everyone on score. The outcomes for Cohort 4 were a marked improvement on a number of areas including women, ethnic minority groups and various professional groups such as midwives and Allied Health Professionals.

Our approach didn’t please everyone, and we had a number of challenges thrown our way. Many of these were contradictory, which in a way reaffirmed we would never make everyone happy. I feel we did it in the most objective way possible, and I am sure there will be learning and ways to keep making it better. I don’t think we got it all right and the lessons learnt work highlights areas for improvement.

I have every faith my colleagues will continue that work, but I cannot begin to explain how stressful outcomes day was. I genuinely felt upset for those who did not get a place. I questioned whether I had done enough to promote and champion diversity and was pretty hard on myself. Now I step back a few months later – I think we made huge steps forwards.

The proportion of applications received, and number of places offered to females increased to 45% and 42% respectively (previously 35% and 39%, respectively). Applications by staff from a black, asian and minority ethnic (BAME) background increased to 37% (previously 29%) and who were successful also increased to 29% (previously 19%). Additionally, 10% of successful offers for Cohort 4 were made to AHP staff, 12% to nurses and 3% to midwives.

Let’s not widen the gap

Why are people so emotive about this programme? I lived and breathed the NHS Digital Academy for 18 months and reflected that there were a number of key themes which came through in motivations, which are not mutually exclusive. This included changing your mindset and way of working, embedding knowledge into your organisation, developing your career pathway, gaining an incredible peer network, doing it for the badge.

The Digital Health Leadership programme is pretty hard going from what I’ve heard (from both the delivery partner as well as participants). Those 100 places need to go to individuals who will get the most from the programme, and they’ve had to demonstrate that in their applications.

What worries me, is that the NHS Digital Academy starting to pop up in job descriptions creates a situation where doing it for the badge becomes the most important thing. It also doesn’t seem right at a point where only 300 individuals have gone through the programme.

We need to instead focus on the Digital Health Leadership programme being one of a co-ordinated set of opportunities rather than putting all eggs in one basket. So if you consider using it in a job description, do think about how to date, while sadly likely reflective of our workforce in this space, it is likely to disproportionately discriminate against women, people of colour and underrepresented clinical professional groups. However, as the offerings available to those in digital, data and tech roles increase, we need to ensure individuals realise there may be better things out there more suited to them (and that’s OK!).

How do we continue the good work?

My hope is that we have started to break down barriers and to have more equal opportunities to access learning, especially those of which are limited. I have faith I am leaving the future vision for the NHS Digital Academy and expansion of the DHLP in good hands, and alongside the wider infrastructure in place – the future is optimistic. Ultimately however, this needs to be connected back to career pathways, competencies, continuous professional development (CPD). Otherwise it does risk being a badge and seen as the only show in town.

I’ve just returned from the Digital Health ReWired festival where the Federation for Informatics Professionals in Health and Care (FEDIP) have just launched their charter, The Next Step for Health and Care Informatics: the new FEDIP Charter, which aligns really nicely to the above. This year is being touted as The Year Of The Digital Professional and I look forward to seeing what it brings. Oh, and I’m also in the process of considering my own application for Cohort 5, which I hope demonstrates the value I see in this – I just need to check it’s the right one for me!