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The workforce
Introduction
The capability framework provides capabilities for a wide section of the workforce.
As of August 2021 there were 1,198,746 NHS hospital and community health service staff working full time14. The NHS has also seen a steady increase (16.9%) over the last 5 years of the informatics workforce in England14.
The capability framework provides capabilities for a wide section of the workforce, including:
nurses
doctors
dentists
pharmacists
paramedics
physiotherapists
other allied health health professionals
bio-informaticians
data analysts/scientists
Some staff also have mixed roles with both a clinical dimension and an elements of their role focussed on IT/digital/informatics projects. The number of different roles and multiple positions (different hats) people have makes developing a framework aimed at multiple professions extremely challenging. To overcome this issue the framework is based around a series of 'archetypes' that represent the type of activities that different individuals may be involved with. Most NHS professionals will sit within one archetype, however some roles may span across several archetypes. The framework can be applies flexibly to different situations accounting for this variability in roles and workflows.
Case Studies
Case Study: eConsult Specialist
The overwhelming pressures across the National Health Service (NHS) are putting a strain on delivery nationwide, and the challenge opens scope for innovation. eConsult have already transformed the delivery of primary care services with over one million eConsults being completed each month - a digital questionnaire that collects key patient information to allow clinicians to improve triage.
Following the rapid growth, eConsult has ventured into Urgent and Emergency Care and outpatients, each of which comes with a whole variety of complexities and challenges. eConsult has partnered with Mid and South Essex NHS Foundation Trust to deliver a patient management system that will reduce the waiting list backlog, reduce Did Not Attend (DNA) rates, revolutionise traige, digitalise Patient Initiated Follow Up (PIFU) and improve patient experience simultaneously. Over 40 outpatient specialty departments will be implementing a specialist list of questions to allow triage at the outpatients' referral stage.
Although this will be the first roll out across an entire Trust's outpatient department, eConsult has been working with the Cardiff and Vale acne clinical trialling a smaller scale project. In doing so, eConsult reduced the patient waiting list clearance time from 20 years to just 3 years in addition to reducing DNA rates from 40% to nearly zero.
The collaboration is merely the start of outpatient transformation that will serve long term benefits to the NHS. Supporting workforce has been crucial to the implementation of this project and a suite of resources have been pulled together to support staff with this new way of working.
Case Study: Whzan remote monitoring supporting high quality care for care home residents in North Central London
Care home residents often have complex health needs which increase their risk of deterioration in the community. Since the start of the COVID-19 pandemic a need has emerged to be able to offer remote care to care home residents, especially given the increased risk of adverse outcomes from COVID-19 outbreaks in this population. North Central London (NCL) Clinical Commissioning Group (CCG) worked in partnership with NCL training hub, NHSx and Solcom to embed the Whzan blue box in care homes. This remote monitoring kit enables care home residents to have their observations taken by staff, after which a NEWS2 score is calculated and the information automatically entered onto a tablet and portal via Bluetooth. This data can then be accessed via clinicians across the local healthcare system.
150 care homes have been trained up by a team of nurse educators on how to take observations using Whzan, recognise soft signs of deterioration and communicate with clinicians using SBAR. >43,000 NEWS2 scores have been taken on 3384 care home residents over a 12 month period. Care home staff report increased confidence in recognising when someone is unwell along with feeling empowered in conversations with clinicians by having additional patient information. GPs, community matrons and Multi-Disciplinary Teams (MDTs) are able to use the data to support triaging patients and clinical decision making when doing telephone or in person reviews. Across all care homes using Whzan there has been a 28% reduction in LAS call outs. The process of embedding this digital technology in care homes using a collaborative approach in NCL has strengthened relationships between staff working for the NHS, Local Authority and Adult Social Care with benefits realised for both residents and staff.