Artificial Intelligence (AI) and Digital Healthcare Technologies Capability Framework published today

Adrian Brooke: It's 12:45 and thank you all for coming. Those who have logged on and we hope you will stay with us for the whole time. So uh, can we ask that? All people who are joining the webinar have their cameras turned off and the microphones on mute the. Uh. Session will be recorded. And if you'd like to ask questions, but this is supposed to be a kind of a chat. And therefore, it's really helpful if there are questions, if you can put them in the chat window, which you can see if you click on this series of icons at the top of the screen, the very first icon in the model, middle of the teams screen. There's chat. If you click that. A window will open. I'll even do it now. A little column appears in in in black on the right-hand side of the screen, and then you can write your question there and then post it using the little uh paper aeroplane icon in the bottom right-hand corner of the screen and then we'll know what. Question you've asked and we can pose that to the panel that we've got. So thank you all for coming. Uhm. Can I start by asking? Uh. All our panel. Members to just briefly introduce yourself and. Where you work, what your job title is, and I I will I will demonstrate by saying my name is Adrian Brooke. I'm medical director at health. And England and my background clinically was in paediatrics and I'm an interested dinosaur from the pre digital age in area. So can I go over to you Sonia next please. 

Sonia Kumar: Hello everyone lovely to be here. My name is Sonia Kumar. I'm a GP by background professor of medical education and I'm an associate Dean at the University of Leeds. 

Adrian Brooke: Thanks, Sonia. And can we then move on to Alan next please? 

Alan Davies: Hi everyone. I'm Doctor Alan Davies. I'm a senior lecturer at the University of Manchester and my background in nursing and computer science. 

Adrian Brooke: Excellent and last but by no means least, Hatim. 

Hatim Abdulhussein: Thanks Adrian. So my name is Hatim Abdul Hussain. I'm a GP in in northwest London, Health Education England, national lead for AI and digital workforce. 

Adrian Brooke: Thank you. So and what we're going to do is just very briefly, uh, kind of to introduce this session, really just set the scene and. What I really just want to do here is in fact to just remind everyone that the AI digital healthcare technologies capability Framework was published this morning at 10:00 AM and is available on the NHS Digital Academy. Website. So the that report and the framework build on the findings and recommendations made in the top hall review, which came out in 2019 and was entitled preparing the healthcare workforce to deliver the digital feature and that outlined a set of recommendations. Preparing the NHS workforce to become world leaders and utilising digital technologies to the benefit of our patients, of course. Now we know clinical teams in near future will be required to use AI, artificial intelligence and other digital health technologies effectively and equitably. Really, for the benefit of all. And that's starting now actually. So this is not, this is not something for the distant future. This is occurring as we speak, but in response to this needs on health education England, HE's how it's foreshortened, it's an arms length body commissioned University of Manchester to undertake a learning needs. Assessment and create a capability framework. And that's to aid learning and development of. Our healthcare workforce. Now the framework aims to help healthcare workers identify gaps in their current knowledge and areas for preparatory activities to support digital transformation of the workforce, as well as their own individual learning. And it's this builds these capabilities that we've just published, build on the foundational digital literacy capabilities first introduced in a health and care digital capabilities framework. 

Adrian Brooke: So the AI and digital healthcare framework extends this with capabilities around the use of. Health data and the technologies that make use of this data, for example applications. On your mobile. Phone or computer wearable technologies, software and programmes, etcetera. And this is further extended with more advanced capabilities like artificial intelligence and of course, the advent of robotics. And capabilities of course range across the whole spectrum from initial awareness through implementing these technologies in a healthcare environment and supporting digital transformation projects. So I'm going to shut up now. I think that's probably welcome for everyone and perhaps I'll turn to Hatim and Alan to present the framework. Thank you. 

Hatim Abdulhussein: Thanks, Adrian. And so I'm just bringing up the slides and hopefully. We can all see you then. Give me a second. Yeah, OK everyone can see the slides. Thanks for joining us. Come here. Yeah, perfect. Alright. So I mean, I but you know myself, we're just gonna go through the the methodology behind the framework and and a brief overview of what the framework includes. But when I'm reflecting on what I'm going to say today, I was just looking back when I started my my GP training as as a registrar and started. Uh, my first placement as a GP in a practise in Hayes. I was doing majority face to face-to-face consultations and practising in a way that seemed very familiar to me and I think going back up only about two or three percent of my consultations were even telephone based, so the majority were with the patient in front of me. I don't want him to ask an emergency at the trainee and we hit the first wave of the pandemic and being an accident emergency, I noticed. Certain things. So I noticed how suddenly our nursing staff and them and see what collecting observations on on a device and we're inputting them into a. Then. 

Adrian Brooke: I’m hearing people are struggling to see the slides, so we've got messages in the chat that says they can't see the slides. 

Hatim Abdulhussein: Let me see if I can share that as a candidate. 

Adrian Brooke: That's a few. 

Hatim Abdulhussein: Give me a second. 

Adrian Brooke: So if you go into presenter and all the we all disappear. That might be easier. Oh. Can someone message to say with the slides on out? Yeah, we've got some. Yes. OK, thank you. That's really helpful. 

Hatim Abdulhussein: Wonderful. Wonderful. So, so. So being in Annie, I noticed that things were changing. So nursing staff were recording observations on, on, on, on a system and we were having to access that system to to be able to look at observations. And we had new healthcare records that we were using in that emergency department. And I remember going in one day in, in paediatric A&E and being told we've got this new system in place and not really being turned, showing how to use it and not really being kind of having had the time to really familiarise myself with the system. I then went into general practice and notice the whole world had changed. Uh, you know, when I logged into my my sister, my suddenly had widgets on the screen that allowed me to text and receive messages from Patty. And suddenly when I was looking at appointments, I had something called the consultation where people were giving me information beforehand and then I had to act upon and thinking about what I. Was going. To do going forward and all of a sudden I was doing about 50 to 60% of my consultations. Uh, either via the telephone or in some cases, even by video consultation. And I reflected on how one we got to this stage, but two, whether I felt that I had the best skills in place to, to be able to, to. Work in this new way. And. And I was also at a point where I was preparing for my general practise exams and a key part of my exams was to record myself consulting with patients and a lot of these consultations were over telephone and video. Now that became an opportunity for me. It allowed me to really analyse the way I consult with patients and to reflect on my educational supervisor around how best to do that and what kind of mitigation I needed to take when I'm consulting with a patient over a video call rather than over a phone or versus a face-to-face consultation. And so when I came into my role at Health Education England, it's very important for me to think about how we do our best to, to help people understand what they need to know, to be able to work with the types of technologies that we interact with patients with. And so that's really the thekey context behind why this is important. It will enable people working in, in, health and care to be able to understand the types of skills they need to have when interacting with people interacting with patients andd using technology passing over to Alan and I'll move the slides along. 

Alan Davies: Thanks. So I'm just gonna talk very briefly about the sort of methods we use to to create the framework. So we used an iterative mixed methods approach to create it that involved code design as well. So this involved carrying out a systematic literature review to look at the academic side of things and where the different gaps were and a series of. Workshops which we did online and then that was followed up by a digital survey as well. Next slide please that in. So the the systematic literature review is really used to to generate some initial concepts and this was carried out by Health Education England's knowledge and management team and we also include as well as the academic literature. We looked at the great literature. So we looked at existing frameworks, international frameworks and other relevant policies and documents and we use this to generate. Set of a set of really groupings of topics and themes and concepts. So looking at the different things that were coming up constantly in the literature, that would seem to be important, and we grouped these together roughly into. Uh, what we call a concept map and that acted as the basis for the workshops to give people a starting point so they could look at the kinds of technologies and things that we were talking about under those different main areas and spark the the debate really. So if you move. To the next slide. So we carried out the workshops online. It was during the pandemic and we used, we used the thing called Myro, which is a an interactive board that allows multiple users to work at the same on the same page basically. And we also put people into breakout rooms and the series of workshops targeted different stakeholder groups. So the first one was really around. So they're people like the top or fellows there. We had NHS clinic or entrepreneurs we had in the second group, we had industry representatives. So this was Babylon Health, Google Health, Barclays and Bupa and the final workshop was focused around subject matter experts. So we used each of these three workshops to use the topics to spark discussion. And consider what the different capabilities might might involve, and then we're able to rank these in order of importance and complexity. Next slide. We use something called the nominal group technique for the workshops and this is quite a useful technique when you've got people that aren't familiar with each other, or you might have power dynamic imbalances. So essentially you've got this nominal phase where you privately consider the information, and we did this offline prior to the workshops, and then we have an item generation phase. This is all around. Radiation. So people come up with ideas without being interrupted. By others and in this we captured that on post. It notes on the Mira board and then you go back around to the clarification and discussion where you can kind of probe into the different ideas and ask people to explain them. And then finally, there's a voting stage where you're able to order the priority of the different items. So we use this to generate a draught version of the framework. Next slide, please. And then we sent that draught framework out via survey for wider participation so we could get more people to give us feedback. We took that feedback on board and then constructed the final version of the framework that you can see in the report. Next slide please. So the framework is as I mentioned before, it's built on top of the original digital literacy framework and that forms the foundation. And then on top of that, we've got a lot of skills around data. So obviously for a lot of these advanced technologies, wearables, AI, machine learning, they're all built on and understanding and use of data. And then on top of that, we've then got those, those technologies. And then on the higher end, we've got things like artificial intelligence and AI. So it's built up in that in that in that way basically. And it sort of straddles the space between the original digital literacy framework, which is very much around basic digital competencies. You know, so can you switch your machine on send emails and do all these fundamental digital things? And then at the other end, we've got special frameworks for special groups like Informaticians. And this framework very much straddles that space in between. The expert frameworks and the very fundamental digital literacies. Next slide, please. So umm the other problem we had here is how do you make a framework where you've got so many different types and roles in the NHS, so many different types of workers in the NHS workforce? So it would be quite a challenge to map these these capabilities onto all those different working groups. And the other problem is some of these work working groups will have different roles. So you might be a clinical nurse, but you might also be involved. In informatics projects, for example, so you might wear multiple hats. So to get around this, we use archetypes instead. So essentially we map. The capabilities onto archetypes and then people can self-identify which archetype or archetypes they belong to, or their managers can do this as well, and the archetypes include things like shapers. So this can be people in leadership positions or arms-length, arm length bodies. We've got drivers. So this can be your CIO's and CIO's. Creators. So these are people that are actually creating some of this stuff, engineers, data. Tests and then we've got embeddings. So these are people actually embedding some of these things into the into the various systems. So it teams and so forth. And then we've got the users as well. So people actually use the technologies and and it is possible that you you can you can come under one or more of these different archetypes at different points. Next slide please. We also use something called Bloom's digital taxonomy. So for any educators out there, you're probably quite familiar with blooms. It's quite a popular framework that's often used in in education, and this is a digital version of that framework. And we mapped all of the different capability statements onto Bloom's taxonomy as well. And it really includes moving from lower-order thinking. Skills through to higher order thinking skills, so at the lower end you've got things like remembering things and and basic understanding moving through to application, analysing, evaluating and then creating. So we use Bloom's taxonomy across the framework and and through the different sections as well. Next slide please. So the framework itself is split into a number of key domains, and these domains include things like digital implementation, digital health for patients, and the public ethical, legal, and regulatory considerations, human factors, health, data management and artificial intelligence. Next slide please. And a number of these domains also have sub domains so you can see there for example that that that they break down further. So AI includes things like robotics, we've got things like management and leadership under human factors and ethics and regulations under under the legal issues and so forth. And inside each of these we've got a number of individual capability statements. Next slide please. So on on each of these, uh, uh domains and sub domains, we've got a number of statements split into 4 levels. They're split into 4 levels to make this compatible with the original digital literacy framework, so it's a familiar structure and the levels really just infer increasing complexity or difficulty. So level one's going to be easier than level 4. And then within each of these levels, you've got the actual. Capability statements themselves and then these are mapped onto those different archetypes that you can see at. The bottom there. So that's a that's a quick whistle stuck tour through kind of how we designed the framework and kind of what the framework consists of. And I'll pass back to hatting. 

Hatim Abdulhussein: Thanks, Alan. And our key message here is says great, we've got a framework, we've got an idea at a very early stage of what these capabilities might be. But how do we make sure that one is sustainable? And two, we get the impact we need to get in terms of me being in my clinic room as a GP to touch the skills that I would need to be able to work the touch technologies that I'm interacting. And so the first thing is to say that technology is, is fast adapting and in our framework, we've done our best to make sure that we're technology agnostic, but we need to make sure that we continue to keep live to, to advancements and developments in this area. And so we're gonna be doing some work to make sure we have a a mechanism in place to continue to review and refresh the the capabilities with the and within the framework. As well as building new areas as things emerge in in, in policy and in healthcare. The second part is we want to empower individual learners to be able to use this framework, so it's about embedding it into existing health, education, England, learning platforms or tools such as the the Learning hub. So that individuals can really measure their own, learning their own aspirations for where they want to get to and and and and. And that will then drive them forward in terms of what kind of skills. They develop based on that material out there. And then the final part is to be able to make sure we're working with their educational bodies. Uh, like, like people like Sonia. Who, who's who's working women, a higher education institution or our all colleges or our professional regulators to be able to support the educational reform that we need as a result of the learning that we have developed over the past year and a half in. Developing this framework. And so that we know that when I am entering my TP training, I have it quite clearly within my remit to be able to develop these skills naturally within the competency, the capabilities that I need to build as part of becoming a GP. I hope that's been a helpful overview of the framework, but and I'll pass it back now over to to Adrian for for for the discussion. 

Adrian Brooke: Thanks Hatim and thanks Alan for for a kind of a lightning tour through the the rationale, background, development and deployment of of the framework. So. So thank you very much. What we'd like to move on now to this discussion on how we can implement that framework. Uh, in undergraduate and postgraduate uh training. So I'm and I'm going to turn to to Tim and Alan. And Sonia, I mean, we have got this. You know this funny triad between? If you like the individual, the framework, the places individuals are in, for example, you know postgraduate or undergraduate courses and and we've got the changing landscape as well. So we've got lots of moving targets. And of course, we've got a regulatory framework as well to navigate as well because some Healthcare is are highly regulated field for obvious and very good reason. Which may not always be quite as adaptive I would imagine, and I don't. If anyone would like to kind of comment on some of the difficulties that that that throws up or you know, maybe around assessments or stuff. 

Hatim Abdulhussein: I can go first and then so whenever. Ohh. When we kicked off this piece of work, I think we made it very clear at the start that we needed to be engaging with with educational bodies right from the start to be able to help them understand one why we're doing this and and two how they might use the product at the end. And some early examples of where that's been in effect is is, for example, the British Institute of Radiology. So we did a piece of work in, in, in January of of last year that looked at the AI and data-driven technologies in the NHS and what workforce groups they affect at the top of that tree, we saw radiology, radiologists and and near the top healthcare scientists as well. And so. In further conversations off the back of that with the British Institute of Radiology, we were able to say, well, look, this is going to be really important for your membership. It's going to be really important for those that are working in the professional groups that that you're responsible for. What can we do to to enable the the that learning that these groups need to need to have to be able to work with these technologies. And we've got a a webinar series and and and. Learning materials that are being developed by the British Institute of Radiology and are launching at the AI Annual Congress as well in a few months time and so. The key is is is to find the the bodies that are, you know, really valued at the importance of this and are looking to to work with us to to to build some of that proof of value. Uh for for uh. The learning in this space. 

Adrian Brooke: Thank you. So so it sounds like some colleges are kind of acknowledging this and you know, sometimes we say in education and we the assessment drives learn. And therefore, if, if you're going to be asked about it in the exam, that's quite a powerful driver. Clearly, a lot of the workforce is not in training or education, but is post training, as it were in in service roles. But still needs to know so the the the if you like the examination, uh press or to make you learn it's slightly less. Urgent. But I'm just wondering. For example, uh, stuff like finals for undergraduates. You know what? What's the inclusion in of the digital kind of agenda in that and how, how might this framework relate to that? Sonia, can you can you? I I know you're GP, but I'm. I'm. I'm. I'm. I'm thinking things like licencing exams and stuff. 

Sonia Kumar: Yeah. 

Adrian Brooke: Like that so. 

Sonia Kumar: Yeah, I know. I've involved in medical education for quite a number of years. I mean, I have to say First off, I mean, I'm really excited by this because it's a very clear outline of the domains that you need to consider with digital health. Technologies, but I think equally I'm also quite worried about how the health service is sort of moving at breakneck speed in how we're adopting digital technologies and indeed how society is as well. We all know that there's Google, there's wearables, there's apps, you know, digital health is part of our everyday lives. But yet when you look at the training needs and how it's being integrated into undergraduate curriculum, and that's across the health professions, postgraduate curricula, you do start to think that actually digital help. Of at best, is is sometimes mentioned it. It isn't. It isn't a strong theme and I think one of the really sort of beautiful ways of highlighting this is the medical licencing exam, which comes in just for medical students in 2024, doesn't really mention digital health, even though it does have an area around of around capabilities. I did a bit of a look yesterday and I was putting in words like technology, digital, remote consulting, anything that could encapsulate what we're talking about today and it just isn't reflected and that that that's new that, that that isn't that hasn't even been launched yet. That's coming out in 2024. So that disconnect between what society. Is is moving ahead with what the NHS and HG's moving ahead with, but yet how educational bodies and that's undergraduate and postgraduate are sort of somehow lagging behind I think will be will be a problem not only for dissemination of this framework, but actually the bigger thing is is actually how are we supporting our patients rather like you her team. I remember a patient coming in with their genome profile and I had a student in with me. You know, I was totally out of my depth and had to counsel the patient about their risk with for various conditions. So not only is there a training need for our pipeline, our students, there's a huge training need for our trainers. You know who who is going to be teaching our students all of these six domains around digital health? So I don't know. I don't want to use the word emergency, but I do think there is a digital health emergency that we need to address. 

Adrian Brooke: Thank you so much. It's really, uh, kind of powerful was call to action, isn't. It yeah that. That the that we need to catch up across the system, maybe it reflects A societal A wider societal issue where we've got the kind of inexorable and ever quickening March of technology. And across society we struggle to catch up and are playing catch up with it. But from a kind of list point of view. And if you like, this is an aspect in a in a in a part of medical education or healthcare, education and practise. So I think that's a really powerful observation. And and it we have got this strange situation. Have we not and I'd be interested to hear people's comments on this that you know that everything is moving really quite rapidly there. Normally in in a lot of healthcare knowledge and understanding. It's sort of held behind a kind of a a bit of a Mystic shroud of learning, isn't it? So we we've. At this aspect of the the the doubling time of medical knowledge and it used to be 50 years and then 25 years, and then ten years. And I think it's currently at about 70 days and shrinking. But for technology which is often released in a commercial setting. 1st and then adapted for healthcare rather than the other way around. Actually, if you like our public our way ahead of us in terms of their use and and often their sophistication certainly for some parts of the population. So I think that's another challenge. How how do you do you think the framework will help? Our our healthcare workforce, if you like, map their progress and their learning journey that helps equips them to meet that challenge. Perhaps I'll ask Alan because you you described the the construction of the framework. 

Alan Davies 

It's thanks. Actually I think I think it has the potential to do that definitely and we've we've certainly been. And and we've we've, we've we've put parts of the framework and mapped that against our new clinical data science programme, for example. So we're trying to try and embed these things in, in some of those postgraduate work that we're doing. We've also got a lot of stuff going on in nursing at the University of Manchester, so particular modules and courses. You know, a lot of them tend to be. That's graduate focus, though, because you know there's a lot of crowded curriculum in a lot of these medical professions. So in medicine and and nursing that they're always putting more and more things in. And obviously digital is very important, but often we're seeing you know that that it's maybe not getting the attention that it deserves, but some people are also trying to embed that into normal normal kind of practise and put it into other units and other things which I think is a good idea. It's another way to to embed some of the digital stuff in there as well. So we're seeing sort of more and more adoption of these things and if it can be incorporated into other modules and. Interdisciplinary learning as well. When we're working with other professional groups, because that's what happens in reality and you're you're going to use this technology a lot to communicate with other groups and other departments. And really we need to start embedding this early on in the undergraduate and postgraduate curriculum. So I think definitely having that. Framework and the ability for people to sort of look at that and see what those requirements might be certainly gives educators something they can start to work with and start to make sure that they're including some of those main elements. 

Adrian Brooke: So, so early adoption, uh dissemination and uptake kind of key key themes I think coming out out of of of your answer. And how how might you see that for example Hatim or Sonya in GP training, given that that's both your clinical backgrounds is, is that something you've you've seen heard? I mean I'd wanna make presumptions, but I suspect has him slightly closer to training than Sonia, but maybe not very not very much. But from from your point of view Hatim have you seen that or Sonya, have you seen that in practise? 

Hatim Abdulhussein: So my reflection during my training is I think that we're on a journey here that similarly we were on with leadership with, with quality improvement, which are areas that have fell in quite naturally into the the, the GP portfolio or or the GP kind of workplace based assessments. And now when I was training that whilst there wasn't a a specific section around digital, I made sure that I. Did a lot of reflection on the way that I use digital tools in in the way I interacted with my patients and I did a I spent a lot of time thinking about, well actually did that make things better? Did that help the, the, the the case or did that actually make things worse? Was that the right modality to to choose to communicate with that patient? And was I excluding them from from care by by by using that modality and I spent a lot of time reflecting on these things more naturally purely because it was important to me. But I think we do need to create the conditions within the portfolio to to support people to to be able to do that reflection and and to be able to make to understand that better because ultimately this is all about safe. Ethical patient care and and and to be able to to deliver safe, ethical patient care you to be able to be competent in working with the tools that you're working with and understand their their strengths and their limitations. 

Sonia Kumar: I just sort of, I suppose just adding from an undergraduate perspective, you know, I I think the evidence around I wrote a paper around this, the evidence around how you teach digital health, how you actually embed this in curricula is quite sparse. So I think that there's there's a real gap. There is, how do we actually get this information and. And skills and values around digital inclusion out to our students. Clearly, PowerPoints not gonna do it. You know, teaching our students all of this in lectures isn't gonna do it. I mean, one thought that I have is is 1 and this is bringing in my experience around community based learning and and being a GP is that students and also just building on what you said her team around quality improvement. One thing that I have done went previous to my role at the University of Leeds. I was at Imperial College London for 10 years and one thing that we did there is that the students year three medical students. Is what we call Community Action projects and we sort of focused these around hot topics such as COVID vaccine hesitancy. And just one thought is that students could do quality improvement projects with communities in that they learn the knowledge base and the skill based around digital health. But they do that through working with communities in upskilling communities, in digital literacy. So you sort of have a double win there that not only the students learning, but actually they're learning through. Nervous because I do think that we need to think about training needs not just of our healthcare professionals, but also the gaps in our in our in, in patients. We need to empower them so that when they are coming with information, they've been able to do a little appraisal of the information themselves and that they're not spending huge amounts of money and time on digital health technologies that may not be. Best for the health? 

Adrian Brooke: Thank you, senator. That that's a really helpful insight actually. So we do have a question and so thank you for the questions and comments which are coming through on the chat. We have a question from Jane Daily that that that was dinner at 12:29 for members of the panel who want to look at the question before I fire it out. View so it says digital first will only be integrated or embedded if workforce contracts and the rewards and recognition system is revolutionised. How does this align with critical and strategic workforce planning? I've got horrible things. I read that and it might come back my way, but does anyone want to kind of start off with that as a response? 

Hatim Abdulhussein: Yeah, I can kick us off and actually it would be great to have your views on that as well, but am I guess the the way the way I see this is is important. Uh, this is a particular group that we haven't necessarily focused on just now. We're talking about undergraduate and postgraduate uh. Training. But actually there's a whole group around continuing professional development who are out there working in the NHS that will need to equally have these skills looked at and be able to kind of be supported to be able to keep their skills up to date or develop their skills where gaps lie. And I think the key here is is, is, is culture of an organisation, top down leadership in terms of saying this is important. To be able to develop the skills in this area, making some of these things are built into. Uh. Annual appraisals so that you're able to at some point, you know, look at your digital literacy use as something like a digital self-assessment tool that we're developing at health education in England and and piloting in, in, in, in, in, in the north of the country to be able to say where am I right now and where do I need to go and have a really open and frank conversation with your line manager in terms of how you then develop those skills and why it's important that you develop those skills. And and so if you have all of that kind of naturally happening within an organisation, you're going to be more digitally mature as an organisation and. And so it's important that we work with with providers to to be able to, to. Enable that. 

Adrian Brooke: Thanks. Thanks for Hatim. Yeah. And I I think from a a workforce planning is really quite a complex thing, isn't it? Because a lot of planning is there's kind of short medium and long term planning and some of that planning you know long term planning assumes or if you like has foresight that there will be. A great deal. Of digital technological change. And and yet it can't be exact in articulating exactly what it would look like or how it affects. If you like the you know what's often only workforce planning cycles as circles, as productivity or your workforce requirements or your learning requirement. Even so, it becomes really quite an inexact science at that stage. And as we know. Kind of current. Progress is not always a good kind of predictor of future growth in in in the area. So it's it's it should be quite easy. I think it's the answer. It's actually very, very difficult to to do accurately beyond very broad assumptions. I think that's one of the issues. So it's a really good question. Kind of highlighting some of the some of the difficulties in in trying to do that, I think reward is a really useful kind of. That local example of how you can reward to your workforce for training. And pursuing that that knowledge, journey and competency and capability journey amongst uh, for, for digital. And we know for example, there are yeah, areas of practise and so protect the example of diagnosis of stroke where. AI technologies for for imaging to to diagnose kind of strokes which are amenable to intervention. I think that's my understanding of the technology that's being. Because you know that's grown from about 10% uptake a couple of years ago and it's about 70% of units and now using it. So there, there, there, there's that rapid growth, it would be quite hard to predict where it's incredibly welcome and and some of the other technological learning advancements. Which require greater interplay with. If you like skill, individual skill might take a bit longer and of course need guarantees and regulation because you know you don't want to be doing robotic surgery on people if you're not properly qualified to to to undertake that procedure. For example, very simplistic view. So umm, I think, uh Alan, you have your hands up. So please do come. 

Alan Davies: So I think hatting was first. 

Hatim Abdulhussein: No, that's fine. And I took it off. I took it off. Go. Go for it. 

Alan Davies: I was just gonna. Yeah, I was just gonna say another another thing that I think is quite important with this as well is we talk a lot about the the digital. Literacy. But as the technologies get more advanced, they're often closely associated with data. So there's this concept of data literacy as well, where you know if, if you're if you're not putting the right data into it or or or doing that in the right way, obviously what you get out of it can be affected. So I think that's another key thing is also having access to this. Data for people to learn from as well, and to learn how to use data and therefore you know. So it's not just the tools that we need to sort of teach people, it's the data that goes into the tools and how that's collected and and maintained as well as it were. And also you know we often have trouble with that in academia getting access to real data sets and things like that to train people on. So we're looking at things like synthetic data and. You know, using things like electronic health record systems and using sort of fake data and things like that. But again, the sooner we can get people using some of these tools and the data that's associated with it as well and getting them comfortable with using data that's going to help as well in this in this. There I think. 

Adrian Brooke: Right, so there's. A really good. Question from Catherine uh Worley at 12:34 for the time stamp aware amongst the panel which says do we need to up skill? The trainers first can't teach effectively something you don't understand yourself which is fantastic question. Catherine and incredibly true. So who would like to have a go at answering that? Hatting I saw the ghost to the nod there, so that that means that means it's you. 

Hatim Abdulhussein: No, I'd love to hear Sonia's opinion on this as as a a senior educator and what your thoughts are in terms of one, I think we might all I'm hoping we're all going to say yes. And two, how do we then do it? 

Sonia Kumar: Well, I suppose just turning this on its head so. This is pre COVID I think 20/17/2018 I or maybe no. It was around 20/19. It was around the time of the total review. I set up a module for medical students called digital health futures and looking at it it wasn't particularly forward thinking but you know it was. It was on the basis of the total review which was where we really started to embed some of this. Learning for medical students. And what became apparent exactly as you say, Catherine, is that none of us really knew as much as the students. And so that really is where the light bulb hit that actually, I do wonder whether it is the new generation. It is our students that will be upskilling us. Obviously, we don't want to do complete reverse teaching, but I do think there is something about Co creating. Any curricular changes with our students, they are so completely savvy not only with just digital tech on their on their smartphones. But also around that there are a lot of students that are really, really excited about digital health and know a lot about it. And so when we ran this module, the students were absolutely teaching us. And so when we developed the module and and we presented some of our our work at conferences, we were very much working alongside. Students. So I think the how has to be with the new generation who have been brought up with digital education and digital health. 

Adrian Brooke: Great. And of course, there's nothing to stop our educators from using the same capability and competency framework themselves, plot their own journey, and make sure they're teaching to the right level. That, as, as you say, you've got to understand a subject properly to be able to teach it. Well, I think that's one that. Really observed. So we're we're just coming to the end, we've got the last couple of minutes and there's one very quick question. Which I'm hoping. There will be a really quick answer to that. I think talks about the cheap digital literacy literacy assessment from Carrie O'Reilly digital literary assessment. Is this available for wider use? 

Hatim Abdulhussein: So yeah, to my understanding, the digital self-assessment tool is is currently being piloted and it's not open for for wider use as of yet. But but then, but hopefully will be soon and I'll I'll share a a link in the chat to the website so that people can stay updated in, in terms of its progress. 

Adrian Brooke: That that. That's brilliant. Fantastic. There are lots of really interesting and insightful comments on the chat, and I can reassure you as we approach the last minute of the webinar because I think we log off at 12. 45. UM that, UM, uh. Recording of the webinar will be will be made available and it will be on the darted web pages. Uh, so, uh, and we'll add a link in the chat which I hope will come soon and and there's a Twitter channel at NHS Digital Academy. So I think this conversation and the developments can be followed on on that, on Twitter. On. And I think I I hope, I hope the link can get posted into that as well. So I I would really, really like to thank our panel today. I'd like to thank Sonia for for our input and development of this. I'd like to thank Alan similarly. Thank you so much. And I'd like to thank I'm Hasim for really kind of, uh, helping coordinate and drive a lot of this in HE. So thank you so. Much. I'd also like to thank. Beth and Emily, who you won't see on this on webinar, but basically without their abilities to organise and corral us four of us into a room or be it virtually at this time, none of this would happen. Thank you so much for listening and tuning in. And I hope we'll have further conversations and look forward to you all all joining us in the future. Thank you. Good afternoon.