“For tech to succeed, for tech to fulfil its potential and deliver on its promise, then human beings are absolutely critical to making it happen. We need a culture change as much as we need a technological change,” says Matt Hancock, Health and Social Care Secretary, in response to the findings of The Topol Review, ‘Preparing the healthcare workforce to deliver the digital future’.
This review, undertaken by Dr Eric Topol, was commissioned by former Secretary of State for Health and Social Care, Jeremy Hunt, to advise on how technological developments including genomics, AI and digitisation are likely to change the roles and functions of clinical staff, the implications of changes for the skills required by professionals in these roles and the consequences for the selection, education and development of current and future NHS staff.
The review finds that: “Within 20 years, 90% of all jobs in the NHS will require some element of digital skills.” It stresses the importance of educating, training and developing both the existing and future workforce to release the potential benefits that digital technology, genomics, artificial intelligence and robotics have to save lives.
The next 10 years will prepare the ground, address data governance, cyber security, agree ethical frameworks and develop staff and organisations to implement digital technologies. This will require cultural change, investment in people, building digital skills and leadership capabilities.
The review states: “Introducing new technologies to support patient care and the workforce needs to be seen as change management, with the technology itself simply the tool to enable change. Most patient care pathways are multifaceted, involving staff with deeply held personal, social and institutional beliefs and practices. To be successful, technology-based change policies need to acknowledge and seek to understand these beliefs and practices. This requires organisations to focus on the following enabling factors: a culture of innovation; prioritising people; an agile and empowered workforce; leadership; effective governance; and investment.”
The Workforce Implementation Plan that Baroness Dido Harding, Chair of NHS Improvement, is leading, has been asked to build on the recommendations of the Topol Review. Specifically, it has been tasked with ensuring that all healthcare professionals should receive core training in genomic literacy to help them understand the basis, benefits and ethical considerations involved; the need to create a career pathway - from undergraduate to specialist - a digitally enabled health system with a culture of continuous learning; and the need to support the educators in the development of the whole workforce.
The ‘tech and enablement’ workstream, led by Sir David Behan, will take this forward as part of its brief.
“If we want to see transformative change in the NHS, then we need to embed digital skills into every level, and every part of it. We must invest in training up the existing workforce. Staff must have the opportunity to learn about digital technologies and develop the necessary skills. They must have ongoing training,” says Matt Hancock.
It will also be important to lead from the top developing senior roles with responsibility and given time to advise on opportunities of digital healthcare techs. Boards need the expertise to make informed decisions.
“We’re going to have a Chief Information Officer or a Chief Clinical Information Officer on the board of every local NHS organisation within the next three years,” Matt Hancock promises.
He also announced the launch of the Topol programme for digital healthcare fellowships – a programme to give clinicians the skills to make a practical difference to their local NHS organisations.
Perhaps one of the reasons why the review stresses the importance of educating, training and investing in the existing workforce is that the NHS is going to be competing for staff with AI expertise against other sectors and, as it acknowledges, there is already a national shortage of AI specialists. The review recommends that to recruit and retain these specialists the NHS needs to make itself an employer of choice, offering flexible jobs and clear career pathways.
However, the reality is that with the NHS facing an existing workforce crisis, with shortages of staff across all disciplines and a growing skills gap, a quantum leap is required to meet the needs of today and tomorrow, where the scale of the challenge to develop a new skill set at pace is daunting.
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