As healthcare organisations continue to combat the latest COVID-19 surge, nurses have reportedly felt chronically exhausted, unappreciated and even ready to leave the profession. Despite the pandemic continuing to accelerate the evolution of the healthcare environment, nursing and midwifery are key areas that will continue to face barriers that challenge their ability to deliver patient-centric care. During the HETT session, 'Reset and Revitalise! The Digital Nursing and Midwifery Agenda 2021 and Beyond', nursing leaders discussed how to encapsulate the advances made during the pandemic and ways to improve collaboration and efficiency in the future. 

The speakers were: Dr Natasha Phillips, CNIO at NHSX, England; Fran Beadle, national clinical informatics lead (nursing) & assistant head clinical informatics at NHS Wales Informatics Service, Wales; Angela Reed, senior professional officer at NIPEC, Northern Ireland; Mark Fleming, nurse consultant mental health, Scottish Government Digital Health and Care NMAHP clinical lead, Scotland; Anne Watkins, senior lead midwife informatics specialist, Aneurin Bevan University Hospital Board, Wales; and Claire Sutton, RN, digital transformation lead, National Care Forum, England.

The discussion was moderated by Caron Swinscoe, senior clinical lead, strategy policy and governance for NHS Digital, England.

Northern Ireland's digital plans

Starting the panel discussion with Northern Ireland's approach to leveraging technology, Reed highlighted the report published last year by Charlotte McArdle, the country's chief nursing officer. Published with the Department of Health, the report looked at the future of nursing and midwifery in Northern Ireland and included a component on how to maximise technology for digital practice in the future.

"We are a small country, but we have big digital plans for the future," Reed stated. "In terms of leadership, we are very fortunate to have a very forward-thinking chief nursing officer currently.

"We also recognise that our executive directors of nursing in the region play a significant role in sitting at tables, where often there are no digital leads. We need to have them up to speed to enable digital practice into the future."

Reed also emphasised the importance of having nurses and midwives present at decision-making levels: "We've also looked at how we plan nursing care and have tried to position ourselves in such a way that that will afford us the opportunities that we need in the future.

The Five Country Digital Leadership Group (DLG) for nursing and midwifery in the UK and Ireland is made up of a collection of expert nurses and midwives who have been involved in digital practice and informatics. The range of expertise spans education, research and practice with stakes in each area.

Reed explained: "We are an advisory council to the government Chief Nursing officers in England, Scotland, Wales, Northern Ireland, and the Republic of Ireland. We worked very closely together with them in 2019, in order to provide an overview of what we wanted to do and to guide the strategy."

Nursing records go digital

Over the last year, Wales has continued to make significant strides in integrating digital technology in its healthcare system. In February 2020, the NHS Wales Informatics Service launched the Welsh Nursing Care Record (WNCR) in several health boards across Wales, enabling nursing documentation to go digital and for nurses to complete assessments at the patient bedside on a handheld device.

Beadle explained: "Our aim is to create greater social and economic value by delivering digital health and care services that have been enabled by technology. As part of that, it's the inclusion of processes, and delivery of fit for purpose solutions that have been developed with clinicians with patient focus groups to ensure that what we make is available to everybody and user-friendly."

Beadle also stated that a primary focus has been placed on standardising the nursing language across Wales: "Even if not everybody is transformed to a digital way of working, we're still using the same data standards to enable that big data analytics. What that also means is that we can train our nurses in Wales, alongside our NHS colleagues to use the same language. So we're all talking exactly the same." 

Amplifying the voice of nurses

In May 2020, NHS England developed the Shared Professional Decision-Making Council, a grassroots council that informs senior leadership teams of the key areas of improvement and strategy implementation. 

Dr Philips explains: "It's clear that we have lots of networks and lots of interested nurses and midwives across England, but sometimes the voices dissipated because it's quite diffused.

"What we're trying to do is amplify that voice, and bring those experts together, almost as a strategic advisory group, to support me in my national role."

Dr Phillips also acknowledged the changing attitudes to nurses brought on by the pandemic: "I think it's fair to say, there has been increasing recognition of the value of nurses in digital health. That's one of the key things that me and my team work at tirelessly. It's starting to pay off in things like increasing our investment in Florence Nightingale Scholars and increasing Topol Digital Fellowships."

"We've seen in some of the deployments during COVID that the importance of the role of the nurse and midwife in joining up care and how digital tech can enable us to do that better. So that's clearly got to be one of the priorities," added Dr Philips. 

Learnings from COVID-19

The panel concluded the session by sharing the different key achievements to come from the pandemic. Speaking of Wales' digital approach, Beadle said: "Although we weren't completely digital across Wales (...) the standardisation work allowed us to develop a rapid escalation document that actually reduced the amount of documentation that nurses were having to do out there on the floor."

Adding his reflections on Scotland's learnings and emerging initiatives, Fleming said: "One of the early things that we did was identify a lead nurse in each of our NHS board areas, and to support the care homes and home care in relation to this. Digitally, we now have the development of a digital strategy for care homes. That will link into our new care home strategy and the evolution of care service for Scotland."

"That link into that senior nurse in that board area allowed us to have that coordinated response. We were able to do that across the whole of Scotland at the touch of a button. That centralised support allowed us to do that, which was just fabulous."

In recognition of the nursing profession, HIMSS has launched the Nursing Informatics Community to establish a voice for the nursing community and to provide expertise, leadership and guidance to global nursing informatics professionals. This week, the HIMSS Women in Health IT annual survey will be launching to place a spotlight on the achievements and commitments made by women leaders in digital health professions in Europe, as well as providing awareness of gender-related challenges. 

Building on this recognition of notable digital health leaders across the globe, this year the HIMSS Future50 Community aims to identify top healthcare IT leaders who have made significant contributions to the sector. The nomination call for the HIMSS Future50 class of 2021 is now open.