Future healthcare staff still ‘largely being trained to work in the non-digital world’, review finds
Scotland is aspiring to become a global leader in the digital technology sector. Key to realising this ambition is to foster digital and data talent across all sectors. This includes healthcare, where the arrival of digital is introducing the most transformative opportunity for renewal the services have experienced since the NHS was established in 1948.
The same applies to social care: Scotland is in the process of setting up a National Care Service (NCS), which in combination with digital offers the potential to completely reimagine ways in which care is delivered at a national level.
Carefully co-designed and co-constructed digitally enabled health and care services, with the right data legislation, information governance and digital infrastructure considerations in place, could produce a seismic shift in integrating health and social care service delivery in practice, making care provision genuinely person-centred and joined up.
While a lot of this is still on an aspirational level in Scotland, digital transformation of health and care is already well under way, and we are beginning to fully understand current and future workforce development needs to ensure Scotland can reap the full potential of this innovation opportunity.
There are three broad categories of staff to consider around this opportunity; these job roles are different but interdependent on each other’s efforts in digitally-enabled service delivery. The first category encompasses frontline health and care staff; the other two categories are focussed on the workforce who will develop, organise and run the new systems, or manage the data these generate.
The nature of work is changing most radically for frontline staff, who need to adopt new ways of working, and to learn entire new skill sets previously not required of them in care delivery.
The second category consisting of the more technical professionals design, develop, deliver, implement digital solutions for use by health and social care. These professionals also ensure the security of these systems from designing to running them.
The third category of staff is fast expanding and growing in importance as a direct result of the digital transformation of health and care. The specialist digital, knowledge, information and data professionals are needed to capture, organise, analyse, and process information and data generated by the digital solutions to support and improve service delivery. Indeed, Health Education England (2020) projects a 69% overall increase in demand for digital and data specialists at NHS England by 2030; the demand for clinical informaticians is predicted to increase by 672%, specialists in IT strategy and development by 325%; and the need for knowledge management specialists by 179% in the same category. Similar trends are anticipated to apply in Scotland.
Leadership at all levels is crucial in enabling and accelerating the digital transformation and in supporting the workforce to acquire the right attitude, culture and skills on how best to utilise digital to support service delivery. Generally, there is a fierce competition for digital and data talent across the economy, which requires 13,000 new digital tech entrants to the job market annually, while fishing in a pool of just 5,000 computing graduates per year.
What does the current talent pipeline look like?
Evidence suggests there is a significant gap between current educational provision and the needs of the health and care sector. In autumn 2021, the DHI carried out a comprehensive landscape review of the Scottish education provision that has the potential to support the digital transformation of health and care, albeit an illustrative one as provision is constantly changing. This study reviewed the online prospectuses of 16 universities and 27 colleges, and included topic-relevant degrees and short-courses in the following subjects, again with a number of exclusions or qualifying points:
- ICT, computing and relevant STEM;
- health and medicine; courses in digital health;
- social care;
- relevant design courses;
- relevant business, management and leadership courses; courses in innovation and entrepreneurship.
Being able to deliver care in a digitally enabled environment requires digital skills and data literacies from all staff. Among the 495 health and medicine courses and 173 social care courses, there were just five dedicated digital health and care courses listed in HE, and two across FE.
That represents 1% of the total course provision. Spot checks into the course content, where this was available online, showed a very patchy engagement with digital as part of professional practice in all subjects.
The role of design is crucial for successfully transforming health and care services. Design approaches can be applied to all aspects of digital transformation journey, including bringing in patients and other stakeholders to envision improved or future services, environments, health and social care solutions and devices, etc. Among the 143 relevant design courses, just one course was dedicated for design in health and care across FE and HE.
ICT, computing and relevant STEM subjects are crucial to digitalisation of health and care services, as these subjects supply a vital pipeline of talent for the development and running of the digital infrastructure and devices supporting the delivery of health and care, as well as in developing future innovations. With 566 courses, the provision available across Scottish HE and FE in these subjects is rich. However, the exposure of students in these subjects to health or care is vanishingly low, except for informatics, where three out of the seven available courses relate to health or medicine, and in data analytics/science, where four options are health specific.
The role of leadership is recognised as vital for the successful transformation of services. Education in entrepreneurship and innovation are also important for creating a pipeline of businesses that will further expand the Scottish digital health and care tech industry.
There appears to be a good provision of business, leadership and management courses in Scotland both at HE and FE (263), with a decent number of these dedicated to health, care or join health and care. However, by looking at the course content, it remains unclear as to what extent these courses prepare the future leaders to work in a digitally transforming environment.
Untapped potential to develop future talent
This landscape review looked at the types of courses available in Scotland; whether this provision is sufficient to meet the future demand is a different question.
As a starting point, the positive news is that the Scottish education landscape has all the right ingredients in place to support a thriving, digitally-enabled health and care sector in Scotland, as well as to respond to the growth-potential presented by the digital health and care industry.
However, this potential currently sits untapped across the education sector. By strategically linking up the existing course content, and creating missing modules where required, it would be possible to create and signpost new educational pathways to lead into roles in digital health and care both for the needs of the public and private sectors. The course provision should be reviewed with a view of looking at interdisciplinary subject combinations, such as how cyber security, AI or machine learning need to be applied within the health and care context, how business management skills are required for digital services, or how clinical knowledge can be applied to produce relevant insights from data.
The other major finding from this review is that the future staff in medicine, health and social care are still largely being trained to work in the non-digital world. Understanding how digital solutions can support and enhance care delivery should be an essential part of the training of these professionals.
This is a serious call for digitally future-proofing curricula across these subjects, including leadership and management courses. In addition, the sector needs to freshen its image to better compete in attracting and retaining skilled staff in these and really become the global leader in digital tech and in health and care innovation.
Time to act is now
The time to address these issues – or opportunities – in the Scottish education sector is now. Digital transformation of health and care is a complex, cross-sectoral concern, which calls for leadership to approach these issues at a systems level. A lot of attention is being paid to the infrastructure and funding needs around digital solutions. Without bringing the current workforce along, and without ensuring that we are also creating the right conditions for an inspired, diverse, and skilled pipeline of talent to emerge and enter these sectors in the future, this growth opportunity will be lost.
The Digital Health & Care Innovation Centre, with a large network of collaborative partners, has co-developed a proposal for a programme work on how to address these issues on a national level. We welcome interested parties to get in touch to help us realise this ambition.