Digital Transformation Diamonds in Community Nursing
29 September 2022 | Ronke Adejolu
Ronke Adejolu shines a light on the vital role, work, and leadership of community nurses in the digital, transformation and innovation space.
Community nurses are a force to be reckoned with across the NHS health and care system. Sometimes referred to as a hidden profession, community nurses are indispensable, highly educated, skilled professionals, kind, knowledgeable, multi-faceted experts, confident, and exceptional people doing extraordinary things across our communities. The Covid-19 pandemic provided much-needed insight into the complex work of community nursing and helped to dispel several misconceptions
In 2021, back in my role as the National Associate Chief Nursing Information Officer, NHS England, a core part of my work was to bring together a unified, strong senior community nursing leadership voice to inform, influence, strengthen networks, increase visibility, join-up collaborative and partnership across the digital landscape, health, care and integrated care systems. Working alongside the incomparable Sam Sherrington (National Deputy Director, Community Nursing, NHS England), I found myself in a much-coveted front-row seat as I immersed myself in the world of community nurses.
Voices rarely heard and faces rarely seen
Community nurses never really stop to acknowledge their own brilliance, and what they bring to the table in clinical practice, education, research, leadership, the digital space or in their collaborative efforts across health, care, and integrated systems. At the height of the pandemic, they navigated through the first wave, with the rapid uptake, adoption and utilisation of digitally assisted remote technologies to support the speedy discharge of patients from acute hospital settings into communities, provide long Covid rehab care and services, making sure people stayed healthy and continued to be supported in their environment, caring for the shielding population, including setting up brand new services to meet the increasing demands.
Out of sight, out of mind
One of the first things I did was to set up a series of new community nursing ‘Show ‘n’ Tell’ sessions in the digital space, with Sam Sherrington leading the first powerful session and sharing insights into the diverse work strands of approximately 86,000 community nurses nationally in, for example neuro, frailty, mental health, sexual health, hospice, prison outreach, ambulance, respiratory, continuing healthcare nurses. Another key session, led by Ann Jacklin, from the National Wound Care Strategy Programme generated immense interest and support from the digital teams. Key speaking slots, courtesy of Dr Crystal Oldman, CEO at the Queen’s Nursing Institute ignited an increased thirst and demand from community nurses to collaborate on more innovative work across national and regional digital programmes of work.
Community Nursing and Digital Misconceptions
It is time to move away from historical misconceptions and false notions that feed the narrative that community nurses are not confident in the use of digital technologies or clinical information systems, need a digital course, find digital or the language too complex, need more digital skills or don’t think digital technology is for them.
The truth is, community nurses know what works, what doesn’t work, and most importantly know what needs to be done to fix it. The questions we should ask ourselves are:
- Do we really understand the needs in community nursing? (workforce, training, infrastructure, patient journeys, pathways, and workflow, etc.)
- Do we value and actively embrace community nursing in the data, digital and innovation space?
- Are we inclusive? Do we collaborate and include the diverse voices of community nursing e.g. (professional and ethnic backgrounds) in data, digital and transformation discussions, strategies, and plans?
- Do community nurses lead, own, and drive digital and transformation requirements including end to end delivery or are only seen as a tick in the box or nice to have towards the end?
- Do we actively seek to engage on digital, innovation and informatics opportunities with all frontline community nurses, across all channels, not just on social media?
- Are community nurses (ALL levels/Grades/Students/Associates) included in digital transformation discussions or are discussions only taking place with people with “digital” in their job titles?
- Have we made “digital” and the language more complex than it should be?
The truth is the landscape of how we deliver care as nurses across systems has changed significantly and will continue to evolve. It is important that community nursing is not left behind. The digital transformation train has bolted out of the station with community nurses already on board; others will join at points through the course of the journey. However, the end goal is to ensure that ALL community nurses are on board, and embedded as active owners with power and influence, not mere participants in digital transformation.
Leadership in Community Nursing
Digital Transformation in community nursing is much bigger than technology, it’s about nurturing an accommodating culture of innovative geniuses, collaboration, creativity, sharing intelligence, building and increasing system-wide knowledge, leading and working across integrated care teams, collaboration, co-designing and working in partnership across health care professions.
We need to focus on our most important resources (digital diamonds in community nursing) by listening to their needs, valuing their insights, intelligence, and most importantly, create a positive, inclusive and sense of belonging that Digital Transformation is done by all of us and not just by a specific group or individual.
As we continue to reset and recover from the pandemic, make digital advancements, reshape, and transform healthcare, safety and services in the interest of our patients and staff, the right leadership to fearlessly articulate and lead community nursing digital and transformation needs remains a key priority.
The future for community nursing in the data, digital, innovation and transformation space is bright, but lessons learned from the pandemic must never be forgotten:
- Value and develop diverse, and multidisciplinary talent and leadership in community nursing and across ICS (Integrated Care Systems) and other regional and national systems
- Put in place talent, professional and skills development and diverse career progression support
- Accelerate and level up digital maturity and infrastructure across community nursing settings
- Strengthen collaborative networks and partnership working across health care professions and settings
- Continue an integrated system-wide approach flexible to adapt to the evolving needs across community nursing
- Actively create more co-design opportunities for community nurses across digital, innovation and data teams
- Embrace a common goal of patient safety, clinical outcomes, and quality care
- Ensure continued and adequate investments for innovation, transformation for community nursing
- Continue to harness and leverage digital health assisted technologies and innovation,
- Support and baseline individualised learning pathways, appropriate transformation and digital education needs for community nurses.
- Continue system-wide conversations to ensure benefits seen during the pandemic response, are maintained.
- Build relationships with health industry partners – community nursing exposure
- Lastly, celebrate our community nurses!
The pandemic has provided invaluable insight into clinical practice across diverse settings including the role of diversity, digital barriers, challenges, constraints, frontline clinical issues. It has also provided a much-needed helicopter view on future possibilities and opportunities to reshape, influence, guide, steer and support the strategic direction of the digital transformation agenda to ensure an aligned, collaborative, diverse, inclusive and joined up approach for nurses.
It’s undeniable that we have exceptional, innovative digital, clinical practice intelligence and talent, in abundance in community nursing. Community nurses are invaluable, irreplaceable, integral, and pivotal to successful digital transformation, improved patient safety, population health and the future of nursing.
The collective voice, power and influence of Chief Nurses in partnership with other executive clinical leaders at Integrated Care System (ICS) board tables is crucial, now, more than ever, to influence, inform decision-making, reshape, provide recommendations on evidenced-based practice, share experiences, challenge practices or patterns that are likely to continue to deliver inefficient or less effective results, that risk the common goal of patient safety or improved clinical outcomes.
We need ICS Chief Nurses to facilitate and nurture a culture change and reorientation around more data-driven care models, an enthusiastic digital ready community nursing workforce to lead, inform, own changes and discussions in the use of digitally enabled health technologies for the delivery of care now and in the future to improve productivity, safety, experience and outcomes for patients and the workforce.
Ronke Adejolu is currently a CNO Senior Clinical Nurse Fellow (Professional and Systems Leadership) at NHS England https://www.fmlm.ac.uk/ronke-adejolu The foundation of her leadership is hardwired in the ethos that embraces an open-door approach, inclusivity, empathy, pragmatism, uniqueness, courage, kindness, integrity, an “achieving together” ethos, inspiring an innovative spark across the nursing and clinical workforce by fostering a culture of innovation and supporting everyone to be their best self and work to high standards to deliver through transformation and digital assisted technologies, safe and best possible care for our patients and the population.