Digital

As one of the great disruptors of health care, recognising it will take time for our clinicians to build confidence. There is a growing need to find solutions to workforce shortages exacerbated by an ageing population with complex health and care needs.

To improve our confidence in AI, we will need to develop awareness and recognition of ethical considerations like fairness, transparency, and accountability supported by internal and external validation, and a robust evidence base with ongoing monitoring whilst complying with regulatory frameworks. This will also ensure operating environments are reliable, modern, secure, sustainable and resilient. We understand that compliance with UK law is not the same as a moral acceptance. Just because we can do something with data or technology does not always mean we should or that it is the right thing to do.

Such digital and data transformation requires consideration of implementation to the workforce in how developments such as artificial intelligence (AI), digital medicine and robotics are likely to change the roles of clinical and professional roles (Topol, 2019). Skills are needed in organisational development and project or programme management, digital clinical safety, and data literacy. Learning new technological skills is essential for digital transformation. But it is not enough we must be motivated to use these skills to create new opportunities. We need digital mindsets, and we recognise the need to address the support to the workforce at all levels as critical to design and implement change.

NHS Dorset recognise the need for support to our public and workforce in the evolving use of digital tools in changing the way we work and access services. To achieve the empowerment of our citizens (success measure 5 of NHS England ICS What Good Looks Like) and help improve access and life expectancy (outcome 3 from the NHS Dorset Joint Forward Plan: 2023-2028 to reduce the gap in healthy life expectancy from 19 years to 15 years by 2043) we need to address two critical issues: digital skills gaps for both residents and ICS staff and health inequalities in particular geographical areas in Dorset.

The Lloyds Bank Consumer Digital Index Report highlighted that 27% of the population have very low digital skills capability and, for those who struggle, health services are the most difficult to access³. There will also be a percentage who do have the digital skills but require some level of signposting and help so that they can confidently access digital health technologies and services. This requires ICS staff to have the knowledge and digital skills to provide the necessary support, particularly for those in frontline roles. If no further action is taken to improve their skills, 5.8 million people will still be digitally excluded in 2032.

Research led by Dorset Chamber as part of the Local Skills Improvement Plan identified the ‘need to upskill current and future staff with basic digital skills (word, Excel, email) to support record management and use of medical technology’. It also raised the issues of cost and accessibility of courses with a desire for more online learning. Locally we have our Embedded Digital Champion programme, supporting learners to access free, online learning for all digital skill levels.

The work aligns with the local authority transformation programme, to improve care services, ensuring people and communities get the support and care they need. It clearly contributes to two priorities: driving economic prosperity and creating stronger healthier communities.

Specifically, it supports the Digital infrastructure and Inclusion Strategy where ‘the vision for Dorset is that in this increasingly digital modern world no place, no community, no individual will be left behind.’

Five strategy aims by 2025

Our digital teams recognise the NHS Dorset commitment to equality, diversity and inclusion. As such we systematically equality impact assess our work and will be undertaking a system quality, equality equity impact assessment (SQEEIA) to as part of finalising our system Digital, Technology and Intelligence (DTI) approach and plans as a means of considering our responsibilities and bringing our system together.

We have the Dorset intelligence and insight Service (DiiS) powering the population health insights for Dorset in combined health and social care datasets in real time. The service has more than one thousand users spanning the ICS with clinicians, operational leads, and commissioning leads leveraging insights to understand the demand and impact on services to improve planning. Here is a case study by the health finance managers association. The data from DiiS informs our insights to health inequalities alongside qualitative feedback from our people and communities.

Each partner organisation has independent engagement arrangements. Representatives from each sit on the Dorset ICS Engagement Leads network. This group facilitates system-wide networking, collaborative working and sharing of good practice with the opportunity to minimise duplication.

The network reports on its activity and feeds into the ICS Engagement and Communications Steering Group and from there to the People and Culture Committee of NHS Dorset.

Our public representatives, the Public Engagement Group and Digital Public Engagement Group – Our Dorset  Chairs, sit on the Integrated Care Partnership, ICS Engagement Leads Network and the ICS Communications and Engagement Steering Group.

Through this work it is recognised that there is a need:

• to inform our public on how we are developing and assuring ourselves on the impact of digital. We will be updating our public sites with such information to improve that understanding and awareness.
• to develop and complete a Digital Technology and Intelligence strategy for the system quality, equality equity impact assessment (SQEEIA).