Paul Curley is Consultant Vascular/Trauma Surgeon, Deputy Medical Director for Quality and Safety & Chief Clinical Information Officer at Mid Yorkshire Hospitals NHS Trust. He is also an alumni of the NHS Digital Academy, Cohort 2.
As an NHS Consultant Surgeon for 23 years you could say I’ve been around. For almost half of that I have been involved in a large Acute Trust in Yorkshire as the Clinical IT Lead in various guises – initially as willing amateur, then as Clinical Director of IM&T and more recently as Chief Clinical Information Officer.
In that time, I have – like many others – seen NPfIT, Connecting for Health, NHS Digital and now NHSX. I’m even old enough to remember the Resource Management Initiative in the 1990s. Clinicians have become involved in these to a greater or lesser extent and quite honestly nursing colleagues have probably embraced the need to lead this change more completely than many doctors. Medics have maintained an air of scepticism and had the “escape plan” of reverting to clinical practice if management, education or involvement in IT doesn’t work out.
Doctors and nurses have the ongoing requirement to revalidate regularly. This effectively allows continued clinical practice. In medicine the cornerstone of revalidation is annual appraisal and this requires review of the entirety of practice. Educationalists can apply/reapply for Honorary Clinical Lecturer status from their local University Medical/Nursing School, can do CPD courses and undertake peer review of teaching. Those pursuing a medical/clinical management career can attend business schools, do an MBA, complete programmes in the NHS Leadership Academy and be mentored within or without their organisation.
But structure to wrap around a career in Medical/clinical informatics is largely absent. The recent creation of the Digital Academy is timely and very welcome – but it is unlikely that there will be enough capacity to accommodate all interested clinicians. Also, for those alumni of the NHS Digital Academy – how do they keep up their competencies throughout an appraisal/revalidation cycle?
The professionalisation of medical/clinical education and medical/clinical management have been widely welcomed. It has to be right to professionalise the medical/clinical informatics workforce. Professions require standards of behaviour and need to engage in self-regulation. If those of us doing clinical informatics are to ensure we behave and perfom as clinical informatics professionals, we need to ensure that there are standards and a mechanism to self-regulate. What should the standards for knowledge, behaviour and development be? Who should recognise training opportunities for CPD? What should be on a curriculum? How could we address failure to uphold professional competence and behaviour in this specialist field?
In medicine, nursing, pharmacy, physiotherapy, occupational therapy and other disciplines, there are bodies to set these standards of education and behaviour. For engineers the same applies. In IT, the British Computer Society (BCS) and CHiME (College of Healthcare Information Management Executives) are aiming to have a UK Chapter. Previously the not for profit UK Faculty of Health Informatics (of which I was a Board member) tried to raise the profile around health IT in the UK with a number of position statements and regular educational events. However, it could not be sustained financially without commitment and financial support.
What the clinical informatics community in the NHS needs is a strong voice, development of a career path, approved standards of education to support membership, a mechanism to recognise high quality training opportunities, and to develop methods of self-regulation. All of these are enshrined in the Faculty of Clinical Informatics for all qualified health and social care professionals. A membership model will help with sustainability, different levels of membership will allow progression, an inclusive approach will embrace existing organisations such as BCS, CHiME and FedIP, but will concentrate on the specific requirement of clinicians to fulfil their requirements to remain registered/validated to practice.
We must recognise the myriad of organisations trying to fill the gaps in the current system and understand that ultimately it makes sense to work towards the position that engineers, IT professionals, doctors, nurses and other clinicians can develop alongside each other in healthcare informatics.
The current position, however, requires a vibrant, articulate, respected, knowledgeable and ambitious organisation to represent clinicians at the start of this journey. I hope you will consider joining the Faculty of Clinical Informatics and drive forward the development of an organisation focussed on supporting the best clinical informatics professionals in the NHS and wider.