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Exclusive: The nurse helping to find digital solutions to frontline NHS challenges

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Making the most of digital technology can help tackle staffing shortages and ensure nurses spend more time on direct patient care, according to a nurse who hopes to convince others of the benefits.

Well-known nursing activist Joan Pons Laplana is one of the first nurses to embark on a new clinical informatics fellowship with NHS Digital and told Nursing Times that he hoped to be a “bridge” between the body and the frontline.

“My role is to ensure all the projects and products they come up with make sense from the point of view of a clinician”

Joan Pons Laplana

However, he admitted that until recently he did not have much of idea of what NHS Digital actually did himself and maintained that the same was true of most nurses.

“Six months ago I did not have a clue about the role of NHS Digital and I think that is a common theme on the frontline – what exactly do NHS Digital do?” he told Nursing Times.

“It is not very clear to a lot of people, so my role is to be the voice of the frontline and to be the bridge between the frontline and NHS Digital and open doors,” he said.

Mr Pons Laplana, who is normally a transformation nurse at James Paget University Hospital NHS Foundation Trust, is one of four health and care professionals to embark on the year-long placement with NHS Digital.

The quartet also includes a social worker, an operating department practitioner and Anthony Kenny, a specialist sexual health nurse from Kings College Hospital in London.

Their appointment comes amid concern that nurses and other key staff are not being involved in the design of new IT systems that they are then expected to use in practice.

A recent survey by the Royal College of Nursing found many nurses were being hindered in using digital technology by a catalogue of “depressingly mundane barriers”, such as out-of-date systems and poor Wi-Fi.

But most worryingly of all, the survey of more than 900 nurses found managers were not allowing nurses enough input into the design of the programmes and IT systems that they relied on day to day to do their job.

NHS Digital has said the launch of the fellowships, which will be evaluated in the autumn, is an attempt to encourage the “two-way” sharing of insight and knowledge between the body and the frontline, as well as to raise awareness of careers in the field of clinical informatics.

“I have got frustrated on the frontline that systems don’t talk to each other”

Joan Pons Laplana

Mr Pons Laplana, who embarked on the fellowship in May this year, said he was very excited about the opportunity and hoped to be able to convey the practical challenges and frustrations experienced by nurses. He also wanted to influence some of the wide range of programmes, products and systems that come under the NHS Digital umbrella.

He said: “My role is to ensure all the projects and products they come up with make sense from the point of view of a clinician – that they are suitable and something that me, as a nurse, would like to use, and that they solve real problems we have at the moment on the frontline.”

While he is only a short way into the NHS Digital placement, Mr Pons Laplana said he had had a chance to explore the body’s remit and meet different teams and was impressed with the scope of the work under way.

“I am very active and like to challenge and to innovate,” he said. “I was quite surprised to find that a lot of the problems that we have at the frontline, which I have been complaining about as an activist, NHS Digital is already working on a solution.”

The fellowship will see Mr Pons Laplana, who is blogging about his experiences and tweeting with the hashtag #MyDigital Journey, join three specific projects including one on the innovative use of data.

“The only way we can do more for less is with more technology”

Joan Pons Laplana

This includes the use of advanced data analytics and modelling to help minimise the impact of winter pressures, which placed unprecedented strain on the health service last winter.

“I was not aware this kind of thing was possible, but it makes sense because if we can predict patterns we can maximise the use of the resources we have,” he said. “At the moment we don’t have enough nurses and enough doctors but in this way we can combine digital technology with our workforce in order to work a lot smarter.”

While some nurses are nervous about technology potentially getting in the way of caring, Mr Pons Laplana said he believed better, more integrated IT systems would actually increase the time nurses were able to spend at the bedside.

This view echoes the interim findings of a major review on health and social care by Lord Ara Darzi, who said maximising the use of technology and artificial intelligence could help with staffing shortages and free up time for direct care.

“I have got frustrated on the frontline that systems don’t talk to each other,” said Mr Pons Laplana. “For example, in my hospital I have seven IT systems so if I want to see the blood test results for a patient I have to go into one system and if I want to see an X-ray I have to go into another system.

“Sometimes you waste 10 minutes for each patient trying to go in and out of systems to check everything is up to date – if I have eight patients then that is 80 minutes of my time that instead of spending time remembering passwords I could have spent on patient care,” he said.

“To come from moaning about the system to realising that NHS Digital is doing something about it – even if we’re not there yet – is reassuring,” he said.

“I can’t remember the last time I wrote a letter or wrote anything down on paper”

Joan Pons Laplana

Mr Pons Laplana is also set to get involved in the next phase of a project designed to help health and social care staff share information about some of the most vulnerable children they encounter.

He said the Child Protection – Information Sharing (CP-IS) project was a vital step forward when it came to ensuring children at risk of abuse or neglect did not slip through the net by alerting nurses and others to potential concerns.

“This will help nurses like me a lot,” he told Nursing Times. “Sometime children come to accident and emergency and time is precious when it comes to doing a lot of assessments.

“But with this, as soon as the child comes in, there will be a flag on the notes to say he or she is on a child protection plan and social services are involved,” he noted.

This would help ensure both new and experienced nurses proceeded with extra caution, said Mr Pons Laplana, who has been shortlisted for the 2018 Nursing Times Awards in the Nurse Leader of the Year category.

“For me, having that flag there will make me more cautious than if it wasn’t there,” he said. “If I am a band 5 and I see a flag like that, instead of waiting I will immediately consult my senior sister or senior consultant to make sure this child is safe.”

He said there was also potential to extend the approach to the protection of vulnerable adults.

“When you go to a hospital it is like going back to the 80s, it is like Dr Who”

Joan Pons Laplana

Mr Pons Laplana said he was also enthusiastic about the potential impact of the third project he will join – a programme to roll out an eRedbook, which will allow parents to record and manage information about their children’s health online or on a smartphone.

Designed to replace the paper version of the Redbook familiar to parents of under-fives, the eRedbook, which includes information on immunisations, height, weight, and developmental milestones, has been trialled in parts of London where the scheme is now being extended.

“What is exciting for me about this is ownership – the mum and dad own the data. That, for me, is the future of the NHS,” he said. “Every time the mum and dad come into contact with a health or care worker all that information is there.

“As a father of three myself, that is very helpful because if, say your child falls and you have to go to A&E the last thing you need is to start thinking ‘Where is the Redbook?’. It will also save a lot of time, because every clinician will be able to follow the journey of this patient,” he said.

He said it was vital that clinicians such as nurses – and patients too – were involved in the design of new systems from the outset.

“NHS Digital is recruiting more and more clinicians, because it is so important that whatever projects they do clinicians are involved and patients are represented because we are going to be the ones who use and benefit from them,” he said.

“And it is the only way we are going to achieve what ministers like Jeremy Hunt and Matt Hancock want, which is for the NHS to be more efficient and effective,” he said. “The only way we can do more for less is with more technology – but technology that talks to each other and makes our lives simpler.”

He highlighted that some of the technology in use at the moment did not make life easier for nurses, while many settings had a confusing mix of IT and paper-based systems.

“Sometimes it is bonkers because we are still using paper,” he said. “I don’t use paper any more – I can’t remember the last time I wrote a letter or wrote anything down on paper. But when you go to a hospital it is like going back to the 80s, it is like Dr Who – because they still use pen and paper.”

Key dates: Joan Pons Laplana

1997: graduates as nurse from EU Infermeria del Mar in Spain

Nov 2000: comes to UK and works in intensive care at Sheffield Teaching Hospitals NHS Foundation Trust

Jun 2012: becomes community staff nurse at Derbyshire Community Health Services NHS Trust

Jul 2015: Telehealth Flo clinical project lead at Arden and GEM clinical support unit

Jul 2016: made transformation nurse at James Paget University Hospitals NHS Foundation Trust

Apr 2018: named as one of four clinical informatics fellows at NHS Digital

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