By Euan McComiskie (@EMAHPInfo)
AHP Advisor, NHS National Services Scotland
AHP Informatics Lead, NHS Lothian
As an AHP (Physiotherapist) who has worked in a range of settings; wards, teams, hospitals, and boards, I know that AHPs provide excellent care and services in many areas. We diagnose, rehabilitate, educate, enable, support, manage and lead to expert levels. But there is one thing we’re not so very good at: understanding the power of and using information to inform our practice or more simply, data!
In my experience, a fear of the unknown and a lack of skills, knowledge and confidence in the AHP workforce are the main barriers to using powerful data to define and improve AHP services. However, that need not be the case.
There are a small but growing band of AHPs around Scotland who are trying to improve AHP data locally, regionally and nationally to make sure that we can evidence the impact we have on the users of our services and how they are delivered. We are seeing AHPs throughout Scotland improving their understanding and skills in this area through for example, participating in the NES NMAHP eHealth Leadership program, and the NMAHP eHealth Network. The last year has seen an increasing number of AHP eHealth Leads employed in NHS boards and the Scottish Government sponsoring an AHP to provide national leadership within the eHealth policy team. This is all very important in terms of growing the AHP eHealth workforce and the positive start of AHPs as leaders and experts in data-land!
A working group led by Lesley Holdsworth (SG Clinical eHealth Lead for AHPs) is working to try to embed some nationally agreed standardised eHealth skills and knowledge as part of the curriculum for all AHP courses in Scotland. A part of this work will also involve setting up a “digital playground” where AHP students can get training access to electronic systems so they can learn about digital healthcare alongside their theoretical and practical learning. The group are also using the experiences of others in the UK in developing this approach but Scotland would be the first country in the UK to have a national approach in place. Scotland leading the UK is a good thought!
Once the changes are made to the curriculum we will start to see newly-qualified AHPs coming into the workforce not only as digital natives outside of work but they will be expecting to use their eHealth skills and knowledge in their day to day practice. We need to embrace their ideas, give them time and space to develop, and the support needed to transform their ideas in to service improvements. Growing an eHealth-enabled AHP workforce in this fashion may go some way to changing how AHPs have traditionally thought about data. A recent study by QMU Physiotherapy students gave more support for this work when they looked at the readiness to accept technology in the workplace. They surveyed 487 NHS Lothian AHPS and QMU AHP students and were able to group them all into categories as well as some cross-group comparisons. A brief summary of their results is included below with the high number of sceptics and low number of explorers and pioneers a clear suggestion that more work is needed to get the AHP workforce ready to embrace data and Informatics with open arms.
We have put our toe in the water on two occasions previously with regard to national AHP data. A national census day was held in 2006 to explore a snapshot of one day’s national AHP data. This suggested that more work was needed to provide further definitions on some data items which triggered the National Clinical Datasets Development Programme (NCDDP) in 2009. However, neither of these projects was able to produce regularly reported and nationally completed data for AHP services. . More recently, efforts have been made to develop the AHP Operational Measures project which hopes to do just this.
Phase 1 of this work aimed to explore the feasibility of being able to extract useful information about AHP services. Two territorial boards working with ISD colleagues helped with this and provided their own data in line with a proposed national dataset which were then tested to determine their value to a range of users from clinicians to service managers, AHP Directors and policy makers. The results so far have been well received widely throughout Scotland and viewed as valuable by the AHP and eHealth teams in the pilot boards. This is a promising strat however it was agreed that further work was needed including a wider consultation of the dataset to ensure that its relevant to all AHPs including those working in social care.
Phase 2 of the Operational Measures project hopes to address these issues and support a wider roll out and is planned to start in late summer with funding decisions imminent. During phase 1 it became evident that there was some work needed within the boards to allow AHP Operational measures data to be submitted. Therefore, to support phase 2, Margaret Hastings is working with NHS boards on an improvement program which will help boards prepare for national data collection, It is also envisaged that this work will be one of the key data sources as AHP services in Scotland measure their performance as part of the Active and Independent Living Improvement Programme (AILIP) which has replaced the National Delivery Plan (NDP).
In the coming few years there will be an increasing need for data from AHPs to support improved effectiveness and efficiency and also to support different ways of working as we accelerate the integration agenda. Without the knowledge and skills to understand, collect and use this data we run the risk of not being able to steer our own future. We know there’s still a long way to go but for the first time, we can see the future and a way to take Scottish AHPs to the next level of data richness, evidencing impact and public health intelligence. Remember, if you don’t count, you don’t count!
Onwards and upwards!