Grafton: ‘The 10 year plan needs to be ambitious – I don’t know if it will be’

Hayley Grafton, chief nursing information officer (CNIO) at University Hospitals Leicester NHS Trust, has high hopes for the NHS 10 year health plan.

But when the chair of Digital Health Networks CNIO Advisory Panel spoke to Digital Health News, she was candid about her concern that the plan won’t be as “brave” as she would like.

Grafton is a member of the plan’s ‘People’ working group, which has provided input on how best to develop a digitally enabled NHS workforce and will give the inside track on the plan at Digital Health Summer Schools 2025.

To unlock digital’s potential it is essential to aim high, she insists, but ambition has to be underpinned by ongoing support for NHS staff.

You called on leaders and policymakers to “position ourselves as enablers, not barriers, to progress”.  What is the most important step that digital leaders can take to enable progress?

AI is so new – people are a bit nervous about it. When it is something you don’t truly understand, you can shy away from it.

I’ve heard many times “Oh you can’t use large language models that are not safety assessed”, but staff are doing it anyway. It is not something we can tightly control.

My point was, let’s embrace it and do the policies that enable this and the background learning so we can support staff to do the right thing.

That’s what we’re trying to do [at UHL]. We have an AI governance body that has different stakeholders that are upskilling themselves and understanding what this technology is and what it does.

AI is being embedded in technologies without us even knowing about it. There’s a responsibility to [say to] suppliers, “what are you doing to assure yourselves that this is fit for medical practice?”

[Digital leaders] need to reassure themselves – and you only get that with understanding and knowledge and sharing lessons.

As healthcare becomes increasingly enhanced by technology, how can we ensure no one is left behind?

It’s important we ask ourselves this. I’ve had nurses wanting to leave nursing because they don’t feel it’s their job anymore; they have to engage with these tools and they don’t feel equipped.

We’re doing our patient administration system implementation this year, and part of the training offering is three different levels [self-directed, facilitated on Teams, face-to-face]. If you need one-to-one support, it’s there for you.

Part of the problem sometimes is we just throw out this technology and don’t truly understand the workflows and how they change. You can only do that by watching people and being next to them. It’s about putting eyes and ears everywhere.

We’ve built a massive [digital] champions network, with about 500 people signed up. I see that as being a real tool in our box for not leaving anyone behind.

We have a policy that all of us in any digital role have to spend at least four hours a month watching people use our technology. I want to pick up where the issues are.

How will the 10 year health plan support the development of a digitally enabled workforce?

Having one of three priority areas in the 10 year plan dedicated to digital is brilliant – it’s getting the recognition it needs.

We spoke at length [in the People workstream] about the preparation that our staff need and the ongoing support to use digital technologies, but how diluted down it will get in the plan, I don’t know.

There are gaps [in education and support] even at post graduate. There’s a layer missing for those that maybe don’t want to go into a CNIO role but want to be agents of change.

There is a risk the plan will be quite non-directive and open to interpretation, which quite a lot of these things are

10 years is a long time to try and plan forward when things are moving at such a fast pace, especially with technology.

I think it needs to be ambitious; I don’t know if it will be.  I don’t know if there will be enough vision in there to really be brave.

There is the risk of it being quite non-directive and open to interpretation, which a lot of these things are.

How can digital leaders at trust level focus on transformation and avoid being overwhelmed by daily pressures and competing priorities?

It’s a constant balancing act.  They are tricky jobs – hugely satisfying but challenging.

The Digital Health Networks have been invaluable. We’ve all got WhatsApp groups and we’ll fire off things daily. We are each other’s support.

It is about learning lessons from people, so we are not reinventing the wheel and it’s about being embedded in the wider workforce.

I’m in all the nursing forums and have a close relationship with the chief nurse. [You really need] to get a handle on the what the priorities are for the trust at any one time.

Sometimes I really want to get this [technology] over the line, and I know how much work has gone into it, but it’s just not the right time, the staff are not going to be ready to take it on.

Can you give us a sense of what you will be talking about at Summer Schools?

Hopefully, we will have the 10 year plan by then, so I’ll reflect on what I was hoping was to be in it, what’s actually come out, and what we need to do.

Hayley Grafton will be speaking at Digital Health’s Summer Schools 2025, 17-18 July at the University of Warwick. The event is supported by Networks sponsors Alcidion, AWS, Altera, Bridgehead, CereCore, Dell Technologies + AMD, Imprivata, Intersystems, Microsoft and Salesforce.

 

This feature was originally published on Digital Health News.