The role of digital nurses in transforming healthcare

By Integrated Care Journal

Judy Sealey, Clinical Solutions Specialist at Altera Digital and former nurse, health discusses the evolving role of digital nurses in health and care and explores why their roles are so important.

Digital nurses are registered nurses who already have a wealth of clinical experience and have developed expertise in using digital technologies to improve patient care. They bridge the gap between traditional nursing practices and the modern digital healthcare landscape, ensuring technology is effectively integrated into clinical workflows to standardise and streamline processes to improve patient safety and enhance their healthcare journey.

How and why did you make the transition into digital nursing?

Judy Sealey: I have worked in the NHS for over 15 years mostly in emergency department (ED) and critical care (ICU) nursing, I have also dabbled a bit in specialist fields like infection control, tissue viability and cardiology as I searched for my true passion. At one time, nursing education was where I thought my passion lay, however, it was while I was a clinical educator in an ICU that was using an electronic patient record (EPR) that my passion for digital healthcare technology blossomed. I started off by making suggestions for optimisations, becoming more involved in refining some of the workflows and ensuring that staff were adequately trained and comfortable using the system. This led me to a variety of other opportunities and experiences.

For the last thirteen or so years I have taken on several roles within this space. My greatest passion and desire is continuous improvement to healthcare delivery and the huge role digital systems plays in this. I know firsthand the challenges of excessive repetitive documentation, time wasted searching for patient paper records, inefficient and clunky digital tools and workflows. I leverage my nursing expertise and wealth of digital skills to advocate for more user-friendly designs, less complex workflows that will enhance patient care and reduce clinicians’ burden and burnout.

How do digital nurses affect patient care and outcomes?

JS: Nurses are the largest workforce in health and care and are therefore the primary users of digital systems. Digital nurses bring a unique skill set to the table. They leverage their clinical knowledge and expertise to enhance digital tools like EPRs, mobile health apps and telehealth platforms. By doing so, they ensure the system is user-friendly, practical, efficient and safe. For example, at Bolton NHS Foundation Trust, collaboration between digital and clinical teams has significantly improved patient safety through better EPR configuration and optimisations.

It sounds like collaboration is key. Can you talk a bit more about what happens when there’s a disconnect between clinical and digital teams?

JS: Unfortunately, that disconnect can often be traced to a lack of clinical input in the design and development of digital tools. Without clinical input, digital solutions may lack the context needed to be truly effective, which can disrupt workflows and compromise patient safety. That’s why digital nurses are essential – their input at every stage of the project ensures collaboration and bridges this gap, ensuring the creation of a system that enhances patient care and patient safety while improving efficiency.

How can healthcare systems better support digital nurses and foster collaboration?

JS: To truly support digital transformation, we need to invest in the digital nursing profession to ensure nurses have the necessary training, skills and dedicated time to be successful in this very important role. Digital nurses should be involved in all patient-facing digital projects, from planning, testing, training to delivery and optimisation. Nurses, being on the frontline, are uniquely positioned to identify service gaps and act on opportunities to make impactful changes.

NHS England’s National Chief Nursing Information Officer (CNIO) advocates for CNIOs in every NHS organisation. What’s your take on this?

JS: That’s a fantastic initiative. CNIOs are essential for every hospital because they play a vital role in ensuring the nursing perspective is represented in all aspects of digital health and care transformation. It underscores the importance of nursing leadership in driving the digital agenda and aligns with the goal of embedding digital nurses in all areas of care delivery. Crucially, the CNIO bridges that gap between clinical and digital teams, translating nursing needs into technical requirements and ensuring technology truly meets the needs of supporting patient care.

Looking ahead, what role do you see digital nurses playing in the future of health and care?

JS: As health and care continues to evolve, digital nurses will play a central role in driving the change in successfully navigating the future of digital healthcare. They will become more involved in the entire process, from selecting the most suitable digital solutions, to designing, implementing, testing, training and, indeed, optimising them. From EPR rollouts to telehealth projects and beyond, they’ll be key in ensuring that digital transformation truly meets the needs of frontline staff and continuously improves patient outcomes. Their involvement will drive innovation, improve patient safety and create efficiencies across the board.

Do you have any final thoughts for organisations looking to embrace the digital nursing profession?

JS: Yes, invest in your nursing workforce and be sure nursing curriculums include some aspect of digital training. Involve digital nurses in all patient-facing projects and make collaboration between clinical and digital teams a priority.

Without this, organisations risk digital transformations that compromise patient safety, hinder rather than support care and increase nurses’ workloads, which can contribute to burnout. An approach that embraces the involvement of digital nurses will drive effective inter-organisational collaboration that will help unlock the full potential of digital transformation and ensure it delivers real value to patients and staff alike.

Judy Seeley, Clinical Solutions Specialist, Altera Digital Health

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Workforce planning programme underway at Countess of Chester Hospital NHS FT

By Integrated Care Journal

A major workforce optimisation programme has started at the Countess of Chester Hospital NHS Foundation Trust in partnership with workforce planning specialists, SARD.

A new workforce optimisation programme has commenced at the Countess of Chester Hospital NHS Foundation Trust. The programme will seek to engage with the Trust workforce to gain a greater understanding of clinical capacity and demand, and empower teams to make more informed decisions about workforce planning. This work will support optimised service delivery, safe and efficient patient care and adequate resourcing to promote staff wellbeing.

Discussing why the project was initiated and the progress so far, Dr Nigel Scawn, Medical Director at Countess of Chester Hospital NHS Foundation Trust, said: “Like many NHS hospitals, we are seeing a rise in demand for our services – coupled with an ageing population who have more complex health needs – so this project is a key part of our workforce strategy which will help to transform services to meet the future change in needs of local patients.

“We’ve completed the discovery and diagnostic phase, which included working with transformation leads, HR teams and our medical workforce to agree plans, review current policies, share SARD methodologies and understand their requirements.

“It’s been a complex, but critical, exercise because every specialty is unique and runs itself slightly differently. Information has been gathered from 303 job plans across the Trust’s 30 specialties and fed into a diagnostic report.”

Over the next twelve weeks, the Trust will focus on the core part of the programme by working closely with clinical consultants to make enhancements to job plans and processes that are aligned with capacity and demand. The process will also involve benchmarking job planning against other NHS Trusts in England.

Dr Scawn added: “At this stage, it’s about piecing all the information together to create a fuller picture of capacity and demand, which we can use to drive informed decisions and decide what resource we need and where. Ultimately, we’re looking to remove some of the peaks and troughs in our capacity and ensure we’re sufficiently resourced and distributed across our clinical areas. This balanced approach will help us make sure we’re using our resources effectively.”

Insights from the programme will support Countess of Chester Hospital NHS Foundation Trust to plan better for future demand. The proactive approach will enable the Trust to devise clear and strategic recruitment plans, especially in areas where demand is anticipated to increase in the short-to-medium term.

In addition, greater oversight and improved job planning capabilities will support the Trust to reach the advanced levels of attainment for medical job planning set by NHS England. The framework ranges from level 0 to level 4 and published data from NHS England indicates that the national average is currently at 0.6. The Countess of Chester Hospital NHS Foundation Trust is expected to be at level 3 on completion of the project.

The Trust also intends to share the outputs and learnings from the work with NHS England to help build a national picture and inform policy and planning.

Phil Bottle, Managing Director at SARD, said: “The Countess of Chester Hospital NHS Foundation Trust’s commitment to redefine its job planning and transform operations is abundantly clear. The Medical Director, Nigel Scawn, and his team are fully embracing new ways of working to resolve long-standing challenges with workforce planning that many NHS trusts are facing. They are demonstrating that best practice goes beyond just deploying job planning systems.

“During the discovery stage, the engagement from the medical workforce has been fantastic and there is a desire to create positive change across the Trust. SARD’s ethical approach to workforce planning is led by service, staff wellbeing and sustainability so we are perfectly aligned with Countess of Chester Hospital NHS Foundation Trust to deliver an effective long-term job planning solution that supports safe and effective patient care. We’re looking forward to helping the trust optimise its workforce planning in the same way we have supported other NHS Trusts including Oxleas NHS Foundation Trust and Cornwall Partnership NHS Foundation Trust.”

The workforce strategy at the Countess of Chester Hospital NHS Foundation Trust is part of an overall improvement programme across the Trust, focusing on improved care for patients and families and a greater emphasis on staff wellbeing. The Trust has three hospitals – The Countess of Chester Hospital, Ellesmere Port Hospital and Tarporley War Memorial Hospital – and provides services to 420,000 people across West Cheshire.

The project is set to be completed by April 2025.

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AXREM hosts event celebrating women in health and care

By Integrated Care Journal

AXREM, the trade association representing the suppliers of diagnostic medical imaging, radiotherapy, healthcare IT and care equipment in the UK held an event to mark International Women’s Day.

AXREM has championed women in health and care during International Women’s Day for several years, but this year elevated its celebration further by hosting an event at The Florence Nightingale Museum at St Thomas’ Hospital, London.

On the eve of International Women’s Day 2025, in an aptly chosen venue, AXREM hosted more than 60 key industry female opinion leaders and key stakeholders.

There was a full programme of speakers including an actor as Florence Nightingale talking about her work, a video address from Baroness Merron, Parliamentary Under-Secretary of State for Patient Safety, Women’s Health and Mental Health at the Department of Health & Social Care; Preeya Bailie Director of Central Commercial Function, Commercial Directorate at NHS England; Saduf Ali-Drakesmith, Head of Sales at Smart Reporting & Vice Convenor of the Imaging IT SFG; Yasmeen Mahmoud, Business Manager HPM UKI at Philips Healthcare; and Kath Halliday, President of the Royal College of Radiologists.

Florence Nightingale was an English social reformer, statistician and the founder of modern nursing. Nightingale came to prominence while serving as a manager and trainer of nurses during the Crimean War, in which she organised care for wounded soldiers at Constantinople. She significantly reduced death rates by improving hygiene and living standards. Nightingale gave nursing a favourable reputation and became an icon of Victorian culture, especially in the persona of “The Lady with the Lamp” making rounds of wounded soldiers at night.

Sally Edgington, AXREM Chief Executive Officer said in her speech: “we have gathered to celebrate the strength, resilience, and brilliance of women in our industry. I am a female leader and currently lead a fabulous all female team, I am biased… but they really are all inspirational, supportive and hard working women and I feel truly blessed to work alongside each of them.

International Women’s Day is not just a day to acknowledge the progress we’ve made, but a day to remind ourselves of the work that still lies ahead. It’s a day to honour the trailblazers, the changemakers, and the unsung heroes who have shaped history and continue to inspire us all today. There are many of these women within our sector and AXREM membership”.

Sally ended her speech by saying: “When women rise, society rises with them. We all benefit when women are empowered, when they are given the tools, the respect, and the opportunity to lead, create, and flourish.

So, to all the women here tonight, to those who inspire us from afar, and to the generations of women who will come after us:

Keep pushing boundaries.

Keep dreaming big.

Keep shining your light.

The world is better because of all of us”

Reflecting on the event, Sally Edgington said: “It was a fabulous evening where we were able to bring together some thought leaders from our industry, it was also an evening where we could announce an AXREM Women’s network, This will further build on the important work AXREM has done over the last few years to really champion women in our industry and female leaders, so I am excited to launch this initiative and see how we can work with our members and stakeholders to develop this.”

Huw Shurmer, AXREM Chair & Strategic and Government Relationship Manager at Fujifilm Healthcare UK, said: “I was honoured to attend this event represented by so many strong women working in our industry. The speakers provided thought provoking content which gave me a different perspective on how far we have come, and how far there is still to go. I am looking forward to seeing the development of an AXREM Women’s Network to provide an industry forum and platform.”

New data sheds light on NHS efficiencies challenge

By Integrated Care Journal

Survey of public sector workers in the UK suggests that 93 per cent of NHS organisations are hindered by substantial process inefficiencies, while most are confident that AI and automation will help to ease administrative burdens.

New research has shed light on the potential impact and scale of process inefficiencies across the NHS. The 2025 UK Public Sector Efficiency Survey, conducted by Appian, in partnership with Coforge, polled 1,000 UK public sector workers, including 242 NHS staff. Of those respondents, 95 per cent stated that they face process inefficiencies in delivering services, averaging out at five hours per week in extra work or delays.

Were this data representative of the NHS’s entire 1.5 million-strong workforce, this would equate to 7.5 million hours of extra work per week.

The top reported obstacles were:

Manual and repetitive tasks
Immediate challenges forcing reactive decision-making over proactive solutions
A need to access multiple legacy systems to review or enter the same information
A lack of training and support

NHS workers also reported process change as a common challenge, with 93 per cent stating that their organisation struggles to adapt its processes (specifically while maintaining productivity amid changing service demands and government policies).

These challenges are intensified by mounting pressure to improve productivity. The 2024 Darzi Report revealed that NHS productivity has declined by at least 11.4 per cent since 2019, and there is a significant gap between the NHS and other sectors in digital transformation progress.

Outdated systems obstruct NHS productivity

Legacy technology remains a significant obstacle to NHS efficiency. A 2025 report published by the Department for Science, Innovation and Technology (DSIT) revealed that NHS England experienced 123 critical service outages last year, due to archaic technology.

“With elective care waiting lists at an all-time high, productivity is an urgent priority,” Peter Corpe, Industry Leader, UK Public Sector at Appian. “The research shows that NHS workers are challenged with legacy technology. Asking them to act as the human glue that binds those systems and technologies together only hinders efficiency further.”

AI and automation: the keys to efficiency?

Despite process challenges, the findings suggest that NHS staff are optimistic about the opportunities process automation and AI technologies offer:

Confidence in AI: 64 per cent of NHS workers expressed some or high confidence in AI’s potential to improve organisational efficiency.
Confidence in automation: 69 per cent believe automating repetitive tasks would simplify their jobs and improve outcomes. Among those already using workflow or process automation tools, 95 per cent reported improvements, including enhanced productivity, improved communication, greater consistency and traceability.

The solution to smarter public services

In a recently released AI Opportunities Action Plan, the government committed to building cutting-edge, secure, and sustainable AI infrastructure to support all public sector organisations, including the NHS. “The government is clear on its mission to automate processes in the public sector,” said Corpe. “AI adoption is no longer a question of if but when.” And according to survey respondents, public sector workers are ready for change.

The solution to process inefficiency, Corpe says, is to make technology part of the process. “And no company is better equipped to deploy AI in enterprise processes than Appian. Appian is the leader in process orchestration, automation, and intelligence. By embedding AI in processes with unified, secure enterprise data, Appian is improving service delivery outcomes. And we’ve been at the forefront of better process outcomes in government for over 25 years.”

“Every NHS organisation is built on processes, and when those processes improve, so do the services delivered,” said Corpe. “With millions of hours a week at stake, resolving process inefficiencies and orchestrating pathways such as referrals or discharge management offers the NHS a chance to work more efficiently. This means more time for strategic and value-driven activities that directly improve patient outcomes.”

Coforge, an Appian partner for over 13 years with 350+ Appian practitioners on staff, has seen these outcomes first-hand. “Modern AI and automation technologies are transforming complex government processes into streamlined digital workflows,” said Coforge Chief Customer Success Officer, John Speight. “By partnering with Coforge, organisations are turning this potential into reality – reducing processing times from hours to minutes to achieve significant cost savings, and deliver smarter, faster, community-focused outcomes.”

Download the 2025 UK Public Sector Efficiency Survey for more findings from public servants.

Digital Implementation, News, Workforce February 18, 2025

AI, simulation and innovation: Navigating the future of healthcare education

By Integrated Care Journal

AI and digital simulation are reshaping healthcare education, offering new opportunities for efficiency, training, and patient care. At the Council of Deans of Health’s Digital Summit 2025, experts explored the promise and challenges of AI integration, from regulatory concerns to the ethical implications of its use in clinical decision-making.

On 28th January 2025, the Council of Deans of Health’s Digital Summit 2025 welcomed 130 attendees from across leadership and academic roles within the healthcare sector, to discuss and debate the current and future direction of digital health.

Following a virtual welcome from the Chair of the Science, Innovation and Technology Committee, Chi Onwurah MP, JISC Director of AI, Michael Webb, discussed the rapidly evolving state of AI adoption within education and healthcare, and the need for regulatory and legislative frameworks to keep pace. Webb argued that we are now into the ‘early reality’ stage of AI adoption, and despite numerous teething problems, AI tools are now so embedded within many digital services that people often do not realise they are using them.

A key aspect of the government’s focus on AI has been efficiency, with the Department for Education a major early investor. The Department is currently exploring the possibility of coding the entire national curriculum, estimating that this could increase the accuracy of automated marking from 30 per cent to 90 per cent, saving teachers a substantial amount of time that could be better used elsewhere.

However, as AI moves into mature operational use, and its input into human lives and decision-making processes increases, it will be increasingly critical to reach a consensus regarding its ethical and responsible use, as well as ensuring that those tasked to use it are able to do so safely and ethically. Webb called on leaders and regulators to set clear boundaries to enable safe exploration of AI, and to create cultures that value curiosity, critical thinking, and progressive human development.

Embedding digital transformation in the future health workforce

This panel examined the need to embed digital literacy into healthcare education to create a healthcare workforce equipped to use technology effectively and meet the future needs of the NHS. Professor Natasha Phillips, Founder of Future Nurse, argued that the pace of technological innovation has outstripped that of pedagogical practice, often placing digitally native students ahead of educators in terms of digital capability. Professor Phillips called for action from regulators to address this disparity, ensuring that the future workforce is prepared to deliver digitally led healthcare.

“We need to weave digital transformation into everything we do and pay attention to people and processes; technological transformation can’t happen without people.”

Professor Natasha Phillips, Founder, Future Nurse

Stating that we stand “on the cusp of the fourth industrial revolution”, Professor Sultan Mahmud, Director of Healthcare at BT Group, made the case for a cultural shift at leadership levels to truly embed digital tools and methods. He observed that a key driver of innovation with NHS trusts is often the personal attitude and culture of those in leadership positions, which can vary substantially from person to another, arguing that “board members not knowing anything about health technology can’t be acceptable”.

(L-R) Professor Natasha Phillips, Founder, Future Nurse; Professor Sultan Mahmud, Director of Healthcare, BT Group; Ed Hughes, Chief Executive, Council of Deans of Health

“The only way is ethics”

Much time was devoted to discussions concerning AI – including the ethical implications of using AI to facilitate and deliver healthcare, alongside its use as an educational tool. Sundeep Watkins, an Education Advisor to the Chartered Society of Physiotherapy, said that AI must be there to supplement and inform, not replace, humans’ clinical and critical judgement. With AI promising to play a critical role in diagnostics, treatment, communication and education, ethical considerations must be at the core of AI’s use and embedded in the way that technology users are taught to ensure that data biases or deficits do not translate to unequal or inequitable care delivery.

“In AI datasets, critical information is often missing – and if you don’t know what’s missing, you don’t know what’s missing.”

David Game, SVP Global Product for Medical Education, Elsevier

Regulatory organisations have started to consider how they might apply the right levels of oversight to this rapidly changing environment, confirmed Jamie Hunt, Head of Education at the Health and Care Professions Council. Paul Stern, a Senior Researcher and Policy Officer at the General Osteopathic Council, reiterated the importance of regulatory oversight of AI to ensure equitable access in education. He added that regulators are now working together with a view to developing a cross-sector regulatory framework for AI’s use in education to reduce regulatory overlap.

AI and associated technologies have the potential to be ubiquitous within simulated medical education and training within the next decade, underscoring the need for effective regulation to render their use safe, effective and equitable. Professor Paula Holt MBE, a Senior Adviser for Nursing at the Nursing and Midwifery Council, explained that for nurses-in-training, 600 of the 2,300 training hours required to register can be completed through simulated training, “allowing students to practice and reflect in a safe, and psychologically safe, environment.” Students like simulated training, added Professor Holt, as they feel it offers an equitable practice environment, and can help them learn to deal with difficult, real-world situations like receiving abuse or racism, or a medical emergency.

Panel covering *The pedagogy of AI: implications for healthcare education*

Professor Sharon Weldon, Professor of Healthcare Simulation and Workforce Development at the University of Greenwich, argued that simulation could be a key tool for attracting a newer generation of healthcare professionals, saying that “fewer and fewer, especially young people, want to go into healthcare. Simulation and AI are their worlds, and we have to embrace it to attract these people.”

“AI is now being incorporated into simulated practice learning – this will change quickly, but the driving fundamentals need to be embedded.”

Professor Sharon Weldon, Professor of Healthcare Simulation and Workforce Development, University of Greenwich

Professor Weldon confirmed that in the US, simulated training has reduced the length of training programmes for private nursing students by up to one-third on some cases – something that could be key for workforce pipeline acceleration globally. Simulated training is now being mandated across all nursing training in India, but Professor Weldon argued the need to work collaboratively with industry partners to ensure that these tools truly add value to a medical education.

The final session saw of the day saw NHS England’s National Chief Nursing Information Officer, Helen Balsdon, join National Chief AHP Information Officer, Prabha Vijayakumar, for an audience Q&A. While both were optimistic that innovation will lead to great strides in predictive analytics, prevention and reducing health inequalities, both cautioned that major progress remains difficult without the fundamental basics of data infrastructure and education in place.

“Good technology is one thing, but too much of implementation focuses on the technology and not on people, and then we wonder why implementation is so poor.”

Helen Balsdon, National Chief Nursing Information Officer, NHS England

“Nurses and midwives collect the most data,” said Balsdon, “but we don’t really harness it. We know we’ve got a shortage of nurses, and we need to work differently to address this – digital can help.”

Critical to this is bringing education and practice close together – in simple terms, to ensure that new entrants into the workforce are equipped with the confidence and minimum foundational understanding needed to use technology effectively.

The overriding note from the Digital Health Summit was optimism that AI and associated technologies offer an unprecedented opportunity to transform healthcare delivery and education for all. However, there was evident caution that the pace of technological change has outstripped the ethical, regulatory and legal frameworks that govern our use of them, and there is a clear need to address this lag. To truly harness the potential AI in healthcare, and digital transformation more broadly, collaboration between educators, regulators, and industry leaders must remain a priority—ensuring that technology enhances, rather than hinders, the delivery of safe, ethical, and equitable care.

The Council of Deans of Health have released a Performance Report following the conclusion of the 2025 Digital Summit, which can be viewed here.

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Nominations open for Our Health Heroes Awards 2025, delivered by Skills for Health

By Integrated Care Journal

Nominations are now open for the Our Health Heroes Awards 2025, celebrating the wider healthcare workforce – from porters and cleaners to receptionists, gardeners and security guards – that supports NHS doctors and nurses on the frontline.

Supported by NHS England, NHS Employers, NHS Shared Business Services, NHS Race & Health Observatory and Integrated Care Journal, Our Health Heroes celebrates the wider healthcare workforce that supports NHS doctors and nurses on the frontline.

From porters and cleaners to receptionists, gardeners and security guards, these often unsung heroes make up roughly 40 per cent of the NHS’s million strong workforce.

Our Health Heroes Awards is a national celebration of their achievements and an opportunity to give thanks for the important role that they play in keeping the health service functioning.

Our Health Heroes Awards 2025 categories:

Individual awards

Clinical Support Worker of the Year
Operational Support Worker of the Year
Outstanding Lifetime Contribution to Healthcare
Apprentice of the Year
Healthcare Volunteer of the Year

Team awards

Best Healthcare Workforce Collaboration
Dedication to a Lifelong Learning Culture
Equity, Diversity, and Inclusion Champion
Digital Innovation

Nominations close at midday on Tuesday 4 March. An expert panel of judges will then decide the finalists in each category.

John Rogers, Chief Executive of Skills for Health, comments: “Our Health Heroes is an opportunity to recognise and celebrate the remarkable dedication of the wider NHS workforce.

“The awards shine a much-deserved spotlight on the unsung heroes – cleaners, porters, security staff, receptionists, medical secretaries and many more – who don’t often get the recognition that they deserve.

“The commitment, compassion and hard work displayed day in day out by the wider healthcare workforce is a credit to, and the backbone of, our NHS.”

Erika Bannerman, Managing Director of NHS Shared Business Services, comments: “The Our Health Heroes Awards are an expression of appreciation for those who make such a significant impact on patient care and the wider community.

“It is vital to acknowledge the contributions of individuals and teams who go above and support the delivery of outstanding care, and we are proud to be able to support the awards again this year.”

The winners of the awards will be announced at a glittering ceremony held at the Queen Elizabeth II Centre in London on 22 May 2025.

To make a nomination visit: www.skillsforhealth.org.uk/awards

Scaling the workforce to meet MSK demand is unrealistic. We need new solutions

By Finn Stevenson

Digital pathways can transform access to care and ensure that those with the greatest need receive the care their conditions require, writes Finn Stevenson, Co-Founder and CEO of Flok Health.

According to recent projections, more than 7.2 million Brits will be living in chronic pain by 2040. With almost a million people already forced out of work due to musculoskeletal (MSK) issues, the welfare bill for back pain alone currently stands at £1.4 billion a year.

As our population ages and demand for treatment increases, one of the key challenges policymakers face is how to ensure patients can continue to access the care they need. With waiting lists for MSK treatment up 27 per cent from January 2023 to March 2024, we need to do more to deliver timely care to those who need it.

Hiring and training more physiotherapists can help make MSK treatment more accessible. It’s no secret that the workforce as it stands is chronically understaffed, and senior figures from the Chartered Society of Physiotherapy (CSP), along with politicians, have underlined the need to boost training and recruitment in the service. Since coming to power in July, Labour has already announced that it will be publishing a new Long Term Workforce Plan in 2025, with leaders signalling their ambition to go beyond the previous government’s commitments on NHS training and recruitment.

But it’s naive to think that simply hiring more people will be enough to service soaring MSK demand. As it stands, staff are so overstretched that the NHS would need to increase the number of physiotherapy positions in England by at least 7 per cent every year, just to keep up with current demand. Reaching this target seems unfeasible, especially considering the fact that physiotherapist numbers in the NHS increased by just 4 per cent from 2022 to 2023, and by only 0.7 per cent the year before. In fact, data collated by the CSP reveals that the annual rise in staffing levels has consistently fallen short of the required 7 per cent, with the largest increase in NHS physiotherapists across the last seven years standing at just 5.2 per cent, in 2019-2020.

With this in mind, it’s clear that any drive to hire and train more colleagues must come alongside a commitment to find new, innovative ways to improve patients’ access to MSK care.

Digital pathways can transform access to care

In September 2024, there were almost 350,000 people on MSK waiting lists in England, with some being forced to wait months to begin treatment. Not only is this frustrating for patients, it can also exacerbate their health problems. Studies show that longer wait times can lead to worsening pain, increased risk of disability, and a hugely detrimental effect on mental health and quality of life. By integrating novel digital pathways, we can deliver care to these patients as soon as they seek help, reducing the risk of deterioration, and accelerating recovery.

Effective digital pathways are already out there. At Flok Health, for example, we’ve developed the UK’s first AI physiotherapist, delivering at-home MSK appointments in a CQC-approved digital clinic on behalf of the NHS. Our system allows patients to be triaged, assessed and treated through a smartphone app, without ever having to wait for a traditional appointment.

Data from the work we’ve done so far shows that 94 per cent of patients describe their experience using Flok’s automated pathway as being “better” or “the same as” the care they would expect to receive from a human physio, with 88 per cent reporting that their symptoms had improved as a result of AI treatment. Crucially, all of these patients were able to access same-day care, with 24/7 appointment availability.

AI-operated digital pathways can also offer major benefits to clinicians. Managing high volume pathways (like back pain) in an AI clinic frees up capacity in the traditional services, allowing staff to focus on the cases where face-to-face appointments matter most. This alleviates pressure on the workforce and ensures those with the greatest need receive the dedicated time and resources that their conditions require.

Bringing care to the community

Another way to improve patient access to treatment is to extend MSK services out into new community settings. There are examples up and down the country where local Trusts have found innovative ways to meet their patients closer to home.

Sussex MSK Partnership introduced community appointment days (CADs) in non-clinical settings in a bid to deliver more scalable care and improve outcomes. These CADs act as a one-stop shop where patients can discuss their health issues with staff, before accessing a range of clinical solutions and other community services. The results of this programme were hugely encouraging, with 50 per cent of attendees discharged immediately and just one third requiring follow-up appointments. On top of this, waiting times for MSK treatment saw a 5-week cut, while staff morale was boosted as a result of seeing the immediate impact of their work.

Time to embrace change

In most NHS settings today, all patients with MSK conditions are funnelled down the same pathway for face-to-face appointments, leading to enormous backlogs, overburdened staff, and compromised care. Training and recruiting more MSK staff is of course important, but insufficient. Solving these issues will mean offering patients a choice of different care pathways. By running novel services like Flok’s AI clinic and Trust-run CADs alongside traditional pathways, we can transform patient access and outcomes while freeing up capacity in the existing services. These newer forms of care delivery are also significantly more scalable and resource-efficient than traditional models, which in today’s NHS is more important than ever.

Operational management: The invisible backbone of NHS success

By Phil Bottle

Phil Bottle, Managing Director of NHS workforce planning specialists, SARD, discusses the unsung importance of operational management to the NHS, including how effective management can be the remedy for a system straining under the weight of misaligned capacity and demand.

Penny Dash’s recent comments cut straight to the heart of a critical issue within the NHS: the absence of robust operational management. Her observation that adding staff has not translated into the anticipated impact is a stark reminder that people alone, without the right systems and processes, cannot untangle inefficiencies or improve outcomes.

But what exactly is operational management in the NHS context? At its core, it’s about ensuring that the vast resources—people, time, and technology—are strategically aligned to deliver the best care for patients. It’s the art of transforming effort into efficiency, of turning plans into practical, measurable outcomes. It’s also about creating a culture of accountability, where teams understand their roles, adapt to challenges, and continuously seek improvement.

The cost of missing discipline

Operational management is not a glamorous term. It doesn’t grab headlines like breakthroughs in medical research or new funding announcements. Yet its absence is felt every day:

Empty outpatient clinics sitting next to overcrowded ones
Elective surgery lists under-utilised due to inflexible staffing
Temporary fixes taking precedence over sustainable solutions

These aren’t isolated problems; they’re symptoms of a system straining under the weight of misaligned capacity and demand. And they highlight the critical need for something often overlooked in healthcare: discipline.

“Dr Dash’s call for more ‘ops managers’ is a recognition that leadership matters.”

Operational discipline doesn’t mean rigid adherence to plans. It’s about creating the flexibility to respond dynamically to real-world challenges. It’s about having clear, standardised processes that still leave room for human ingenuity. It ensures the right people, in the right roles, supported by the right tools, are empowered to adapt and improve.

It is something clearly missing and sorely needed. Yet as unglamorous as this work may seem, these are the hard yards that need to be made for meaningful progress.

Unlocking potential through workforce planning

Workforce planning is one of the linchpins of effective operational management. Done well, it provides the foundation for aligning capacity with demand. It highlights inefficiencies and opportunities, offering clarity on how resources can best support service delivery.

However, traditional approaches to workforce planning often fall short. Data may be fragmented or inconsistent, job plans may fail to reflect actual service needs, and staff often feel excluded from decision-making. The result? A process that stalls and fails to deliver the needed impact.

What’s needed is a shift in focus:

From fragmentation to integration
Workforce data should tell a cohesive story, not present conflicting narratives. This requires shared frameworks, clear language, and accessible tools that translate data into actionable insights.
From top-down to collaborative
Operational management isn’t a one-person job. It’s a team effort that thrives on engagement at every level—from senior leaders to frontline staff. Collaboration fosters ownership, ensuring that changes are not only implemented but embraced.
From short-term fixes to long-term sustainability
Quick fixes may alleviate immediate pressures, but sustainable operational management looks ahead, anticipating future challenges and building resilience into systems and processes.

Leadership and accountability

Dr Dash’s call for more ‘ops managers’ is a recognition that leadership matters. But perhaps even more critical is focusing on the processes those leaders oversee. Operational management isn’t just about systems; it’s about the people who run them. Effective leaders don’t simply keep the cogs turning—they identify inefficiencies, question the status quo, and work collaboratively to drive meaningful change.

This may mean rethinking whether current processes are fit for purpose or innovating entirely new ways of working. For example, underutilised elective services or ‘dark hours’ in clinical spaces could be addressed by flexing traditional staffing models or introducing creative solutions such as cross-team task-sharing.

Equally, accountability plays a pivotal role. As Paul Corrigan pointed out, the NHS must create environments where success and failure are acknowledged and acted upon. However, accountability should not equate to punitive measures like league tables. Instead, it should foster collaboration between trusts, encouraging the sharing of best practices and lessons learned. Data is crucial here—not as a blunt instrument, but as a tool to illuminate areas of strength and opportunities for growth.

A moment of opportunity

The challenges are clear, but so too are the opportunities. Meeting today’s demand is as critical as planning for the future. Predictive analytics can help model upcoming needs and support proactive decision-making, but current demand models are just as vital. These tools allow teams to allocate resources efficiently, manage capacity in real time, and ensure patients receive timely care. Balancing immediate pressures with future-proofing is the operational challenge of our time—and one that must be tackled head-on.

Operational management is more than a behind-the-scenes function. When strengthened, it unlocks efficiency, empowers teams, and transforms patient care. The time to focus on “ops, ops, ops” isn’t years away; it’s now.

Will NHS England’s medical consultant job planning improvement guide work?

By Phil Bottle

Phil Bottle, Managing Director of NHS workforce planning specialists, SARD, explains how a limited view of workforce data is preventing trusts from workforce planning effectively, and explores whether NHS England’s newly published job planning improvement guide will help solve the problem.

Let me start with a story. Back in 2010, when I was head of learning and development in the NHS, I’d watch our director of workforce in a blind panic every month as they pulled together a board report. The report was simple: who works for the trust, including substantive, part-time, honorary contracts, and temporary staffing costs. So why the panic? Because nobody knew the answers.

Month after month, they scrambled to piece it together. This wasn’t a capability issue — our director of workforce was an excellent leader, and adept in their role. The problem was systemic; nobody had the data, and more concerningly, nobody knew where to look.

This problem existed long before I joined the NHS, and unfortunately, it still exists today. So, when I saw NHS England’s new improvement plan, my initial reaction was, hopefully, a step forward. Workforce planning has been a constant struggle. But the real question is: does this improvement guide truly help solve the underlying issues?

The positives: A step in the right direction

I’ve been around the workforce planning block for almost two decades. I’ve seen countless attempts to kick-start meaningful change. The most notable difference with this guide? It ties job planning directly to patient value, something often overlooked. Too often, job planning has been about capacity without understanding how that capacity impacts patient outcomes. Finally, a patient-centric focus — this is progress.

The plan also discusses some important areas that need addressing; consistency, engagement, utilisation of data-driven insights, leadership focus, capability, process structure, and demand and performance metrics. These are key areas for improvement, and I support these measures.

The familiar oversight

However, here’s the big ‘but’ — this guide, like many before it, focuses too much on procedure, and not enough on resistance, lack of perceived value and inconsistent linkages to demand. These are the familiar hurdles that those doing the job know all too well lead to poor engagement, and the real root causes of 20+ years of subpar workforce planning.

“The data isn’t being utilised effectively, and everyones knows it.”

It’s like telling someone, “just try harder.” No amount of process improvements will solve the underlying barriers unless we address the core issues. As it stands, it feels more like a numbers game. Those who truly understand workforce planning and its relationship with patient safety outcomes and workforce wellbeing know it’s far more complex.

Workforce planning is not as straightforward as finding a round peg for a round hole. It’s more akin to a 1,000-piece puzzle — having the right people, with the right skills, in the right place, at the right time. Without this, a team’s, a department’s, or on a bigger scale, an organisation’s ability to deliver safe services and ensure staff wellbeing can resemble a shaky house of cards ready to tumble.

The root cause of poor job planning

A barrier to improving the consistency of job planning is cultural resistance. This is understandable to a certain degree, as job planning feels incredibly personal, even though it shouldn’t be. There’s a strong resistance to anything perceived as a threat to individual autonomy.

There is also an ambivalence towards the process due to the lack of perceived value. Why should anyone engage in this process if the data isn’t used for anything? The improvement guide talks about triangulating data with HR and Finance, but without demand modelling, it feels empty. The data isn’t being utilised effectively, and everyone knows it.

“Workforce planning… it’s failing because trusts don’t have the time and capacity to make it work.”

The inconsistent link to demand makes it feel like an afterthought. Demand should be at the core of job planning — ‘this is the demand on my service, and here’s the capacity to meet it’, not the other way around.

As a result, people don’t engage in job planning as it is seen as a process that doesn’t improve wellbeing, workloads, service objectives, or patient outcomes. The same applies to safe staffing, reducing backlogs, or achieving service goals.

The biggest issues: Time and capacity

Here’s the crux: workforce planning isn’t failing because of systems, leadership, or metrics. It’s failing because trusts don’t have the time and capacity to make it work. The process is complicated and labour-intensive, requiring significant hours from multiple people to be truly effective.

Until we address this fundamental issue — the lack of time and capacity — job planning, and therefore workforce planning, will continue to fall short.

Familiar solutions, same old problems

I’m not saying the challenges are easy to fix, but they are solvable. We need to think outside the box, beyond risk aversion, regulations, and procurement rules, and focus on what will add real, tangible value. Solutions that flatten the landscape by dealing with all the root problems holistically, rather than manage the hill. Solutions that tackle data analysis, engagement, expertise, tools, and training and provide tangible outcomes like better quality management information, not simply enabling more input methods.

This improvement guide offers procedural fixes, but it doesn’t tackle the deeper, systemic issues that have prevented job planning from being effective for so long. Real change will only happen when we address the root causes that are holding workforce planning back.

A People Powered NHS – A call to all health leaders

By Dr Allison Smith

Dr Allison E Smith, Director of Research & Insight at the Royal Voluntary Service discusses the key role that volunteers can play in delivering on core NHS goals.

The Prime Minister’s speech on 11th September 2024 pledged that this would be the ‘biggest reimagining of the NHS since its birth’. Hence, as we reflect on the plan for the future, we should challenge ourselves to think differently and work in ways which prioritise patient care and staff wellbeing. We should be bold and ambitious as the founders of NHS were in 1948.

In the original blueprint of the NHS, it was always intended to be a partnership between the state, the citizen and their communities. Public participation in the NHS e.g. via volunteering, informal carers and patient groups, has always played a vital role in the delivery of better health care. But in many ways, public involvement is a postcode lottery – a few areas do it really well, some do it (not well), and others have nothing. From the perspective of a volunteer-involving charity like Royal Voluntary Service – who have been supporting the NHS since before it was even founded – it is hard to get volunteering truly embedded in healthcare delivery. It still feels as if we are on the outside looking in or ‘pushing water uphill’. The purview of ‘integration’ appears largely limited to that of the NHS with social care.

With the public consultation on the 10-Year Health Plan, now is the time to rethink how the NHS – and wider healthcare system – works collaboratively with the public for the common good. System leaders need to stop putting up barriers to public participation and think ‘how can I build inclusive blended teams of staff and volunteers?’. Leaders should be embracing and nurturing the public interest and love for the NHS; 66 per cent of those signing up for the NHS and Care Volunteer Responders programme do so because they ‘want to support the NHS’.¹

The business case – in terms of the impact of volunteers on the NHS and wider healthcare system – we feel has been made.² The NHS and Care Volunteer Responders (NHSCVR) programme – first launched during the pandemic – has continuously proved its effectiveness, from driving system efficiencies to better patient care, workforce recruitment, and staff morale. For system leaders and frontline staff that embed NHSCVR within their local delivery there are big gains to be had.

For those unfamiliar with NHSCVR, this programme is a unique partnership between a charity (Royal Voluntary Service), a public service (NHSE) and a tech company (GoodSAM). It can match, via an App in real-time, requests for support from staff or patients with members of the public that can lend a hand. The programme is a key auxiliary service supporting the NHS and patients to expedite patient discharge, provide practical support to patients at home, deliver equipment for virtual wards, and provide support to ambulance crews waiting outside A&E. It is a free resource for local areas, is NHS approved, and can provide a critical safety net to mobilise volunteers at scale at times of high demand on the system.

In the past four years the programme has achieved significant scale; more than 2.6 million activities have been delivered in support of patients and the NHS, 221,000 individuals have been supported, and over 1 million members of the public responded. And while these numbers are indeed impressive, on the ground in local areas the programme delivers significant benefits for the system, staff, and patients – see table below.

The data also finds that those who volunteer report higher wellbeing. In a 2021 study by the London School of Economics, those that volunteered experienced statistically significant higher wellbeing compared to those who did not volunteer, and this wellbeing impact lasted for at least 3 months.⁶

This article is a call to all NHS system leaders; the breadth of impact – from this programme – plus others (see Helpforce) surely warrant the immediate integration of volunteers in NHS ‘BAU’, and centre stage in our reimagining of the NHS over the next 10 years.

Royal Voluntary Service will be attending the Integrated Care Delivery Forum in London on the 5th November.

For more information or to connect with a member of our team, please reach out to your Regional Relationship Manager. Contact details are available at nhscarevolunteerresponders.org.

References

¹ NHSCVR baseline survey, n=8481)

² See King’s Fund 2018 Views from the Frontline, Helpforce, 2020, Volunteer Innovators Programme

³ Programme data & Volunteer Annual Survey March, n=6302

⁴ Staff Annual Survey October 2024, n=345

⁵ Client/Patient Survey June/July 2024, n=687

⁶ https://blogs.lse.ac.uk/covid19/2021/06/02/happy-to-help-how-a-uk-micro-volunteering-programme-increased-peoples-wellbeing/