Chris Tack and Melanie Martin talk about their work as two of the inaugural cohort of Topol digital fellows
The Topol review on digital healthcare in 2019 made recommendations to enable NHS staff to make the most of innovative technologies to improve services and called for them to develop their digital skills to support patients. This led to the Topol Programme for Digital Fellowships in Healthcare being created by Health Education England (HEE).
Physiotherapists Melanie Martin and Chris Tack were selected and tell Frontline about the outcome of their projects, which allowed them to combine their current roles with digital transformation work.
Tack’s project developed a digital competency framework for the 14 allied health professions. Tack, clinical specialist MSK physiotherapist at Guy’s & St Thomas’ NHS Trust (GSTT), says: ‘It was my contention that evaluation of the baseline levels of digital knowledge and skills were essential for individuals and organisations to perform a learning needs analysis to guide future education and development.
‘I aimed to develop a framework to delineate what the competency requirements for the understanding and use of digital technology were for the 14 AHP roles, and how they change between bands 3-9.
‘This would subsequently be built into the HEE self-evaluation platform for digital literacy, so that each registered AHP could log in, specify their profession and Agenda for Change band, and be evaluated according to the requirements identified in the framework.
‘This could then allow them to understand their digital competency needs, and be signposted to appropriate resources to develop their skills.’
His research suggested that most individuals will have a very superficial thumbnail view of digital knowledge and skills applicable to practice.
‘The landscape of what ‘digital’ means to individuals in physiotherapy is huge,’ he says, ‘which makes the challenge of understanding “digital” very daunting. We certainly can see that the requirement for digital knowledge and skills increases as you progress through the Agenda for Change bands, as we see for other key aspects of clinical practice.’
He says that all physiotherapy staff should be able to use digital technology to aid their non-clinical administration associated with continued professional development, whilst being confident enough to be an advocate for the evolution of digital technology in practice.
Developing digital leaders
The framework describes all 124 competencies across 10 domains of digital competency. It also includes links to the delineated framework specifically for physiotherapy.
Tack concludes: ‘The work undertaken as part of my fellowship gives all individuals and leadership the guidance as to how to evaluate the learning needs for themselves or their staff. This will prepare everyone to engage with technology both now and in the future.’
He believes that the fellowship is a programme focused on developing digital leaders to fill the gap between clinicians and the chief clinical information officer. It allows individuals to be surrounded by other digitally focused staff, who all have the same vision and motivation for change that is described in the Topol review.
‘The ethos of the review - developing people, building culture, being visionary - they are drivers of the fellowship. It gave me confidence that real transformation of healthcare is possible, and the skills to facilitate changes in practice.’
Remote monitoring service
Melanie Martin is now working as a senior delivery manager (innovation) at NHSX. The aim for her Topol fellowship was to build upon an earlier ‘proof of concept’ rheumatology remote monitoring service at GSTT. She wanted to expand the digital service to support rheumatoid arthritis patients to track disease progress between hospital visits, whilst alerting clinicians to any deterioration. The solution was to design, test and implement a two-way short-messaging service (SMS) remote monitoring service for patients, which captures a disease-specific patient-reported outcome measure every four weeks whilst allowing for other SMS contact from patients between clinic visits.
The service was designed for patients, with patients, to test an assumption that they would be willing to provide data on a regular basis, in exchange for a service which offers greater flexibility and would impact positively to support the right care, right time agenda.
‘As I began my Topol fellowship in September 2019, the reality for many rheumatology outpatient services was an outdated and unsustainable operating model,’ Martin says.
‘The problem I was addressing was how best to optimise follow-up appointments and whilst ensuring everyone felt looked after, whilst wasting no one’s time, especially not patients. Enter remote monitoring, the process of using technology to monitor patients outside of a traditional care setting, such as in their own home.’
She says that the key to unlocking a cross-boundary solution has been to come together across the South East London Integrated Care System and implement a unified remote monitoring pathway.
‘We now have over 250 patients actively engaged using the service from six hospital services across three NHS trusts. Patients describe a service they can trust to manage their data safely for the purpose of care and which provides care when they need it most.’
Reflecting on her fellowship, she adds: ‘I have learnt so much about myself, as a service designer and about the system.
You cannot deliver digital transformation alone.’
Martin urges other physios and AHPs to consider applying for the programme. ‘The value of the Topol fellowship is the gift of time to develop both your ideas and yourself as a future digital leader. You will be contributing to a growing community which needs to gain experience from what groups of AHPs can offer.
‘This can only be achieved through pollinating fellowships with an inclusive multi-professional workforce, which is representative, and who together can shape the digital landscape of the NHS to meet the needs of a digitally-enabled workforce better equipped to serve our patients.’
CSP professional adviser (digital and data) Euan McComiskie says:
The work done by Melanie Martin and Chris Tack has great importance for their own learning and practice and for other physios. ‘There is an ever increasing focus all things digital,’ he says.
‘Melanie has created a remote monitoring service for her rheumatology patient group and rolled it in to a sustainable service. She is ahead of her time considering the drive for the pandemic to push others into similar positions.
‘Her work is a great example of what can be done on a relatively tight budget to deliver efficient and safe remote support for a group of patients.’
McComiskie added that Tack’s work has the potential to be a huge tool for all areas of the physiotherapy profession – from undergraduates all the way up to digital physio experts.
‘Chris developed AHP digital competencies, which are being published by Health Education England and also being translated into something for other countries too.
‘It is genuinely a ground-breaking piece of work and of huge value not only in physiotherapy but across the AHPs and further afield.’
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