ASSIST. Association for Informatics Professionals in Health and Social Care PRESS RELEASE

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1 ASSIST Association for Informatics Professionals in Health and Social Care PRESS RELEASE Health Informatics Professionals: an embattled group A survey of the NHS HI Workforce Introduction Health Informatics ICT, information management, clinical coding and health records is critical to modernising the NHS and improving patient care. An ASSIST survey of the NHS Health Informatics workforce paints a picture of an embattled group of staff with low morale. Summary Information provided by 111 NHS organisations across England, covering 6,000 Health Informatics (HI) staff, indicates: The HI workforce in England numbers about 25,000, about 2% of the total NHS workforce. ICT (37%) and medical records (26%) are the largest groups. Uncompetitive pay is making it especially difficult to recruit ICT and information management specialists. Vacancy rates range from 12% for information managers to 7% to senior HI managers. Future skills shortages are predicted in project management, information analysis and ICT training. Agenda for Change has produced inconsistent outcomes and raised questions about the job evaluation methodology for HI specialists. There is a case for national recruitment and retention premia. There is strong support for establishing a formal Health Informatics profession. A report on the survey is attached.

2 Key statements Andrew Haw, Chair of ASSIST, comments: Front-line services rely critically on information and information technology. These depend on a skilled, professional and motivated workforce. With tough competition for informatics specialists from all sectors of the economy, the ASSIST survey highlights the need for urgent action across the NHS on: Health Informatics workforce planning; recruitment and retention; and the establishment of Health Informatics as a formal profession. ASSIST are working closely with NHS Connecting for Health and the Information Centre for Health and Social Care, whose invaluable support made this survey possible. Conclusion / next steps ASSIST is following-up the survey in meetings with senior officials at NHS Connecting for Health, the Information Centre for Health and Social Care, and the Cabinet Office s e- Government Unit, and the UK Council for Health Informatics Professions (UKCHIP). ENDS Notes for Editors: 1. ASSIST is the Association for Informatics Professionals in Health and Social Care and is a member group of the British Computer Society. 2. The Health Informatics Workforce Survey, commissioned by ASSIST, was supported by NHS Connecting for Health and the Information Centre for Health and Social Care. The fieldwork and analysis was carried out by Tribal Consulting between March and July Responses were received from a 111 Trusts, PCTs and Heath Authorities covering almost 6,000 informatics staff, equivalent to a response rate of about 24%. 3. ASSIST aims are: Influence policy and provide advice to the NHS Set, raise and maintain professional standards Facilitate personal networking and the exchange of information Provide a forum for activities and events 4. The ASSIST National Council is made up of elected officers, chairs of sub-committees and representatives from ten local branches from around the UK. Further information on ASSIST is available from Further information on this ASSIST Press Release is available from Andrew Haw, Chair of ASSIST s National Council (telephone or andrew.haw@uhb.nhs.uk) or from Brian Derry, Vice-Chair of ASSIST s National Council (telephone or brian.derry@leedsth.nhs.uk).

3 Health Informatics Workforce Survey ASSIST (), the Association of Informatics Professionals in Health and Social Care, has commissioned a survey of the Information, Communications and Technology (ICT) and Information Management workforce in the English NHS. The survey was supported by NHS Connecting for Health and the Information Centre for Health and Social Care. The fieldwork and analysis was carried out by Tribal Consulting between March and July Responses were received from a 111 Trusts, PCTs and Heath Authorities covering almost 6,000 informatics staff, equivalent to a response rate of about 24%. The survey estimates that there are some 25,000 informatics staff in the NHS in England, comprising: Senior Managers 7% Health Records staff 26% Knowledge Management staff 9% ICT staff 37% Information Management staff - Clinical Coders 5% Information Management - others 13% Clinical Informatics staff 3% The other main findings are: Significant recruitment problems exist for ICT Services and Information Management staff, primarily due to uncompetitive rates of pay. Vacancy rates range from 12% for Information Managers to 4% for Senior Managers and Clinical Informatics staff. Staff retention is being affected by low morale; informatics staff feel embattled, overworked and under-valued. Agenda for Change (AfC) has been contentious in many areas. Significant numbers of appeals have been lodged, particularly in ICT Services, Health Records staff and Senior Managers. Future skills shortages are anticipated in Project/Programme Management; Information Analysis and ICT and System Trainers. There is strong support for establishing a formal informatics profession. On the basis of the survey findings, ASSIST is making recommendations in six main areas: 1. Make-up of the workforce Workforce planning measures are needed to ensure that: Informatics staff work to clear professional standards, both technically and ethically. Morale is supported. The status of the emerging Health Informatics profession is in accordance with its importance to the NHS.

4 Technical and professional standards are followed and regulated, both for in-house and out-sourced informatics services. Robust information on the informatics workforce is collected regularly, for planning and tracking progress. 2. Challenges to recruitment and retention Different aspects of the total employment package are important in the recruitment of different types of staff. Recruitment campaigns should be tailored accordingly. Uncompetitive pay is seen as the biggest barrier to recruitment of all types of NHS informatics staff. A strategy is needed to address this, possibly including national recruitment and retention premia under Agenda for Change. 3. Future skill shortages Action should be taken as part of a workforce planning strategy to address the predicted shortages. There is a pressing need for the systematic assessment of wider NHS policy implications for the capacity and skills of the informatics workforce. 4. Professionalism Most respondents want greater professionalisation of Health Informatics. This survey is in itself an excellent example of the sort of collaborative working between professional associations and Government agencies that will be required to establish the profession. The staff wanting a formal profession of Health Informatics must be actively involved in its development. They will need a clear understanding of the responsibilities and expectations of members of any formal and credible professional body, notably: an explicit registration process with transparent and objective membership criteria mandatory regulation of standards of behaviour and conduct to ensure that members remain fit to practice. Only a minority of survey respondents were in favour of mandatory registration and regulation. Those leading the establishment of the profession must thus develop a clear marketing strategy to indicate the benefits and the need for compulsory regulation 5. Impact of Agenda for Change Many respondents felt that local implementers of AfC did not understand the roles and skills of informatics staff, and that the AfC job evaluation methodology was biased against non-clinical technical specialists. Examples were cited of inconsistent outcomes, both between and within NHS organisations, for well-defined roles e.g. IT support staff, clinical coders and information analysts. This sits uneasily with the objectives of AfC. The adverse impact cannot be overcome at this stage; however, it could be alleviated now by a drive for greater consistency in the Job Evaluation process, by publicising the depth of feeling and by the ongoing review of the Knowledge and Skills Framework in support of AfC. The use of recruitment and retention premia would also alleviate the feeling of being under-valued a feeling that is clear in some of the comments received.

5 6. Morale The strong impression from the survey is of an embattled group of staff, with low morale, feeling under-valued and unable to control their own destiny in the face of the pace of policy and organisational change. Informatics staff have a wide range of job roles, responsibilities and skills. They vary considerably in their work experience, skills and qualifications. This heterogeneity is both a strength and a weakness: there is strength in the cross-fertilisation and sharing of experiences that takes place; there is a weakness in the tensions within such a diverse group. Three measures would go a considerable way towards improving morale: The establishment of a formal professional body for Health Informatics. This would immediately improve the perceived status and self-esteem. It would also accelerate the adoption of professional standards of conduct and the use of industry best practice standards, with the associated benefits to the NHS. The creation of a meaningful strategic workforce plan. This should help shape and develop this important staff group within the NHS. It would also provide concrete evidence that the NHS values this group of staff and is planning constructively for its future development. Review the basis of the implementation of AfC, including the National Occupational Standards and the Knowledge and Skills Framework, and ensure a better understanding of informatics roles amongst those charged with local implementation. Explore national recruitment and retention premia. ASSIST September 2006