The two first chief nursing information officers (CNIOs) in primary care, Cheryl O’Sullivan and Louse Bell in Dorset, explain how their role – and nursing – is crucial to the digital future of the sector.

The impact of the Covid-19 pandemic has brought new challenges to nursing – but in general practice, it has also opened a plethora of opportunity to explore and utilise the potential of digital technology and has been a key driver towards developing new models of care.

The community of CNIOs has been growing. The CNIO is now seen as an integral member of any hospital leadership team. But what about primary care? At the Digital Nursing Summit this year, Ruth May, NHS England chief nursing officer, pledged her support for a CNIO role in every healthcare organisation – giving the profession ‘the voice, coordination and network, to make a significant impact within the digital sphere,’ she said.

We are proud to be stepping into new territory to be just that: CNIOs supporting primary care within Dorset. It is an honour to be that strong nursing voice, bridging the gap between technology and clinical practice and helping empower nursing teams to enact change.

The NHS Long Term Plan, released in 2019, sets the direction towards widespread digitally enabled care – helping people to stay well, recognise important symptoms early and manage their own health, supported by digital tools. During the pandemic, nurses have embraced, changed and adapted, with a shift towards remote monitoring. Digital technology has become an integral and positive addition to providing quality, accessible healthcare.

We can now leverage this digitalisation to our advantage, developing a primary care network ‘digital first model’ driving the ‘empowered self-care’ agenda. Nurses in general practice have unique and trusted relationship with patients and their families. It is our responsibility to build confidence in digital healthcare, ensuring that new technologies improve patient outcomes, meeting the needs of both patients and healthcare teams.

Below, we talk through what the CNIO role involves and what digital technology can offer nurses in general practice.

Workforce readiness

Digital inclusion is paramount not only for our patients, but our staff. Each of our PCNs are unique and at different stages of digital maturity. A lack of confidence or time are barriers we have encountered amongst nurses. Increasing individual motivation to develop those capabilities through building relationships, ultimately can increase job satisfaction. New roles are also emerging, and our digital care coordinators, now based in the majority of our PCNs, act as an ambassador for digital with patients and colleagues in equal measures.

In addition to collaboration with our current nursing workforce, we are engaging with our trainee GPNs and their university providers. Many GPNs have joined us from other areas of nursing but a growing proportion have chosen practice nursing as a first career destination. Addressing the education competencies of the future nurses in primary care will equip them with the skills to embrace digital and become future change agents, developing our future digital nurse leaders.

Clinical engagement

We view ourselves as clinical champions, uniquely positioned in that we sit in both the IT and clinical world. Wearing both ‘hats’, we work in partnership with PCNs to support teams in using a population health approach to assess the health, risks and inequalities of their populations and target resources that help prevent ill health and promote wellbeing. This is through accelerated access to services at home, such as evidence-based remote pulmonary rehabilitation, structured diabetes education, blood pressure @home or supported self-management of long-term conditions. By looking beyond traditional pathways, we empower patients to take back control and work collaboratively to make decisions about their health while enabling flexibility and equity of service.

We inform, influence, and help embed approaches to these digital interventions to increase their uptake and adoption at scale. The role requires partnership working and collaboration. We frequently visit nursing teams to work alongside them to reduce the barriers they may be experiencing. Our digital health huddles support integration through facilitating a safe space to come and share experiences, gain support, learn together and gain ownership of digital transformation.

Measuring impact

The impact of digital healthcare is demonstrated through our patient stories: the patient who engaged with remote pulmonary rehabilitation, who now gets out to exercise regularly; the patient who now understands his blood pressure and has taken control of his own health while his hypertension is managed remotely without the need to make appointments.

The workforce has benefited in the upskilling of current staff and the development of new roles. This has led to an empowered workforce, which has ownership and job satisfaction, with the possibility of developing new career pathways and improving retention.

Looking towards the future

Our hope is that we can further close the digital divide by exploring how to address the inequalities caused by homelessness, poverty, or transient populations. We envisage a growing network of CNIOs working in primary care, working together to help drive the digital agenda forward.

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