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How to hire a digital and transformation lead

20 January 2023

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Digital and transformation leads were added to the additional roles reimbursement scheme (ARRS) in September 2022 to optimise ‘new technology and other initiatives’ across PCNs. Clinical director and IT specialist Dr Neil Paul takes a look at this new role

It probably shouldn’t have come as a surprise when NHS England told us we could use additional roles money on a digital and transformation lead – one per PCN, with a maximum reimbursement at rate equivalent to Agenda for Change band 8a.

This seems a reasonable response to the complaint that we have struggled to get innovation up and running or implemented and this is a way of pushing the accelerate button.

NHS England has said these roles must use data to: improve patient access and staff experience; support population health management; understand the ‘type and intensity’ of training needed; facilitate clinically led innovation; make sure practices are using the latest technology to offer more telephone lines; monitor their call response times; and offer support with the NHS app which, since November, help patients review their test results.

Should you have a digital and transformation lead?

While it sounds attractive remember the ARRS pot’s original aim was to reduce the workload of the GP and perhaps its unstated aim was to get more patients seen. We were encouraged to adopt new clinical roles into primary care that some had been piloting but hadn’t taken off widely.

A good question for a PCN is ‘Are you going to get value from this digital and transformation lead over, say, an advanced clinical practitioner?’.  

To be worthwhile the role needs to deliver value to the practices and their patients and not end up either trying to promote top-down solutions that the PCN or practices don’t support, or filling in spreadsheets to ‘feed the beast’.

Consider splitting the role

The role is advertised as Digital and Transformation and while these are linked, they could be separate tasks that overlap.

The digital side of the role covers everything from data analysis to strategic planning. The transformation side covers building relationships with the wider system and facilitating working between practices. The job also entails being charged with reviewing a PCN’s digital maturity.

You don’t need to have one person that does it all – decide what is important and hire accordingly. My PCN is thinking of having two people each half time – one delivering the digital and the other transformation but with significant overlap.

Think about sharing with other PCNs. Many PCNs work closely with others perhaps in a federation – you could share a person or have more than one with different skills/competencies that do various things.

Who to hire

It is quite a high-level role but shouldn’t be someone who spends their life in meetings. Be clear that they are to help practices deliver their GMS/PCN work and look at what help your practice managers, PCN managers and partners may need. It is a lead role – the admin person who updates smart cards and changes printer cartridges isn’t who this is targeting –so don’t treat it as an easy way to save a salary.  Of course, you may have suitable internal candidates as primary care IT expertise and experience is key – something a lot of outside people may not have.

I would be wary of taking on ex-clinical commissioning group (CCG) staff who are displaced and looking for work. Some may be excellent and have the right skills, but many won’t really get the operational pressures of primary care and may struggle with knowing who they are serving or have the right IT background.

Some PCNs are wondering if they can all their existing PCN manager their transformation lead and fund them from this pot. I understand the idea behind this though I would be cautious. If you go down this route, are you going to get more work done? This role is about adding capacity.

On the other hand, adopting this approach might free up DES/leadership money to spend on something more flexible that doesn’t have to follow the ARRS rules, including more clinical director/GP time. I am well aware that some managers are attracted to this option as the future of ARRS funding may be guaranteed while money for leadership may not.

Using third party companies to bring in the right expertise may be an option. The roles were originally intended to be for employees but many PCNs have used external companies to fulfil other jobs. There are contractors with the right skills out there but do bear in mind there is a danger they may prefer to sit around the table in big meetings rather than focus on practice-level action to improve staff members’ working lives. Another concern is that some won’t understand primary care and they may not be affordable (some are used to more than band 8a-level wages. Still, many consultants/contractors are very bright people with interesting skills so it’s an option to consider.

What responsibilities might the role entail?

I’ve seen lots of negative comments on forums about this role and as I’ve stated the key is to make sure they add value to practices. At my PCN, I’m confident that we can develop a role within the set job description that will add value for the practices. As examples, some of the areas we  want the digital lead to manage and or deliver themselves include:

  • Getting the most from our chosen Business Intelligence tool. We have found that its invaluable for looking at access, capacity, and demand but it needs engagement and setting up.
  • Spreading the work done locally on templates, protocols and searches but also ensuring people are maximising the use of Ardens which has been bought locally
  • Review websites, social media and practice comms to check they meet the latest guidance and are delivering what practices and patients need.
  • Look at information processes e.g. phone answering/incoming letters/coding etc and help with delivering workflow optimisation as well as understand whether automation can help reduce workload and make the job more enjoyable.
  • Help us collect analyse and understand data from a variety of sources, ensuring that PCN wide initiatives such as Enhanced Access, service specifications, and the Investment and Impact Fund indicators are understood and delivered.
  • Work with the PCN education lead around gaps in IT knowledge skills and expertise.
  • Work with practices and practice managers to understand what solutions are out there that they may benefit from.
  • Attend relevant useful meetings on our behalf and feedback while avoiding becoming too focussed on meetings.

In summary, the digital and transformation lead can be a useful role to help your practices and clinicians. Think carefully whether you need one, what you want them to do, whether the role can be shared between PCNs, and make sure you spend time getting the right person.

Dr Neil Paul is a GP partner in Cheshire and Clinical Director of SMASH (Sandbach, Middlewich, Alsager, Scholar Green and Haslington) PCN