Digital nursing 3: nursing leadership in digital technology

The need for nursing leadership in digital is clear. A contributor to the RCN’s (2018) consultation on the digital future of nursing called for nurses to step up and take leadership of digital systems: “We need nurses to lead and make decisions… Too often it is realised after money has been spent that it’s been on the wrong things.” The RCN’s (2018) report showed that even well-established digital nursing posts were vulnerable to downgrading or axing, as one former nursing leader revealed: “I was the clinical lead for informatics at a senior-nurse level for two years. It would be wrong to assume that the progress achieved in response to the Covid-19 pandemic means senior nurse leaders in digital are now valued appropriately. To date, nurses with an interest in digital have found their way to leadership roles by various routes and with no requirement for an informatics qualification. NHS England’s (2022) guidance for nursing on the What Good Looks Like (WGLL) framework for digital transformation, aimed at board-level nurse leaders, details the essential ingredients for success in integrated care systems and organisations, including ensuring there is a digital nurse leader with accountability across the nursing workforce, who has the digital expertise and time to lead transformation.

Dr Phillips, in partnership with Health Education England (HEE), is undertaking a review of the skills and support nurses and midwives need to practise and lead a digitally enabled health and care system. The Phillips Ives Nursing and Midwifery Review, led by Dr Phillips and Dr Jeanette Ives Erickson, builds on HEE’s (2019) Topol Review of the impact of digital technologies on the future NHS workforce. Support and protection for nursing leadership in data, information, knowledge and technology is key to unlocking the benefits of digital in healthcare (RCN, 2018). The clinical lead at NHS Digital, who is also a nurse, spelled out why seniority matters: “Without digital leaders in senior positions, there is a danger that digital strategies won’t truly address the requirements of digital transformation – it is about so much more than the technology. Dr Phillips has spoken of the need to build clinical leadership “from top to bottom” and has said one of her key ambitions is to “create a community that can support each other” in digital nursing (Ford, 2020).

To develop many more digital leaders, the NHS Digital Academy is expanding its flagship Digital Health Leadership Programme (aimed at the most senior leaders such as CNIOs, chief information officers and CCIOs) and providing new support for aspiring leaders at a less-senior level (HEE, ndb). Much of the literature on nurse leaders in digital has emphasised the need for nurses to retain their professional identity and remain rooted in nursing priorities (RCN, 2018). The move to professionalise digital nursing, heralded by England’s chief national CNIO, means that leaders in the near future should have a firm grounding in specialist informatics and be valued for this expertise. Leading digital transformation is complex, so nurses should not be expected to take on these roles without specialist training and recognition. Nurses at all levels were essential to the digital progress achieved during the Covid-19 pandemic; they will need support to build on that progress, guard against the risks and unlock the benefits of the digital age.