The three challenges facing the NHS
Ahead of her session at Digital Health Rewired in March 2023, Misbah Mahmood reveals how the role of the digital midwife is changing and the key part it plays in digital transformation for NHS trusts.
The role of a digital midwife has traditionally been under-recognised, but that is now thankfully changing.
In March 2021, the Royal College of Midwives launched a position statement calling for every trust in the country to recruit, or train, digital midwives. And, in the same month, NHSX launched a new national digital midwife role.
I was among the first generation of digital midwives and was recruited into my role five years ago, initially as a six-month secondment. Since then, I’ve joined a huge online community of digital midwives and today I’m part of a team of seven.
My role has substantially evolved over the years and I’m keen to highlight not only its unique importance, but also, how much it resembles the work of digital nurses and chief clinical information officers (CCIO).
Regardless of the roles we hold though, one thing is clear – we all need to work together to deliver digital transformation.
There are some differences between digital midwives and other specialities. As a digital midwife, we focus specifically on delivering digital maternity transformation. We are a subject matter expert and recognised digital leader.
As part of the Maternity Transformation Programme, digital midwives “use their clinical expertise to streamline [traditional midwifery] processes and provide digital solutions for safer, more personalised care.”
But we shouldn’t get bogged down with titles. Most of the work of digital midwives resembles the digital nurse and CCIO roles closely and is equally important. On a day-to-day basis, I spend my time on similar tasks, but in a maternity context.
For example, I engage with suppliers and stakeholders about the scope of digital transformation projects. We work towards national initiatives, update computer systems, elicit feedback from service users, and help teach and train clinicians.
Most of my skills are transferrable to other digital roles. For example, data analysis and considering how systems will affect service users and clinicians. I have project thinking and management skills and have carried out large-scale digital implementations.
I also try to understand how digital change can work in practice. For example, logging in and out of five different systems where half the data is missing is never going to be fit for purpose.
Many of the challenges I face are also common to digital roles in other parts of the hospital. Interoperability is something CCIOs, digital nurses and midwives all face in our job.
As such, it’s essential for digital midwives to avoid working in a silo. We need to work together with CCIOs and digital nurses to ensure seamless data sharing and delivery of digital care.
It’s important to realise that, when a woman or birthing parents’ data is managed through a Maternity Information System (MIS), this is only a single episode in that patient’s journey.
Once the patient (and baby) leaves the maternity services for postnatal care, they are no longer a maternity-specific patient. They move from the maternity ward, and their data also transfers to more general nursing and clinical information systems.
Working together has grown more important with the growth of the digital agenda in the last five years. Increasingly NHS trusts are dealing with the introduction of artificial intelligence, for example.
Patient expectations of managing their own health is also growing with the introduction of remote monitoring and virtual wards. Patients today can unlock their car with their mobile phone and even access their bank account, so why is it so difficult to access their notes online?
It’s much easier to transfer a woman or birthing parent to another trust if the clinical record is stored digitally, ensuring better and quicker care planning.
IT teams alone are often unable to keep up with demand. Midwives today, for example, are heavily dependent on laptops to do their job. Part of my team’s role is helping ensure midwives have the right hardware whenever they need it.
I’ve been incredibly lucky that my trust pioneered the digital midwife role at a time when it had less recognition. Today I’m one of two digital midwives at the trust, aided by two digital support midwives and three data quality support.
I was lucky to have the opportunity to complete a one-year Florence Nightingale Leadership Scholarship, which led me to be mentored by the deputy Chief Midwifery Officer. Today’s digital midwives have even more opportunities thanks to a PG Cert for Digital Maternity Leaders at Imperial College.
The course has two levels: a foundation and a PGCERT level. I’m honoured to be completing the first cohort of the PGCERT.
The work we’ve done over the last five years as digital midwives is already transforming patient care. For example, one of the projects I’m involved in is delivering self-referral to maternity services, with prioritisation through EPR.
Pregnancy outcomes improve the earlier a patient is seen, and through our self-referral system, patients who are of a later gestation can be prioritised sooner.
In the future, by collaborating to collect and use data, and expanding our digital role, we hope to further improve patient outcomes to deliver the best possible care.