Survey identifies embattled group

The Association of Informatics Professionals in Health and Social Care (ASSIST) commissioned a survey of the information, communications and technology (ICT) and information management workforce in the English NHS, and found a number of problem areas including uncompetitive pay and recruitment shortfalls. Furthermore it highlighted predicted shortages of skills in project management, information analysis and ICT training.

Health informatics (HI) – ICT, information management, clinical coding and health records – are critical to modernising the NHS and improving patient care.

Andrew Haw, chair of ASSIST, commented that front-line services relied critically on information technology which depended on a skilled, professional and motivated workforce.

He continued: “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 is working closely with NHS Connecting for Health and the Information Centre for Health and Social Care, whose invaluable support made this survey possible. “

ASSIST is following up the survey in meetings with senior officials at NHS Connecting for Health, the Information Centre for Health and Social Care, the Cabinet Office’s e-Government Unit, and the UK Council for Health Informatics Professions (UKCHIP).

The ASSIST survey fieldwork and analysis was carried out by Tribal Consulting between March and July 2006. Responses were received from 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%), and 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 undervalued.

Agenda for Change (AfC) has been contentious in many areas. Significant numbers of appeals have been lodged, particularly in ICT services, and among 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:

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.

Technical and professional standards are followed and regulated, both for in-house and outsourced informatics services.

Robust information on the informatics workforce is collected regularly, for planning and tracking progress.

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 premiums under Agenda for Change.

Future skill shortages