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Chris Dickson
April 11, 2019

Why the NHS struggles to recruit Health Informaticians?

This is the second blog post on NHS Health Informaticians, in the first post we looked at what makes a good Health Informatician which you can read here, in this post we are going to look at why we struggle to recruit and retain them in the NHS.


It may be a massive oversimplification but for me the main reason Health Informatics in the NHS is rarely seen as a career to aspire to comes down to two main things, lack of fair recompense and lack of opportunity. 



From the introduction of Agenda for Change (AfC) in the NHS to standardise pay across all Trusts based on on a fair system of qualifications, experience and expected level of responsibility it has not been possible to attract candidates of the highest calibre to work in the field. The issue being that the AfC was not designed with IT and informatics professionals in mind and would undervalue the roles put to them due to this lack of understanding.


I have come across some brilliant analysts in the NHS, however more often than not a couple of years later they show up on LinkedIn in a new role outside of the NHS or in quite a few cases working for consultancies that sell them back to the NHS at some multiple of their original cost to the system, and who could blame them, once you reach a certain point in the NHS pay scale the only way to move up is to move out.



It is very unusual for me to have the opportunity to work with a fully manned team able to keep on top of the demands on them from the business, more often you have overworked staff doing unpaid overtime just to keep up with reports that they run every week/month/quarter etc. a constantly growing list of 'adhoc' requests for information. What this means is that once you are given an area to cover you will almost certainly only ever get the opportunity to look at something different if you are covering for another member of your team but of course that has to be on top of your normal more than full time job. This environment does not lend itself to a number of important ways to keep staff motivated. Variety, challenge and skill development are all placed secondary to meeting business needs, in addition the manager is likely to be drawn into delivery of reports and therefore too busy to coach or mentor staff they are responsible for.


So what do we need to do?

Invest to save is an overused saying, but in the case of NHS informatics it is true. Investing time in understanding the team you have, their strengths and weaknesses, investing in those staff to make them feel appreciated and that there is a clear development pathway for them, investing in the right technologies to make their work easier.


On an individual level understanding the members in your team, holding regular 1-2-1 with them (not just the annual development reviews mandated) they will feel more appreciated and listened to, it is amazing the difference this can make to the attitude of an underperforming team member. I have always believed a team should be more than the sum of its parts and therefore pay close attention to the combinations of characters within a team, I have used tools such as Myers Briggs and Belbin to understand the characters available to me and especially when looking at filling vacancies within a team knowing the type of character I need to bring in to balance a team or the type of character in need to avoid, that would prove disasterous to the productivity of a team. Simply by making staff feel valued and giving them a strong team ethos, productivity will increase and retention of staff will improve.


Ensuring that the first budget to be cut isn't the training budget is essential, i'd prefer to have motivated, upskilled permanent members of staff than short term extra manpower to overcome problems, if you do have to bring in support try to make sure it isn't just an extra pair of hands without good justification - of course there are situations where you just need more staff but I would challenge that even in these situations those staff may have some knowledge they could pass on. Interim staff need to be filling a skill gap in the team and part of the performance review of that short term post has to be knowledge transfer, an interim that doesn't teach is a waste of money. Also any staff that go on a training course need as part of doing the course create a presentation to give back to the team about what they have learnt, unless they are the junior-most member of staff there will likely be at least one other team member who will also need to know some of what they have learnt, it also has two benefits for the presenter, it helps consolidate their learning to have to present it and presentation skills are a muscle that needs exercising regularly.


Having the right technologies in place can be the difference between a massively productive team and one roundly slated by their customers as incapable. The NHS has massive variability in terms of the investment in technology within its organisations, if you are unlucky enough to be in one of the lower quartile organisations the working life of an anlalyst can be a very painful and unfulfilling existence. Some foundation technologies that must be in place to allow efficient informatics teams are;

  • a responsive data warehouse with multiple feeds and an understood data model
  • a tool allowing the routine running of reports and extracts on an automated schedule
  • a tool allowing fast data exploration and adhoc report development

In the future you can add a statistics software for running advanced analytics including supervised and unsupervised machine learning algorithms.

Without these technologies in place query writing and iterating can take far longer than necessary, staff time can be completely absorbed running routine reports that should be automated and ad hoc report development is tortuous.

Just to be clear and for the avoidance of doubt Microsoft Excel is not suitable for any of the above uses.


So even though we can't do anything about the amount of money the NHS is willing to pay for analytical ability and experience we can make the environment people work in engaging and rewarding, we can give staff the chance to develop and enhance their skills. In short we focus on opportunity rather than recompense.


If your organisation is reviewing its data strategy or is looking to review the staff and structures you have in place and you would like help or just an experienced eye over your plans contact us to find out how we can help.

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Next week we will look at how Promatix are trying to help this cause. 

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