In conversation with… Dr Charlotte Roberts, Senior Programme Manager at KSS AHSN
In this interview we speak to Kent Surrey Sussex Academic Health Science Network (KSS AHSN) Senior Programme Manager, Dr Charlotte Roberts. We cover everything from Charlotte’s background as a clinician, to the role of AHSNs in tackling healthcare inequity and the importance of clinical leadership in deploying digital infrastructure.
Charlotte was interviewed in October 2021 - this piece was originally published as subscriber-exclusive content.
Tell us a bit about yourself and what your role entails
“I'm actually a clinician by background. I trained as a doctor, studying medicine alongside international health. I've always been really interested beyond health delivery, with contributors like social determinants of health, and how health is interlinked with migration and civil unrest for example.
"After I graduated from medical school and completed my foundation years (two years of clinical rotations), I wasn't sure what I wanted to do next and I didn’t know if I wanted to specialise straight away. I took a pause, and was lucky enough to have an opportunity to be seconded to Public Health England for a year Fellowship. There, I learned what it's like being a doctor who's also involved in management and leadership. It was in 2013-14, and there were lots of exciting and challenging public health things going on that year. From TB strategies, to disease outbreaks, to new shingles vaccines, and parliamentary questions around poliovirus. And then towards the end, we had the start of the Ebola pandemic. I was involved in COBR briefings and supporting the national incident control centre for the UK’s response.
“I've always been really interested beyond health delivery, with contributors like social determinants of health, and how health is interlinked with migration and civil unrest for example.”
"I loved that work so much that I wasn’t sure if I was ready to go back to being a clinician. After that, I joined a non-profit international organisation and was working around introducing measurement of patient-reported-outcomes. It was a great opportunity to really understand what is important to the patient and ensuring that we measure it correctly. And doing so in a way that we can compare and share learnings between countries. We're not always very good at actually measuring what’s most important to patients in many countries, and here we didn’t just want to look at an x-ray after a joint replacement and say “this looks good”. Instead we need to measure what the patient says matters to them and their experiences... can they walk? Can they work? Can they stand up easily and shower? Can they do what they want to do?
“We are focused on driving and supporting the adoption of well-evidenced-and-value-bringing innovations into the health and social care system.”
"And as a result of that work, I heard about AHSNs. KSS AHSN were actually involved in one of the projects and I thought that their work was really progressive and an organisation I wanted to work with them. I'm now a senior programme manager where I co-lead a brilliant team focusing on industry and technology navigation, as well as work amongst a small but inspirational wider KSS AHSN team. We are focused on driving and supporting the adoption of well-evidenced-and-value-bringing innovations into the health and social care system.”
What, as a former clinician, is the most important skill you’ve brought to KSS?
"I really value my clinical background and I think in every role that I've ever done, I always still want to feel like a doctor, even though that looks very different to what lots of “typical” doctors do.
"I really do use a lot of my medical training every day, not in the way of keeping up to date clinically, or knowing every new drug on the market, but through the ability to understand conditions, understand how our health and social care service is set up, and understand many of the challenges and complexities facing health and social care. I also recognise that our health and social care service doesn't always get it right, and that we must listen to patients all the time and that we’re here to learn from patients, not the other way around.
"I also think it helps me speak with other clinicians. I really find that it does break down barriers between two people. If I say I'm a clinician, there’s this kind of unspoken mutual understanding, even if I don't always understand all the intricacies!
"Finally, there’s a lot to be send for empathy. I stand in a unique position where I can understand where the system is coming from, and understand the challenges - particularly at the moment with a lot of negative narrative in the press. To be able to recognise the very real pressures the system is under is incredibly important. I can not only understand and apply where innovations can usefully help and not be a distractor, but my background also means that I am equipped to understand
the innovators.”
How does KSS work with the NHS, and what scope do you think there is for a future role?
“From my clinical experience I know how hard it can be to change existing cultures, practices and behaviours – even the teeniest changes and improvements can be difficult to embed – it is also hard as a busy clinician or manager to know what new tech is out there, find time and headspace for trying new things, write a business case to get funding for an innovation, tell which companies have got the best products, or make sure patient needs are at the centre of pathway change. We try and be an honest broker working and making connections between the NHS, the wider health social care system, academia, and industry. Our mission is to transform lives through innovation.
“We try and be an honest broker working and making connections between the NHS, the wider health social care system, academia, and industry.”
"I'd say most of our day-to-day interactions are with parts of the NHS and social care system. It can be working with care homes, to train staff around various different scoring mechanisms, early warning scoring, to help them raise concerns and escalate the health concerns of their residents. We also do a lot of work with individual clinical teams to understand their challenges and how innovations may be able to help address them.
"We support NHS England and Improvement programmes to drive innovations to be taken up. For example, innovations which have really good evidence of better outcomes for patients as well as return on investment over time. We help identify the barriers to why they've not been taken up to date, and try to break those down.
"I think we are really good convener of the system, serving our citizens as well as we can.”
What do you think is the biggest barrier to implementing new technologies in the NHS?
“If you'd asked me pre-pandemic, I’d probably have a slightly different list. I think there’s a lot of work already published (King’s Fund, Nuffield Health) on the narrative and the barriers to innovation in the NHS prior to the pandemic, but we've seen a lot of those barriers disappear with COVID-19. Particularly adopting things like digital technology at rapid pace.
"I think now it's a case of looking at the innovations that have been adopted, and actually working out what to keep, what to stop and move on from, or what to modify. I think a lot of things were taken on in the short term, but now we've got that headspace to think: what do we actually need? How do we use things that are going to help everyone?
"I think one of the biggest barriers is the headspace and the people. Technology is nothing if there's no one there to use it. You can have all the technology in the world but at the end of the day, we still need our health and social care workforce, in the most supported way, to be able to use all of this technology. So, providing the headspace, the training, the education, the practical support, the choice, and the ability to adapt all of those elements to support the workforce is the biggest barrier in my eyes.”
If the NHS could do one thing tomorrow to make digital a reality, what do you think it should be?
“There is a lot of funding coming through the system. We need to ensure we truly understand what our citizens want and what services actually need, and that we’re not worsening digital exclusion.
"We work with some brilliant innovators, but we really need to make sure that they are genuinely addressing the problem and we don't have a scenario where by doing something in one part of the system, you create pressures or unintended consequences elsewhere.
“Let’s ensure we give staff the time and resources to trial new things, to adopt, to use technologies and innovations in a way which suits their systems, and their patients.”
"I think we also need to be more time and resource into implementation. We put a lot of funding into research, but don't always then have the equivalent investment for the implementation of transformation and projects.
"We need to recognise the amount of clinical leadership and the implementation support needed for innovations to be successful. Let’s ensure we give staff the time and resources to trial new things, to adopt, to use technologies and innovations in a way which suits their systems, and their patients.
"You can find out more in KSS AHSN’s latest Innovate publication which is about digital inclusion and has the piece from Sussex ICS Digital Programme Director Mark Watson about the approach in Sussex.”
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