Don’t underestimate the power of ‘pen pushers’

Save time and money by upskilling your analytical workforce and making better decisions. An a new article in the HSJ from me and the brilliant Mark Foy

Non-clinical NHS work can get a bad rap from outside observers. Staff like analysts are often framed as back office-dwelling pen pushers, existing to restrict or impede important clinical work.

We’d argue the work of staff like analysts is actually crucial to a well-oiled organisation: easing the burden of administration on clinicians and helping to make sense – and use – of the mountains of patient data providers hold. The more providers invest in training their analytics teams, the better insights they can glean and the better decisions they can make.

But before we make this case, we want to thoroughly debunk the view that pen pushers slow down or hold back clinicians. This view, if our newspapers are anything to go by, is commonly held. Just last month, one national ran with the headline “NHS to slash bureaucracy by recruiting doctors and nurses over pen-pushers.”

Of course, this disdain for perceived “bureaucracy” extends far beyond the health service. Just look at Clint Eastwood as Dirty Harry in The Enforcer: a character who derides the “pen pushing son of a b*tch” who won’t give him access to police files without a written request.

We’re sure, however, that there’s a very complex record management system that pen pusher has to maintain. They don’t want to lose important crime records so naturally have devised a document logging and request system to obtain and track records that ultimately speeds up the time it takes police officers to obtain files. Poor old Eastwood might not realise it, but without this pen pusher, he’d be on his hands and knees for days trying to find what he’s after in a record room rather than on the street serving up justice.

The same applies to NHS pen pushers. They are there to assist and enable not hinder and restrict. Their absence would lead to absolute chaos. They can answer important questions for clinicians and other staff members in minutes, for example.

Imagine a consultant wants to find out: “How many patients did I see in the clinic last year and what was the DNA rate?” The alternative is the consultant manually looking through records (either paper or electronic), counting outcome forms for 12 months and making a note of the total number of patients and how many did not attend. This would be a solid few days’ work, during which that consultant has to halt all patient-related activity. Sure, time is wasted and patients are put at risk. But at least there are no pen pushers, eh!

An analyst could answer this question in less than 2 minutes. Give them a little longer and they could highlight any themes and trends from the attendances and DNAs. An issue could be detected and an improvement made to improve outcomes and experience for patients on the back of that analysis.

Not to mention, the analyst could complete this task for every consultant employed by the Trust simultaneously. Exactly how much time they save on just this one basic process quickly becomes an incomprehensible calculation.

Analysts, of course, can do so much more than track DNA rates. The insight and efficiencies that professional, well-trained and supported analysts can identify rewards above and beyond saving clinicians’ time.

Why should you upskill your analysts — and how can you do so?

To be clear, system leaders and decision-makers will be the ones to reap much of the rewards of upskilling your analysts. Skilled analysts will provide you with the best information and insight, further improving your decision quality. You don’t want to be making decisions for your organisation or population on “duff info” or spurious insight.

Skilled analysts can help with problem formulation, working directly with you and other decision-makers to better understand the root of a problem and focus analysis on the key “upriver” issues. They will help apply some “system 2” thinking to counter and refine heuristics: informing a solution that will invariably be able to be tracked and evaluated so you can see that it is working.

A skilled analyst can also help you “pull back the curtain” on artificial intelligence, machine learning, and analytical approaches.

You don’t need a degree, master’s, PhD and/or decades of analytical experience to help interpret results from external consultancies claiming to use these tools. How can you check if it’s smoke and mirrors? Is it useful? Is the type of analysis appropriate for the problem? Have they managed bias? What was the source of the data and the quality?

Let your analyst do the due diligence so you can be confident of the decisions that spring from these approaches.

Actually upskilling your analysts is easy, with numerous ready-built communities here to support them. AphA can help with signpost training, and the NHSR Community and PyCom support the use of amazing free-to-use analytics software “R” and “Python”. The Midlands Decision Support Network has been upskilling analysts for years (and not only in the Midlands), and you can get bespoke training from commissioning support units and internal consultancies like the Health Economics Unit.

All this can be built around the analytical competency framework to help support your analysts’ careers and professionalisation.

Much of the funding already exists for this upskilling as it’s built into trust and integrated care system’s training budgets. Nonetheless, AphA research found last year that most newer Band 5 analysts had not been given funding for continuing professional development.

As you can probably tell, we believe analysts enable others to do what they do best. Letting analysts do what they do best will enable others to do what they do best. It isn’t a competition, or a clinical versus non-clinical war in the NHS. Teams work together and support each other with their relevant skill sets. Not everyone in the NHS is responsible for direct patient care but everyone in the NHS is indirectly responsible for patient care.

We’re proud to be NHS pen pushers and believe we should let people do what they do best for the benefit of patients.

We’ll finish by going a step further and suggesting we need even more pen pushers — especially analysts.